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  • 101.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Polyzois, Ioannis
    Trinity College Dublin.
    Persson, G. Rutger
    University of Washington.
    Treatment modalities for peri-implant mucositis and peri-implantitis2013Inngår i: American Journal of Dentistry, ISSN 0894-8275, Vol. 26, nr 6, s. 313-318Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To review treatment modalities used for pen-implant mucositis and peri-implantitis. Methods: A literature search was performed in PubMed for articles published until May 2013 using peri-implantitis and pen-implant mucositis and different modalities of treatment as search terms. The search was limited to the English literature. Titles and abstracts were searched in order to find studies eligible for the review. Results: The present review reported that treatment of pen-implant mucositis lesions using mechanical therapy is possible. The additional use of professionally delivered antimicrobials has commonly failed to show additional benefits as compared to mechanical debridement alone. The scientific evidence on the efficacy of non-surgical and surgical therapies in the treatment of peri-implantitis is limited. Complete resolution of peri-implantitis using mechanical, laser, or photodynamic therapy does not seem to result in a predictable outcome. Following surgical interventions around implants diagnosed with peri-implantitis, clinical improvements as judged by reductions of probing depths and bleeding on probing have been reported. Bone or bone substitutes have been used in attempts to regenerate bone loss around implants. When regenerative modalities have been employed, radiographic evidence of defect fill has been reported. Few long term follow up studies on the treatment of peri-implantitis are available. Positive treatment results can be maintained over a period of 3-5 years. Regardless of the treatment performed, adequate plaque control by the patient is fundamental to treatment success. If the patient cannot obtain an adequate level of oral hygiene, the infection around the implants will reoccur.

  • 102.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och Folkhälsovetenskap.
    Quirynen, Marc
    Belgien.
    Risk indicators for peri-implantitis: a narrative review2015Inngår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, s. 15-44Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To examine the existing evidence in identifying risk indicators in the etiology of peri-implantitis. Material and methods: A literature search was performed in MEDLINE via PubMed database of the US National Library of Medicine, for articles published until October 2014 using Medical Subject Heading search terms + free text terms and in different combinations. Results: The microbiota associated with peri-implantitis is complex, demonstrating differences and similarities to the one seen at periodontitis sites. Plaque accumulation at dental implants triggers the inflammatory response leading to peri-implant mucositis/peri-implantitis. Individuals with a history of periodontal disease and smokers have an increased risk of developing peri-implantitis. There is some evidence to support the role of genetic polymorphism, diabetes, and excess cement as risk indicators for the development of peri-implantitis. There is also evidence to support that individuals on regular maintenance are less likely to develop peri-implantitis and that successful treatment of periodontitis prior to implant placement lowers the risk of peri-implantitis. Conclusions: Plaque accumulation at implants will result in the development of an inflammation at implants. A history of periodontal disease, smoking, excess cement, and lack of supportive therapy should be considered as risk indicators for the development of peri-implantitis.

  • 103.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Roos-Jansåker, Ann-Marie
    Behandlingar av infekterade implantat analyseras2009Inngår i: Tandläkartidningen, ISSN 0039-6982, Vol. 101, nr 7, s. 48-50Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [sv]

    Vid Högskolan i Kristianstad utvärderas olika behandlingsmodeller av peri-implantär mukosit och peri-implantit, inflammerad vävnad och benförlust kring implantat. En viktig del av behandlingen är att underlätta för patienten att rengöra runt implantaten.

  • 104.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Roos-Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Claffey, Noel
    School of Dental Science, Trinity College, Dublin.
    Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review2008Inngår i: Journal of Clinical Periodontology, vol. 35 (8 Suppl.), 2008, Vol. 35, nr 8 Suppl, s. 305-15Konferansepaper (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To review the literature on non-surgical treatment of peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS: A search of PubMed and The Cochrane Library of the Cochrane Collaboration (CENTRAL) as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: Out of 437 studies retrieved a total of 24 studies were selected for the review. Thus the available evidence for non-surgical treatment of peri-implant mucositis and peri-implantitis is scarce. CONCLUSIONS: It was observed that mechanical non-surgical therapy could be effective in the treatment of peri-implant mucositis lesions. Furthermore, the adjunctive use of antimicrobial mouth rinses enhanced the outcome of mechanical therapy of such mucositis lesions. In peri-implantitis lesions non-surgical therapy was not found to be effective. Adjunctive chlorhexidine application had only limited effects on clinical and microbiological parameters. However, adjunctive local or systemic antibiotics were shown to reduce bleeding on probing and probing depths. Minor beneficial effects of laser therapy on peri-implantitis have been shown; this approach needs to be further evaluated. There is a need for randomized-controlled studies evaluating treatment models of non-surgical therapy of peri-implant mucositis and peri-implantitis.

  • 105.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Roos-Jansåker, Ann-Marie
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics Division of Oral Microbiology, University of Berne.
    Infection at titanium implants with or without a clinical diagnosis of inflammation2007Inngår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 18, nr 4, s. 509-516Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To assess the microbiota at implants diagnosed with peri-implantitis, implant mucositis, or being clinically healthy. Material and methods: Clinical and microbiological data were collected from 213 subjects (mean age: 65.7 +/- 14) with 976 implants in function (mean: 10.8 years, SD +/- 1.5). Forty species were identified by the checkerboard DNA-DNA hybridization method. Results: Implant mean % plaque score was 41.8 +/- 32.4%. Periodontitis defined by bone loss was found in 44.9% of subjects. Implant mucositis was diagnosed in 59% and peri-implantitis in 14.9% of all cases. Neisseria mucosa, Fusobacterium nucleatum sp. nucleatum, F. nucleatum sp. polymorphum, and Capnocytophaga sputigena dominated the implant sub-mucosal microbiota and the sub-gingival microbiota at tooth sites. Implant probing pocket depth at the implant site with the deepest probing depth was correlated with levels of Eikenella corrodens (r=0.16, P < 0.05), the levels of F. nucleatum sp. vincentii (r=0.15, P < 0.05), Porphyromonas gingivalis (r=0.14, P < 0.05), and Micromonas micros (r=0.17, P=0.01). E. corrodens was found in higher levels at implants with mucositis compared with implant health (P < 0.05). Subjects who lost teeth due to periodontitis had higher yields of F. nucleatum sp. vincentii (P < 0.02) and N. mucosa (P < 0.05). Independent of implant status subjects with teeth had higher levels of P. gingivalis (P < 0.05), and Leptotrichia buccalis (P < 0.05). Conclusions: At implant sites studied, few bacteria differed by whether subjects were dentate or not or by implant status.

  • 106.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Roos-Jansåker, Ann-Marie
    Kristianstad Public Dental Services.
    Persson, Rutger G
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute: a randomized clinical trial2018Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051XArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To assess whether the treatment outcome differed between surgical debridement, with or without a bone substitute.

    MATERIALS AND METHODS: 41 adults with 3 or 4 wall peri-implant bone defects were enrolled in a 1-year RCT. Surgical debridement (control group), or in combination with a bone substitute (Endobon® ) (test group) was performed.

    RESULTS: Radiographic evidence of defect fill (primary outcome) was only significant in the test group (p = 0.004). At year 1, no bleeding on probing (BOP) in the control and test groups were 7/20 (35%) and 10/21 (47.6%), respectively (χ2=0.67, p=0.41). Plaque scores did not differ by study group at baseline (p=0.31), or at year 1 (p=0.08). Mid-buccal soft tissue recession changes did not differ by groups (p=0.76). Successful treatment outcome (defect fill ≥ 1.0 mm, PPD values at implant ≤5 mm, no BOP, and no suppuration was identified in 1/20 (5.0%) control, and 9/21 (42.9%) test individuals (F= 7,9, p <0.01). Number needed to treat analysis identified an absolute risk reduction of 32.8% in benefit of the test procedure. (F= 7,9, p <0.01).

    CONCLUSIONS: Successful treatment outcome using a bone substitute was more predictable when a composite therapeutic endpoint was considered. This article is protected by copyright. All rights reserved.

  • 107.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, E.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    University of Bern.
    Mechanical treatment of peri-implant mucositis: a double-blind randomized longitudinal clinical study2009Inngår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 24-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Infection and inflammation in tissues adjacent to dental implants are common. There are few controlled studies assessing interventions. We assessed if mechanical debridement with titanium curettes, is equally effective as an ultrasonic device in reducing clinical signs of inflammation and the total bacterial load. Materials and methods: Thrity two subjects (mean age 62.5 S.D ± 11.7) with one implant each demonstrating peri-implantitis were randomized in two intervention groups. Clinical and microbiological data were obtained before and during 6 months. Group one received debridement using titanium hand-instruments and group two received ultrasonic treatment using a coated working end. Results: At the different time-points, data analysis by independent t–test, or Mann–Whitney U tests failed to demonstrate group differences. Comparing baseline data with results at 6 months (merged groups) demonstrated that overall PI scores and at implants decreased (mean diff: 20.2%, S.E ± 6.3, 95%CI: 7.0 to 32.7, P < 0.002) and (mean diff: 27.2% S.E ± 7.9, 95%CI: 11.3 to 43.1, P < 0.001). Bleeding scores at implants improved (P < 0.01). PPD scores at implants did not improve (P = 0.30). Conclusions: No differences in treatment outcomes between the two treatment methods studied were found. While PI and BOP scores improved no effects in PPD were identified.

  • 108.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Department of Periodontology and Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I: clinical results2009Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr 7, s. 604-609Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Peri-implantitis is a frequent finding in patients with dental implants. The present study compared two non-surgical mechanical debridement methods of peri-implantitis. MATERIAL AND METHODS: Thirty-seven subjects (mean age 61.5; S.D+/-12.4), with one implant each, demonstrating peri-implantitis were randomized, and those treated either with titanium hand-instruments or with an ultrasonic device were enrolled. Data were obtained before treatment, and at 1, 3, and 6 months. Parametric and non-parametric statistics were used. RESULTS: Thirty-one subjects completed the study. The mean bone loss at implants in both groups was 1.5 mm (SD +/-1.2 mm). No group differences for plaque or gingival indices were found at any time point. Baseline and 6-month mean probing pocket depths (PPD) at implants were 5.1 and 4.9 mm (p=0.30) in both groups. Plaque scores at treated implants decreased from 73% to 53% (p<0.01). Bleeding scores also decreased (p<0.01), with no group differences. No differences in the total bacterial counts were found over time. Higher total bacterial counts were found immediately after treatment (p<0.01) and at 1 week for ultrasonic-treated implants (p<0.05). CONCLUSIONS: No group differences were found in the treatment outcomes. While plaque and bleeding scores improved, no effects on PPD were identified.

  • 109.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Gösta Rutger
    Department of Periodontology and Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Erratum. Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I2009Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr 12, s. 1076-1076Artikkel i tidsskrift (Annet vitenskapelig)
  • 110.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Tonetti, Maurizio
    Europerio 6: Stockholm, Sweden 4-6 20092009Konferanseproceedings (Annet vitenskapelig)
  • 111.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Wallin-Bengtsson, Viveca
    Public Dental Health Services, Kristianstad.
    Berglund, Johan
    Blekinge Institute of Technology.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Periodontitis in older Swedish individuals fails to predict mortality2015Inngår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, nr 2, s. 193-200Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This study aims to assess mortality risk and its association to health aspects in dentate individuals 60 years of age and older.

    MATERIALS AND METHODS: Medical and periodontal data from 870 dentate individuals (age range 60-96) participating in the Swedish National Study on Aging and Care in Blekinge (SNAC-Blekinge) with survival statistics over 6 years were studied.

    RESULTS: During 6 years of follow-up, 42/474 of the individuals (8.9 %), who at baseline were between age 60 and 75, and 134/396 individuals of the individuals (33.9 %), who at baseline were ≥75 years, died. Surviving dentate individuals had more teeth (mean 19.3, S.D. ± 7.9) than those who died (mean 15.9, S.D. ± 7.3; mean diff 3,3; S.E. mean diff 0.7; 95 % CI 2.0, 4.6; p = 0.001). A self-reported history of high blood pressure (F = 15.0, p < 0.001), heart failure (F = 24.5, p < 0.001, observed power = 0.99), older age (F = 34.7, p < 0.001), male gender (F = 6.3, p < 0.01), serum HbA1c with 6.5 % as cutoff level (F = 9.3, p = 0.002) were factors associated with mortality. A medical diagnosis of heart disease, diabetes, any form of cancer, or periodontitis failed to predict mortality.

    CONCLUSIONS: A self-reported history of angina pectoris, chronic heart failure, elevated serum HbA1c, and few remaining teeth were associated with mortality risk. A professional diagnosis of cardiovascular disease, diabetes, cancer, or periodontitis was not predictive of mortality.

    CLINICAL RELEVANCE: Self-health reports are important to observe in the assessment of disease and survival in older individual.

  • 112.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Blekinge Institute of Technology, Karlskrona.
    Widén, Cecilia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Department of Periodontics, University of Washington, Seattle.
    Cytokine expression in peri-implant crevicular fluid in relation to bacterial presence2015Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 7, s. 697-702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The aim was to assess clinical inflammatory parameters, cytokine levels, and bacterial counts in samples from implant crevicular fluid in cases with untreated peri-implantitis.

    MATERIAL AND METHODS: Several bacterial species known to up-regulate pro-inflammatory cytokines have been associated with peri-implantitis. The Luminex magnet bead technology was used to study cytokines in crevicular fluid. The checkerboard DNA-DNA hybridization method was used to study bacterial counts in samples from 41 implants (41 individuals).

    RESULTS: Profuse bleeding and suppuration was found in 25/41 (61.0%) and 17/41 (41.5%) of the implants. The reliability of duplicate cytokine processing was high. In the presence of profuse bleeding, higher pg/ml levels of IL-1β (p = 0.016), IL-8 (p = 0.003), TNF-α (p = 0.024), and VEGF (p = 0.004) were found. Higher concentrations of IL-1β were found in the presence of suppuration, and if Escherichia coli (p = 0.001) or Staphylococcus epidermidis (p = 0.05) could be detected.

    CONCLUSION: Profuse bleeding and/or suppuration in untreated peri-implantitis can be associated with higher concentrations of IL-1β, IL-8, TNF-α and VEGF in peri-implant crevicular fluid. A higher concentration of IL-1β in peri-implant crevicular fluid was found in samples that were positive for E. coli or S. epidermidis.

  • 113.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Blekinge Institute of Techology, Dublin Dental University Hospital, Dublin.
    Widén, Cecilia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, Rutger G.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Cytokine and microbial profiles in relation to the clinical outcome following treatment of peri-implantitis2017Inngår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, nr 9, s. 1127-1132Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To study whether cytokine levels and bacterial counts in p atients with peri-implantitis reflect clinical treatment outcome following non-surgical management.

    MATERIALS AND METHODS: Luminex magnet bead technology and checkerboard DNA-DNA hybridization were used to assess treatment outcome after treatment at the implant with the most severe peri-implantitis in 41 participants.

    RESULTS: Study group mean age was 40.3 years (SD ± 9.9). Stable treatment outcome after 6 months (no further bone loss, probing pocket depth decrease ≥0.5 mm, no bleeding/suppuration) was identified in 9 of 41 (22%) participants. Peri-implant crevicular fluid (PICF) levels were also lower for Il-1β (P < 0.01), and with trends of lower cytokine levels in PICF for TNF-α (P = 0.071), PDGFBB (P = 0.071), as well as for VEGF (vascular endothelial growth factor) (P = 0.071), and bacterial counts for Actinomyces israelii, Aggregatibacter actonomycetemcomitans (Y4), Campylobacter gracilis, Echerichia coli, Fusobacterium periodonticum, Leptotrichia buccalis, Parvimonas micra, Staphylococcus haemolyticus, Streptococcus anginosus, and Tannerella forsythia. Increasing levels of IL-1 β and S. aureus (r(2)  = 0.856) were found only at implants with non-stable outcome. A reduction of PICF levels for selected cytokines and bacteria studied had a sensitivity of 0.77, and a specificity of 0.80 against the clinical outcome as gold standard. Data analysis failed to differences in treatments (PerioFlow(®) versus YAG: ER laser) for changes in the expression of cytokines and bacteria studied.

    CONCLUSIONS: At 6 months, clinically stable treatment outcome of peri-implantitis is associated lower levels of putative pathogens total bacterial load with ≥30% reduction of IL1-β, L-6, and VEGF levels in PICF.

  • 114. Riben-Grundstrom, C
    et al.
    Norderyd, O
    André, U
    Renvert, Stefan
    Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Blekinge tekniska högskolan .
    Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial2015Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 5, s. 462-469Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To evaluate the clinical treatment effects of a glycine powder air-polishing or ultrasonic device on peri-implant mucositis.

    MATERIALS AND METHODS: Thirty-seven patients with one implant diagnosed with peri-implant mucositis (probing depth ≥4mm (0,2N) and bleeding on probing (BOP) (primary outcome)) were randomly assigned to treatment with either glycine powder air-polishing (GPAP) or ultrasonic (US) debridement. Treatment was performed at baseline and at 3 and 6 months. Professional supra gingival cleaning was performed at 9 and 12 months. Oral hygiene instructions were reinforced at each visit.

    RESULTS: At 12 months there was a statistically significant reduction in mean plaque score, bleeding on probing and number of periodontal pockets >4 mm within the treatment groups compared to baseline. The percentages of diseased sites were significantly reduced for both groups.

    CONCLUSIONS: Treatment with a glycine powder air-polishing or an ultrasonic device is effective in non-surgical treatment of peri-implant mucositis. This article is protected by copyright. All rights reserved.

  • 115.
    Roos-Jansåker, A.-M.
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Surgical treatment of peri-implantitis using a bonegraft substitute with or without a resorbable membrane: 3-year radiographic control2009Inngår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 24-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Infection and inflammation in tissues adjacent to dental implants are common. There are few controlled studies assessing interventions. We assessed if mechanical debridement with titanium curettes, is equally effective as an ultrasonic device in reducing clinical signs of inflammation and the total bacterial load. Materials and methods: Thrity two subjects (mean age 62.5 S.D ± 11.7) with one implant each demonstrating peri-implantitis were randomized in two intervention groups. Clinical and microbiological data were obtained before and during 6 months. Group one received debridement using titanium hand-instruments and group two received ultrasonic treatment using a coated working end. Results: At the different time-points, data analysis by independent t–test, or Mann–Whitney U tests failed to demonstrate group differences. Comparing baseline data with results at 6 months (merged groups) demonstrated that overall PI scores and at implants decreased (mean diff: 20.2%, S.E ± 6.3, 95%CI: 7.0 to 32.7, P < 0.002) and (mean diff: 27.2% S.E ± 7.9, 95%CI: 11.3 to 43.1, P < 0.001). Bleeding scores at implants improved (P < 0.01). PPD scores at implants did not improve (P = 0.30). Conclusions: No differences in treatment outcomes between the two treatment methods studied were found. While PI and BOP scores improved no effects in PPD were identified.

  • 116.
    Roos-Jansåker, Ann Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part I: implant loss and associations to various factors.2006Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 283-289Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of the present study was to evaluate the long-term result of implant therapy, using implant loss as outcome variable.

    MATERIAL AND METHOD: Two hundred and ninty-four patients had received implant therapy (Brånemark System) during the years of 1988-1992 in Kristianstad County, Sweden. The patients were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 9-14 years after implant placements, the patients were again called in for a complete clinical and radiographic examination.

    RESULTS: Two hundred and eighteen patients treated with 1057 implants were examined. Twenty-two patients had lost 46 implants and 12 implants were considered "sleeping implants". The overall survival rate was 95.7%. Implant loss appeared in a cluster in a few patients and early failures were most common. Eight patients lost more than one fixture. A significant relationship was observed between implant loss and periodontal bone loss of the remaining teeth at implant placement. Maxillary, as opposed to mandibulary implants, showed more implant loss if many implants were placed in the jaw. A significant relationship between smoking habits and implant loss was not found.

    CONCLUSION: A history of periodontitis seems to be related to implant loss.

  • 117.
    Roos-Jansåker, Ann-Marie
    et al.
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Long-term stability of surgical bone regenerative procedures of peri-implantitis lesions in a prospective case-control study over 3 years2011Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, nr 6, s. 590-597Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    P>Objectives To evaluate the extent of bone fill over 3 years following the surgical treatment of peri-implantitis with bone grafting with or without a membrane. Material and Methods In a non-submerged wound-healing mode, 15 subjects with 27 implants were treated with a bone substitute (Algipore (R)) alone and 17 subjects with 29 implants were treated with the bone substitute and a resorbable membrane (Osseoquest (R)). Implants with radiographic bone loss >= 1.8 mm following the first year in function and with bleeding and/or pus on probing were included. Following surgery, subjects were given systemic antibiotics (10 days) and rinsed with chlorhexidine. After initial healing, the subjects were enrolled in a strict maintenance programme. Results Statistical analysis failed to demonstrate changes in bone fill between 1 and 3 years both between and within procedure groups. The mean defect fill at 3 years was 1.3 +/- (SD) 1.3 mm if treated with the bone substitute alone and 1.6 +/- (SD) 1.2 mm if treated with an adjunct resorbable membrane, (p=0.40). The plaque index decreased from approximately 40-10%, remaining stable during the following 2 years. Conclusion Defect fill using a bone substitute with or without a membrane technique in the treatment of peri-implantitis can be maintained over 3 years.

  • 118.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions2006Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 290-295Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of this study was to analyse the proportions of peri-implant lesions at implants after 9-14 years of function.

    MATERIAL AND METHODS: Two hundred and ninety-four patients underwent implant therapy during the years 1988-1992 in Kristianstad County. These individuals were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 218 patients with 999 implants were examined clinically and radiographically.

    RESULTS: Forty-eight per cent of the implants had probing depth > or =4 mm and bleeding on probing (peri-implant mucositis). In 20.4% of the implants, the bone level was located 3.1 mm apical to the implant shoulder. Progressive bone loss (> or =1.8 mm) during the observation period was found in 7.7% of the implants. Peri-implantitis defined as bone loss > or =1.8 mm compared with 1-year data (the apical border of the bony defect located at or apical to the third thread, i.e. a minimum of 3.1 mm apical to the implant shoulder), combined with bleeding on probing and or pus, were diagnosed among 16% of the patients and 6.6% of the implants.

    CONCLUSION: After 10 years in use without systematic supportive treatment, peri-implant lesions is a common clinical entity adjacent to titanium implants.

  • 119.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a 5-year follow up2014Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, nr 11, s. 1108-1114Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To compare two regenerative surgical treatments for peri-implantitis over five years.

    MATERIAL & METHODS: Twenty-five individuals with peri-implantitis remained at study endpoint. They were treated with a bone substitute and a resorbable membrane (13 individuals with 23 implants) [Group 1], or with bone substitute alone (12 individuals with 22 implants)[Group 2]. All study individuals were kept on a strict maintenance program every third month.

    RESULTS: 5-year follow up demonstrated clinical and radiographic improvements in both groups. No implants were lost due to progression of peri-implantitis. Probing depths were reduced by 3.0 mm ± 2.4 mm in Group 1, and 3.3 mm ± 2.09 mm in Group 2 (NS). In both groups, radiographic evidence of bone gain was significant (p < 0.001). At year 5, the average defect fill was 1.3 mm (S.D. ± 1.4 mm) in Group 1 and 1.1 mm (S.D.± 1.2 mm) in Group 2 (mean diff; 0.4 95% CI -0.3,1,2, p=0.24). Bleeding on probing decreased in both groups. Baseline and year 5 plaque scores did not differ between groups and was reduced from 50% to 15%.

    CONCLUSION: Both procedures resulted in stable conditions. Additional use of a membrane does not improve the outcome. This article is protected by copyright. All rights reserved.

  • 120.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part III: factors associated with peri-implant lesions2006Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 296-301Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of the present paper was to analyse, on patient and implant basis, factors related to peri-implant lesions.

    MATERIAL AND METHODS: Two hundred and eighteen patients treated with titanium implants were examined for biological complications at existing implants 9-14 years after initial therapy. The effects of several potentially explanatory variables, both on patient and on implant levels, were analysed.

    RESULTS: On the implant level, the presence of keratinized mucosa (p = 0.02) and plaque (p = 0.005) was associated with mucositis (probing depth > or =4 mm + bleeding on probing). The bone level at implants was associated with the presence of keratinized mucosa (p = 0.03) and the presence of pus (p < 0.001). On the patient level, smoking was associated with mucositis, bone level and peri-implantitis (p = 0.02, <0.001 and 0.002, respectively). Peri-implantitis was related to a previous history of periodontitis (p = 0.05).

    CONCLUSIONS: Individuals with a history of periodontitis and individuals who smoke are more likely to develop peri-implant lesions.

  • 121.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Submerged healing following surgical treatment of peri-implantitis: a case series2007Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, nr 8, s. 723-727Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of >= 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore((R))), a resorbable membrane (Osseoquest((R))) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations.

  • 122.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort study2007Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, nr 7, s. 625-632Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim of this prospective cohort study was to compare two regenerative surgical treatment modalities for peri-implantitis. Material and Methods: Thirty-six patients having a minimum of one osseointegrated implant, with a progressive loss of bone amounting to >= 3 threads (1.8 mm) following the first year of healing, combined with bleeding and/or pus on probing, were involved in this study. The patients were assigned to two different treatment strategies. After surgical exposure of the defect, granulomatous tissue was removed and the infected implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore((R))). In 17 patients (Group 1), a resorbable membrane (Osseoquest((R))) was placed over the grafted defect before suturing. In 19 patients (Group 2), the graft was used alone. Results: One-year follow-up demonstrated clinical and radiographic improvements. Probing depths were reduced by 2.9 mm in Group 1 and by 3.4 mm in Group 2. Defect fill amounted to 1.5 and 1.4 mm, respectively. There was no significant difference between the groups. Conclusion: It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane.

  • 123.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Egelberg, J
    Treatment of peri-implant infections: a literature review2003Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 6, s. 467-485Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objectives: The purpose of the present paper is to review available information on the treatment of peri-implant mucositis and peri-implantitis.

    Materials and Methods: The results of animal research and human studies are presented. Proposed strategies for the treatment of peri-implantitis presented in the literature are also included.

    Results: Most of the information accessible at this time derives from case reports. The reports provide evidence that efforts to reduce the submucosal infection may result in short-term improvements of the peri-implant lesion. They also indicate that regenerative procedures in intrabony peri-implant defects can result in the formation of new bone.

    Conclusions: Several uncertainties remain regarding the treatment of peri-implantitis. Properly conducted long-term follow-ups of consecutively treated cases would seem to be a realistic avenue for accumulation of more information. This may assist in establishing the predictability, magnitude and stability of improvements that can be achieved.

  • 124. Sanz, Mariano
    et al.
    Chapple, Iain L
    Derks, Jan
    Figuero, E.
    Grazianni, Filippo
    Heitz-Mayfield, Lisa
    Herrera, David
    Jansåker, Ann-Marie
    Jepsen, Sören
    Klinge, Björn
    Loos, Bruno
    Mombelli, Andrea
    Papapanou, Panos
    Polyzois, Ioannis
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Salvi, Giovanni
    Kunz, Pascal
    Lundgren, Anna-Karin
    Willi, Rene
    Clinical research on peri-implant diseases: consensus report of Working Group 4.2012Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, nr Suppl 12, s. 202-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Two systematic reviews have evaluated the quality of research and reporting of observational studies investigating the prevalence of, the incidence of and the risk factors for peri-implant diseases and of experimental clinical studies evaluating the efficacy of preventive and therapeutic interventions.

    MATERIALS AND METHODS: For the improvement of the quality of reporting for both observational and experimental studies, the STROBE and the Modified CONSORT recommendations were encouraged.

    RESULTS: To improve the quality of research in peri-implant diseases, the following were recommended: the use of unequivocal case definitions; the expression of outcomes at the subject rather than the implant level; the implementation of study validation tools; the reporting of potential sources of bias; and the use of appropriate statistical methods.

    CONCLUSIONS: In observational studies, case definitions for peri-implantitis were agreed. For risk factor determination, the progressive use of cross-sectional and case-control studies (univariate analyses), to prospective cohorts (multilevel modelling for confounding), and ultimately to intervention studies were recommended. For preventive and interventional studies of peri-implant disease management, parallel arm RCTs of at least 6-months were encouraged. For studies of non-surgical and surgical management of peri-implantitis, the use of a composite therapeutic end point was advocated. The development of standard control therapies was deemed essential.

  • 125.
    Schwarz, Frank
    et al.
    Tyskland.
    Becker, Kathrin
    Tyskland.
    Bastendorf, Klaus-Dieter
    Cardaropoli, Daniele
    Italien.
    Chatfield, Christina
    Storbritannien.
    Dunn, Ian
    Storbritannien.
    Fletcher, Paul
    USA.
    Einwag, Johannes
    Tyskland.
    Louropoulou, Anna
    Nederländerna.
    Mombelli, Andrea
    Schweiz.
    Ower, Philip
    Schweiz.
    Pavlovic, Pedja
    Sahrmann, Philipp
    Salvi, Giovanni E.
    Schweiz.
    Schmage, Petra
    Tyskland.
    Takeuchi, Yasuko
    Van Der Weijden, Fridus
    Nederländerna.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis2016Inngår i: Quintessence International, ISSN 0033-6572, Vol. 47, nr 4, s. 293-296Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Air polishing was introduced as an alternative approach for the supra- and submucosal biofilm management at dental implants. An international expert meeting involving competent clinicians and researchers took place during the EUROPERIO 8 conference in London, UK, on 4 June 2015. Prior to this meeting a comprehensive systematic review dealing with the efficacy of air polishing in the treatment of peri-implant mucositis and peri-implantitis was prepared and served as a basis for the group discussions. This paper summarizes the consensus statements and practical recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis.

  • 126.
    Schwarz, Frank
    et al.
    Tyskland.
    Becker, Kathrin
    Tyskland.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och Folkhälsovetenskap.
    Efficacy of air polishing for the non-surgical treatment of peri-implant diseases: a systematic review2015Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 10, s. 951-959Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Focused Question: In patients suffering from peri-implant diseases, what is the efficacy of air polishing on changing signs of inflammation compared with control treatments (i.e. alternative measures for plaque removal with or without adjunctive antiseptic and/or antibiotic therapy)? Material & Methods: After electronic database and hand search, 10 full-text articles were independently screened by two reviewers. Finally, a total of five studies (six publications) fulfilled the inclusion criteria. The weighted mean difference (WMD) [p; 95% CI] in bleeding on probing-(BOP) (primary outcome) and probing pocket depth-(PD) reductions was estimated using a random effect model. Results: All studies reported on residual BOP scores after therapy. A narrative data synthesis did not reveal any major improvement of bleeding index/BOP or disease resolution following air polishing over mechanical debridement at mucositis sites. At peri-implantitis sites, WMD in BOP reduction between test and control (mechanical debridement with or without local antiseptic therapy, Er:YAG laser) groups was -23.83% [p = 0.048; 95% CI (-47.47, -0.20)] favouring air polishing over control measures. Conclusions: While glycine powder air polishing is as effective as the control treatments at mucositis sites, it may improve the efficacy of non-surgical treatment of peri-implantitis over the control measures investigated. A complete disease resolution was commonly not obtained.

  • 127. Stenport, Victoria Franke
    et al.
    Roos-Jansåker, Ann-Marie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Kuboki, Yoshinori
    Irwin, Chris
    Albrektsson, Tomas
    Claffey, Noel
    Failure to induce supracrestal bone growth between and around partially inserted titanium implants using bone morphogenetic protein (BMP): an experimental study in dogs2003Inngår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 14, nr 2, s. 219-225Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The effect of bone morphogenetic protein on supracrestal bone growth around partially inserted implants in a dog model is described. The lower premolar teeth (P1, P2, P3 and P4) were extracted on both sides of the mandible in six dogs. At a surgical exposure 12 weeks later, two 10-mm turned titanium implants were partially inserted, approximately 15 mm apart, in the areas of the P1 and P3 in each side of the mandible, allowing five threads to protrude from the bone crest. A titanium mesh was fastened to the coronal aspect of the two fixtures and the space beneath the mesh was filled with bone morphogenetic protein (S300 BMP) in combination with an insoluble bone matrix carrier, or with the carrier alone. The mesh was covered with an ePTFE membrane. Thus, a space for potential bone formation was created between the two implants. The surgical flaps were coronally positioned and secured with vertical mattress sutures. After 16 weeks of healing, biopsy specimens were retrieved and examined histologically. Bone was not formed around the protruding implants or in the created space between the implants in any case. The carrier was incompletely resorbed. We conclude that supracrestal bone growth beyond the crestal limit with or without BMP in such a large space as in this experimental design may not be possible.

  • 128.
    Tonetti, Maurizio S
    et al.
    Kina.
    Bottenberg, Peter
    Belgien.
    Conrads, Georg
    Tyskland.
    Eickholz, Peter
    Tyskland.
    Heasman, Peter
    Storbritannien.
    Huysmans, Marie-Charlotte
    Nederländerna.
    López, Rodrigo
    Danmark.
    Madianos, Phoebus
    Grekland.
    Müller, Frauke
    Schweiz.
    Needleman, Ian
    Storbritannien.
    Nyvad, Bente
    Danmark.
    Preshaw, Philip M.
    Storbritannien.
    Pretty, Iain
    Storbritannien.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Schwendicke, Falk
    Tyskland.
    Trombelli, Leonardo
    Italien.
    van der Putten, Gert-Jan
    Nederländerna.
    Vanobbergen, Jacques
    Belgien.
    West, Nicola
    Storbritannien.
    Young, Alix
    Norge.
    Paris, Sebastian
    Tyskland.
    Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.2017Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, nr Suppl. 18, s. S135-S144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems.

    AIMS: The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing.

    METHODS: Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion.

    RESULTS: Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders.

    CONCLUSIONS: Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.

  • 129. Tonetti, Maurizio S
    et al.
    Jepsen, Søren
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology2014Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41 Suppl 15, s. S36-43Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The scope of the discussions of this consensus report was to assess the strength of the scientific evidence and make clinical and research recommendations for surgical interventions to cover exposed root surfaces and enhance soft tissues at implants.

    METHODS: Discussions were informed by three systematic reviews covering single recessions, multiple recessions and soft-tissue deficiencies at implants. The strength of the evidence was assessed using a modification in GRADE. The group also emphasized the need to report the experience of the surgeon and the performance of the control intervention (CONSORT guidelines for non-pharmacological treatment).

    RESULTS: A moderate strength of evidence supported the following statements for single (moderately deep, mostly maxillary) recessions without inter-dental attachment loss: (i) The addition of a connective tissue graft (CTG) improved outcomes of coronally advanced flaps (CAF). (ii) The addition of enamel matrix derivative (EMD) improved the outcomes of CAF. For multiple recessions, preliminary data indicate that flaps specifically designed to treat this condition are worthy of additional attention. Emerging data indicate that it is possible to obtain complete root coverage at sites with some inter-dental attachment loss. With regards to soft-tissue deficiencies at implants, several procedures are available, but great heterogeneity among studies does not allow drawing conclusions at this time.

    CONCLUSIONS: The group highlighted that periodontal plastic procedures are complex, technique-sensitive interventions that require advanced skills and expertise. At single recessions, the addition of autologous CTG or EMD under CAF improves complete root coverage and may be considered the procedure of choice at maxillary anterior and premolar teeth. The adjunctive benefit needs to be put in the context of increased morbidity of the donor area or increased cost. Additional research is needed to: (i) assess the role of alternatives to autologous soft-tissue grafting in combination with CAF; (ii) identify the optimal surgical design and the need for additional soft-tissue grafting (or alternatives) at multiple recessions, recessions with inter-dental attachment loss and soft-tissue deficiencies at implants.

  • 130. Tonetti, Maurizio S
    et al.
    Van Dyke, Thomas E
    Beck, James
    Bouchard, Philippe
    Cutler, Chris
    D’Aiuto, Francesco
    Dietrich, Thomas
    Eke, Paul
    Graziani, Filippo
    Gunsolley, John
    Herrera, David
    Hart, Thomas
    Shearer, Barbara
    Jepsen, Søren
    Kantarci, Alpdogan
    Loos, Bruno G.
    Progulske-Fox, Ann
    Schenkein, Harvey
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Tonetti, Maurizio
    Van Dyke, Thomas
    Williams, Ray
    Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases2013Inngår i: Journal of periodontology, ISSN 1943-3670, Vol. 84, nr 4 Suppl, s. S24-S29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: This consensus report is concerned with the association between periodontitis and atherosclerotic cardiovascular disease (ACVD). Periodontitis is a chronic multifactorial inflammatory disease caused by microorganisms and characterized by progressive destruction of the tooth supporting apparatus leading to tooth loss; as such, it is a major public health issue.

    AIMS: This report examined biological plausibility, epidemiology and early results from intervention trials. PLAUSIBILITY: Periodontitis leads to entry of bacteria in the blood stream. The bacteria activate the host inflammatory response by multiple mechanisms. The host immune response favors atheroma formation, maturation and exacerbation. Epidemiology: In longitudinal studies assessing incident cardiovascular events, statistically significant excess risk for ACVD was reported in individuals with periodontitis. This was independent of established cardiovascular risk factors. The amount of the adjusted excess risk varies by type of cardiovascular outcome and across populations by age and gender. Given the high prevalence of periodontitis, even low to moderate excess risk is important from a public health perspective. Intervention: There is moderate evidence that periodontal treatment: (i) reduces systemic inflammation as evidenced by reduction in C-reactive protein (CRP) and improvement of both clinical and surrogate measures of endothelial function; but (ii) there is no effect on lipid profiles--supporting specificity. Limited evidence shows improvements in coagulation, biomarkers of endothelial cell activation, arterial blood pressure and subclinical atherosclerosis after periodontal therapy. The available evidence is consistent and speaks for a contributory role of periodontitis to ACVD. There are no periodontal intervention studies on primary ACVD prevention and there is only one feasibility study on secondary ACVD prevention.

    CONCLUSIONS: It was concluded that: (i) there is consistent and strong epidemiologic evidence that periodontitis imparts increased risk for future cardiovascular disease; and (ii) while in vitro, animal and clinical studies do support the interaction and biological mechanism, intervention trials to date are not adequate to draw further conclusions. Well-designed intervention trials on the impact of periodontal treatment on prevention of ACVD hard clinical outcomes are needed.

  • 131. Tonetti, Maurizio S
    et al.
    Van Dyke, Thomas E
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases.2013Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 40 Suppl 14, s. S24-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: This consensus report is concerned with the association between periodontitis and atherosclerotic cardiovascular disease (ACVD). Periodontitis is a chronic multifactorial inflammatory disease caused by microorganisms and characterized by progressive destruction of the tooth supporting apparatus leading to tooth loss; as such, it is a major public health issue.

    AIMS: This report examined biological plausibility, epidemiology and early results from intervention trials. PLAUSIBILITY: Periodontitis leads to entry of bacteria in the blood stream. The bacteria activate the host inflammatory response by multiple mechanisms. The host immune response favors atheroma formation, maturation and exacerbation.

    EPIDEMIOLOGY: In longitudinal studies assessing incident cardiovascular events, statistically significant excess risk for ACVD was reported in individuals with periodontitis. This was independent of established cardiovascular risk factors. The amount of the adjusted excess risk varies by type of cardiovascular outcome and across populations by age and gender. Given the high prevalence of periodontitis, even low to moderate excess risk is important from a public health perspective.

    INTERVENTION: There is moderate evidence that periodontal treatment: (i) reduces systemic inflammation as evidenced by reduction in C-reactive protein (CRP) and improvement of both clinical and surrogate measures of endothelial function; but (ii) there is no effect on lipid profiles - supporting specificity. Limited evidence shows improvements in coagulation, biomarkers of endothelial cell activation, arterial blood pressure and subclinical atherosclerosis after periodontal therapy. The available evidence is consistent and speaks for a contributory role of periodontitis to ACVD. There are no periodontal intervention studies on primary ACVD prevention and there is only one feasibility study on secondary ACVD prevention.

    CONCLUSIONS: It was concluded that: (i) there is consistent and strong epidemiologic evidence that periodontitis imparts increased risk for future cardiovascular disease; and (ii) while in vitro, animal and clinical studies do support the interaction and biological mechanism, intervention trials to date are not adequate to draw further conclusions. Well-designed intervention trials on the impact of periodontal treatment on prevention of ACVD hard clinical outcomes are needed.

  • 132. Van der Weijden, G A
    et al.
    van Bemmel, K M
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Implant therapy in partially edentulous, periodontally compromised patients: a review2005Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, nr 5, s. 506-511Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The purpose of the present study was to perform a review using a systematic approach to evaluate the long-term (>/=5 years) success of implants placed in partially edentulous patients with a history of periodontitis as evidenced by loss of supporting bone and implant loss.

    MATERIAL & METHODS: An electronic search of the National Library of Medicine, Washington DC (Medline-PubMed) was performed using specific search terms to identify studies assessing, in periodontitis patients, the success of implants with regard to bone level outcomes. Search was performed on abstracts registered up to October 2003.

    RESULTS: The searches identified 877 abstracts. Titles and abstracts were independently screened by two reviewers (G.A.W. & K.M.B.) to identify publications that met the inclusion criteria. Review of these abstracts resulted in 13 publications for detailed review. These papers were reviewed by the three authors. Finally four papers which met the criteria of eligibility were independently selected by the three reviewers.

    CONCLUSION: Based on the limited data, it seems justified to conclude that the outcome of implant therapy in periodontitis patients may be different compared to individuals without such a history as evidenced by loss of supporting bone and implant loss.

  • 133.
    Wallin Bengtsson, Viveca
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Berglund, Johan
    Institute of Technology, Karlskrona.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    A cross-sectional study of the associations between periodontitis and carotid arterial calcifications in an elderly population2015Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, nr 2, s. 115-120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate if the presence of periodontitis is associated with carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population.

    MATERIALS AND METHODS: Study individuals were randomly selected from the Swedish civil registration database representing the aging population (60-96 years) in Karlskrona, Sweden. Bleeding on probing (BOP) and the deepest probing measurement at each tooth were registered. The proportions of teeth with a probing depth ≥5 mm and the proportion of teeth with bleeding on probing were calculated. Analog panoramic radiographs were taken and the proportion of sites with a distance ≥5 mm between the alveolar bone level and the cement-enamel junction (CEJ) were assessed. A diagnosis of periodontitis was declared if a distance between the alveolar bone level and the CEJ ≥5 mm could be identified from the panoramic radiographs at >10% of sites, probing depth of ≥5 mm at one tooth or more and with BOP at >20% of teeth.

    RESULTS: Readable radiographs were obtained from 499 individuals. Carotid calcification was identified in 39.1%. Individuals were diagnosed with periodontitis in 18.4%. Data analysis demonstrated that individuals with periodontitis had a higher prevalence of carotid calcifications (Pearson χ (2) = 4.05 p < 0.05) and with a likelihood of 1.5 (95% CI = 1.0, 2.3, p < 0.05).

    CONCLUSIONS: Data analysis demonstrated a significant association between periodontitis and carotid calcification.

  • 134.
    Wallin Bengtsson, Viveca
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Assessment of carotid calcifications on panoramic radiographs in relation to other used methods and relationship to periodontitis and stroke: a literature review2014Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, nr 6, s. 401-412Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objectives. To assess the literature on carotid calcifications defined from panoramic radiographs (PMX) and concurrent diagnosis of stroke and periodontitis.

    Materials and methods. A literature search screening for publications using search terms such as PMX and carotid calcification, stroke and periodontitis was performed in November 2012.

    Results. A total of 189 articles were retrieved, among which 30 were included in the review. The sensitivity for PMX findings of carotid calcifications (CC) compared to a diagnosis by Doppler sonography varied between 31.1–100%. The specificity for PMX findings of carotid calcifications compared to a diagnosis by Doppler sonography varied between 21.4–87.5%. Individuals with CC findings from PMX have more periodontitis and risk for stroke.

    Conclusions. There is a shortage of well-designed studies in older dentate individuals assessing the associations between periodontitis and radiographic evidence of CC and in relation to stroke or other cardiovascular diseases.

    Statement of Clinical Relevance. Carotid calcifications are prevalent in patients with periodontitis and such individuals may have an increased risk for stroke. The absence of signs of carotid calcification on panoramic radiographs is indicative of no calcification of carotid arteries.

  • 135. Widenheim, Jan
    et al.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Birkhed, Dowen
    Förebyggande tandvård1997 (oppl. 1)Bok (Annet vitenskapelig)
  • 136. Widenheim, Jan
    et al.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Birkhed, Dowen
    Förebyggande tandvård2003 (oppl. 2)Bok (Annet vitenskapelig)
  • 137.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Coleman, M.D.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Rumpunen, K.
    Protection of human erythrocytes against oxidative stress by berries2012Inngår i: Journal of Berry Research, ISSN 1878-5093, E-ISSN 1878-5123, Vol. 2, nr 3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Berries contain several bioactive compounds that can protect against oxidative stress. In this study we evaluated the protective effect of different sequential extracts (ethyl acetate, ethanol and water) of seven berry species: bilberry (Vaccinium myrtillus), blackcurrant (Ribes nigrum), elderberry (Sambucus nigra), lingonberry (Vaccinium vitis-idaea), rose hips (Rosa sp.), sea buckthorn (Hippohae rhamnoides) and strawberry (Fragaria × ananassa). The protective effect was tested on human erythrocytes and the antioxidant capacity was also evaluated in vitro by the FRAP assay. In the erythrocyte assay all sea buckthorn extracts were superior in antioxidant effect to other berry extracts. The ethyl acetate extract of bilberries, and the ethanol and water extracts of blackcurrants, also protected the erythrocytes from oxidation. In contrast, water extracts of rose hips, bilberries and strawberries had a pro-oxidant effect on erythrocytes. The water extract of rose hips was superior to the other berry extracts in the FRAP assay. Thus, the results of the erythrocyte assay did not correlate with the results of the FRAP assay, but provided additional insights into the potential protective effects of berry extracts against oxidative stress.

  • 138.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Coleman, Michael
    Storbritannien.
    Critén, Sladjana
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Karlgren-Andersson, Pernilla
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Blekinge Institute of Technology & Trinity College, Dublin .
    Persson, G Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. USA.
    Consumption of bilberries controls gingival inflammation2015Inngår i: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 16, nr 5, s. 10665-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Bioactive molecules in berries may be helpful in reducing the risk of oral diseases. The aim of this study was to determine the effect of bilberry consumption on the outcome of a routine dental clinical parameter of inflammation, bleeding on probing (BOP), as well as the impact on selected biomarkers of inflammation, such as cytokines, in gingival crevicular fluid (GCF) in individuals with gingivitis. Study individuals who did not receive standard of care treatment were allocated to either a placebo group or to groups that consumed either 250 or 500 g bilberries daily over seven days. The placebo group consumed an inactive product (starch). A study group, receiving standard of care (debridement only) was also included to provide a reference to standard of care treatment outcome. Cytokine levels were assayed using the Luminex MagPix system. The mean reduction in BOP before and after consumption of test product over 1 week was 41% and 59% in the groups that consumed either 250 or 500 g of bilberries/day respectively, and was 31% in the placebo group, and 58% in the standard of care reference group. The analysis only showed a significant reduction in cytokine levels in the group that consumed 500 g of bilberries/day. A statistically significant reduction was observed for IL-1b (p = 0.025), IL-6 (p = 0.012) and VEGF (p = 0.017) in GCF samples in the group that consumed 500 g of bilberries daily. It appears that berry intake has an ameliorating effect on some markers of gingival inflammation reducing gingivitis to a similar extent compared to standard of care.

  • 139.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Critén, Sladjana
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, Rutger G
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Measuring inflammatory markers in saliva in polyphenols research2016Inngår i: 29th International Horticultural Congress on Horticulture: Sustaining Lives, Livelihoods and Landscapes (IHC) / [ed] Finn, CE & Mezzetti, B, 2016, s. 201-206Konferansepaper (Fagfellevurdert)
    Abstract [en]

    There is currently an interest in the possible anti-inflammatory effects of intake of fruits and berries. The aim of this study was to determine whether the twice daily administration of a berry beverage rich in polyphenols had effects on salivary levels of a selected group of pro-inflammatory cytokines for one week in a pre-and post-study design. Levels of selected cytokines were compared in whole saliva and saliva obtained using commercially available collection devices (Salivette (R) Cotton and Salivette (R) Synthetic rolls). Twenty healthy subjects drank 200 mL of a berry beverage consisting of equal parts of bilberries (Vaccinium myrtillus), black currant (Ribes nigrum), lingonberries (Vaccinium vitis-idaea), sea buckthorn (Hippophae rhamnoides) diluted with 50% water. Levels of cytokines, IL-1 beta, IL-8, IL-12 and TNF-alpha were assessed. Levels of cytokines differed between sources of collection but were highest in whole saliva. The use of cotton or synthetic rolls does not seem to be useful as a method for saliva collection and cytokine analysis. There was no significant change in the levels of selected cytokines at baseline and after intake of the berry beverage in whole stimulated saliva. There was a large inter-individual variation in cytokine levels.

  • 140.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Critén, Sladjana
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, Rutger G
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Measuring inflammatory markers in saliva inpolyphenols research2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    There is currently an interest in the possible anti-inflammatory effects of intake of fruits and berries. The aim of this study was to determine whether the twice daily administration of a berry beverage rich in polyphenols had effects on salivary levels of a selected group of pro-inflammatory cytokines for one week in a pre- and post-study design. Levels of selected cytokines were compared in whole saliva and saliva obtained using commercially available collection devices (Salivette® Cotton and Salivette® Synthetic rolls). Twenty healthy subjects drank 200 mL of a berry beverage consisting of equal parts of bilberries (Vaccinium myrtillus), black currant (Ribes nigrum), lingonberries (Vaccinium vitis-idaea), sea buckthorn (Hippophae rhamnoides) diluted with 50% water. Levels of cytokines, IL-1β, IL-8, IL-12 and TNF-α were assessed. Levels of cytokines differed between sources of collection but were highest in whole saliva. The use of cotton or synthetic rolls does not seem to be useful as a method for saliva collection and cytokine analysis. There was no significant change in the levels of selected cytokines at baseline and after intake of the berry beverage in whole stimulated saliva. There was a large inter-individual variation in cytokine levels.

  • 141.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Ekholm, A.
    Department of Plant Breeding and Biotechnology Balsgård, Swedish University of Agricultural Sciences, Kristianstad.
    Coleman, M.D.
    School of Life and Health Sciences, Aston University, Birmingham.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Naturvetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Rumpunen, K.
    Department of Plant Breeding and Biotechnology Balsgård, Swedish University of Agricultural Sciences, Kristianstad.
    Erythrocyte antioxidant protection of rose hips (Rosa spp.)2012Inngår i: Oxidative Medicine and Cellular Longevity, ISSN 1942-0900, s. 621579-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rose hips are popular in health promoting products as the fruits contain high content of bioactive compounds. The aim of this study was to investigate whether health benefits are attributable to ascorbic acid, phenols, or other rose-hip-derived compounds. Freeze-dried powder of rose hips was preextracted with metaphosphoric acid and the sample was then sequentially eluted on a C18 column. The degree of amelioration of oxidative damage was determined in an erythrocyte in vitro bioassay by comparing the effects of a reducing agent on erythrocytes alone or on erythrocytes pretreated with berry extracts. The maximum protection against oxidative stress, 59.4±4.0% (mean ± standard deviation), was achieved when incubating the cells with the first eluted meta-phosphoric extract. Removal of ascorbic acid from this extract increased the protection against oxidative stress to 67.9±1.9%. The protection from the 20% and 100% methanol extracts was 20.8±8.2% and 5.0±3.2%, respectively. Antioxidant uptake was confirmed by measurement of catechin by HPLC-ESI-MS in the 20% methanol extract. The fact that all sequentially eluted extracts studied contributed to protective effects on the erythrocytes indicates that rose hips contain a promising level of clinically relevant antioxidant protection.

  • 142.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Holmer, Helene
    Kristianstad Central Hospital, Kristianstad.
    Coleman, Michael
    England.
    Tudor, Marian
    Kristianstad Central Hospital, Kristianstad.
    Ohlsson, Ola
    Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Sättlin, Susanna
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Persson, G Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Systemic inflammatory impact of periodontitis on acute coronary syndrome2016Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, nr 9, s. 713-719Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: A causative relationship between acute coronary syndrome (ACS) and periodontitis has yet to be defined. The aim of this study was to assess differences in levels of serum cytokines between individuals with or without ACS or periodontal comorbidity.

    MATERIAL AND METHODS: In a case-control study, individuals with ACS (78 individuals, 10.3% females) and matching healthy controls (78 individuals, 28.2% females) were included. Medical and dental examinations were performed to diagnose ACS and periodontitis. Serum levels of cytokines were assessed using Luminex technology.

    RESULTS: A diagnosis of periodontitis in the ACS and control group was diagnosed in 52.6% and 12.8% of the individuals, respectively. The unadjusted odds-ratio that individuals with ACS also had periodontitis was 7.5 (95% CI: 3.4, 16.8, p<0.001). Independent of periodontal conditions, individuals with ACS had significantly higher serum levels of IL8 (mean: 44.3 and 40.0 pg/ml) and vascular endothelial growth factor (VEGF) (mean: 82.3 and 55.3 pg/ml) than control individuals. A diagnosis of periodontitis made no difference in serum cytokine expressions.

    CONCLUSION: Elevated serum levels of VEGF were associated with ACS. Serum cytokine expression in individuals with ACS is unrelated to periodontal conditions. This article is protected by copyright. All rights reserved.

  • 143.
    Widén, Cecilia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen Oral hälsa.
    Antibacterial activity of berry juices, an in vitro study2015Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, nr 7, s. 539-543Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    The aim of the present study was to evaluate in vitro antibacterial activities of blackcurrant and sea buckthorn juices on bacteria associated with gingival inflammation.

    Materials and methods

    The growth of selected bacteria (Streptococcus mitis, Streptococcus mutans, Streptococcus sanguinis, Streptococcus gordonii, Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa) was studied in vitro on agar plates. The content of phenols in the different extracts was measured with HPLC-ESI-MS.

    Results

    The spectrometric analysis identified that the highest level of the single phenols studied was found for ferulic acid (113 μg/ml) in blackcurrant juice. Sea buckthorn contained low levels of selected phenols. Total bacterial inhibition for all bacterial species studied was found at 20% berry juice concentration with pH varying between 4.1-5.4.

    Conclusions

    The present study identified that in vitro bacterial growth on agar plates was inhibited by blackcurrant and sea buckthorn juices and that low juice pH explains bacterial in vitro growth. This may have clinical implications in biofilm development, reducing the risks for both tooth decay and gingivitis.

  • 144.
    Zubair, Muhammad
    et al.
    Department of Plant Breeding and Biotechnology, Swedish University of Agricultural Sciences, Balsgård, Kristianstad.
    Ekholm, Anders
    Department of Plant Breeding and Biotechnology, Swedish University of Agricultural Sciences, Balsgård, Kristianstad.
    Nybom, Hilde
    Department of Plant Breeding and Biotechnology, Swedish University of Agricultural Sciences, Balsgård, Kristianstad.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Widen, Cecilia
    Department of Plant Breeding and Biotechnology, Swedish University of Agricultural Sciences, Balsgård, Kristianstad.
    Rumpunen, Kimmo
    Department of Plant Breeding and Biotechnology, Swedish University of Agricultural Sciences, Balsgård, Kristianstad.
    Effects of Plantago major L. leaf extracts on oral epithelial cells in a scratch assay2012Inngår i: Journal of Ethnopharmacology, ISSN 0378-8741, E-ISSN 1872-7573, Vol. 141, nr 3, s. 825-830Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim of study The present study was undertaken to evaluate the effects from different leaf extracts of the traditional medicinal herb Plantago major L. (plantain) on cell proliferation and migration in vitro, as a test for potential wound healing properties. Materials and methods Water and ethanol-based extracts were prepared from Plantago major fresh and dried leaves, and tested in vitro in a scratch assay with oral epithelial cells. Results The scratch assay produced reliable results after 18&#xa0;h. Most of the tested extracts increased the proliferation/migration of the oral epithelial cells compared to the negative control. A concentration of 1.0&#xa0;mg/mL (on dry weight basis) appears to be optimal regardless of type of extract, and among the alternatives, 0.1&#xa0;mg/mL was always better than 10&#xa0;mg/mL. Ethanol-based extracts with a concentration of 10&#xa0;mg/mL had very detrimental effects on cell proliferation/migration. At the other two concentrations, ethanol-based extracts had the most beneficial effect, followed by water extracts of fresh leaves, ethanol plus water extracts of dried leaves and, finally, water extracts of dried leaves. This study suggests that both the water extracts and the more polyphenol-rich ethanol-based extracts of Plantago major leaves have medicinal properties. Further research is, however, needed to determine what compounds are responsible for the wound healing effects.

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