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  • 151. Lang, Niklaus P
    et al.
    Berglundh, Tord
    Abrahamsson, Ingemar
    Claffey, Noel
    De Bruyn, Hugo
    Donos, Nikolaus
    Heitz-Mayfield, Lisa J.A.
    Klinge, Björn
    Mombelli, Andrea
    Palmer, Richard M.
    Quirynen, Marc
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Salvi, Giovanni E.
    Schwarz, Frank
    Sculean, Anton
    Vignoletti, Fabio
    Zitzmann, Nicola U.
    Periimplant diseases: where are we now?--Consensus of the Seventh European Workshop on Periodontology.2011Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, nr Suppl 11, s. 178-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 152.
    Lang, Niklaus P.
    et al.
    Faculty of Dentistry, Comprehensive Dental Care, The University of Hong Kong.
    Jepsen, Søren
    Universtitätsklinikum, Department of Periodontology, Rheinische-Friedrich-Wilhelm-Universität, Bonn.
    Abrahamsson, Ingemar
    Albrektsson, Tomas
    Becker, Jürgen
    Berglundh, Tord
    Botticelli, Daniele
    Brunette, Donald M.
    Bullon, Pedro
    Esposito, Marco
    Geis-Gerstorfer, Jürgen
    Jansen, John A.
    Nisand, David
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Schou, Søren
    Wennerberg, Ann
    Bösch, Adrian
    Sax, Caroline
    Implant surfaces and design (Working Group 4)2009Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 20 Suppl 4, s. 228-231Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 153.
    Lauenstein, Marc
    et al.
    Department of Periodontology, University of Bern.
    Kaufmann, Marion
    Department of Periodontology, University of Bern.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Clinical and microbiological results following nonsurgical periodontal therapy with or without local administration of piperacillin/tazobactam2013Ingår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 17, nr 7, s. 1645-1660Artikel i tidskrift (Refereegranskat)
    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.

  • 154.
    Leander, Camilla
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Bladh, Rosemarie
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Tandstatus hos patienter som behandlats för huvud- och halscancer med radioterapi samt deras upplevleser av sin munhälsa.2009Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med denna studie var att undersöka tandstatus fem år efter genomförd radioterapi mot huvud- och halscancer och jämföra med status omedelbart före radioterapistart. Ytterligare ett syfte var att undersöka hur patienterna upplever sin munhälsa. En kvantitativ deskriptiv tvärsnittsstudie har utförts på 21 patienter som har behandlats med radioterapi involverande hela eller delar av munhålan som stod på tur att kallas för en femårskontroll. Patienterna kallades från ett patientregister tillhörande sjukhustandvården på Käkkirurgiska kliniken i Lund. Studien delades in i tre delar: journal- och röntgengranskning, klinisk undersökning samt att patienterna fick besvara ett antal frågor rörande deras munhälsa. Resultatet visade att 43 (2.3 i medeltal range 0-6) tänder hade gått förlorade på fem år. Huvuddelen av de undersökta patienterna upplevde en påtaglig sänkt livskvalité efter genomgången radioterapi. Tänder har förlorats, lagats och ersatts. Låg salivsekretion, tugg- och sväljsvårigheter, karies samt osteoradionekros uppvisas som en sannolik följd av radioterapi.

     

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  • 155. Leonhardt, Asa
    et al.
    Dahlén, Gunnar
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man2003Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 74, nr 10, s. 1415-1422Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 156. 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.2002Ingår i: Journal of the International Academy of Periodontology, ISSN 1466-2094, Vol. 4, nr 3, s. 95-100Artikel i tidskrift (Refereegranskat)
    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.

  • 157.
    Lindhe, Jan
    et al.
    Department of Periodontology, Faculty of Odontology, The Sahlgrenslea Academy at Göteborg University.
    Meyle, Joerg
    Department of Periodontology, Zentrum für Zahn-Mund-und Kieferheilkunde, Justus-Liebig-Universitätt Giessen.
    Zitzmann, N.U.
    Berglundh, T.
    Heitz-Mayfield, L.J.A.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Roos-Jansåker, Anne-Marie
    Clarke, E.
    Polyzois, I.
    Peri-implant diseases: consensus report of the Sixth European Workshop on Periodontology.2008Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, nr 8 Suppl, s. 282-285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 158.
    Lingström, Peter
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    The stickiness and the retention of foods2006Ingår i: Nutrition in practice, ISSN 1470-4722, Vol. 7, nr 3, s. 7-10Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    In modern society, diet and nutrition are very complex issues and are known to be closely related to oral health and disease. A number of product-related factors are known to determine the eff ect a food may eventually have in the mouth. One common recommendation given to patients by the dental profession, when it comes to both dental caries and plaque formation, is to avoid “sticky foods”. In this context, this means that the patient should limit consumption of food products that are retained in the oral cavity for a long period, as the stickiness of these products prolongs contact with the teeth. Foods and their metabolic end-products may adhere to soft tissues, dental hard tissues, dental plaque, carious lesions and probably also calculus, which may in turn have a negative infl uence on several of these. Th e amount of residue and the effi ciency of its removal are closely related to the chemical and physical characteristics of the product.

  • 159. Lundgren, T
    et al.
    Parhar, R S
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Tatakis, D N
    Impaired cytotoxicity in Papillon-Lefèvre syndrome2005Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 84, nr 5, s. 414-417Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 160.
    Lundgren, Tord
    et al.
    Loma Linda University, California, USA.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Periodontal treatment of patients with Papillon-Lefèvre syndrome: a 3-year follow-up2004Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, nr 11, s. 933-938Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/AIM: Conventional mechanical periodontal treatment of Papillon-Lefevre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented.

    METHODS: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin-metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years.

    RESULTS/CONCLUSION: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene.

  • 161.
    Meholli, Florina
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Rawi, Anbereen
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Upplevelser av cigarettrökning och uppfattning om dess påverkan på orala hälsan bland en grupp högskolestudenter: en kvalitativ studie2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syfte: Syftet med studien var att belysa hur studenter som dagligen röker minst tio cigaretter upplever det egna tobaksbruket. Ett ytterligare syfte var att belysa studenternas uppfattning om cigarettrökningens påverkan på den orala hälsan. Material och metod: En empirisk studie med kvalitativ design tillämpades. Datamaterial samlades in genom intervjuer där åtta studenter från Högskolan Kristianstad deltog. Intervjuerna baserades på en intervjuguide på tolv frågor, som varade i cirka 10-15 minuter. Data analyserades genom kvalitativ innehållsanalys. Resultat: I studiens resultat framgick att deltagarna upplevde lugnande och avslappnande känslor i samband med sin cigarettrökning. Dessa känslor framgick främst vid rökning under stressfulla situationer och var huvudanledningen till att deltagarna fortsatte röka. I samband med sin rökning upplevde majoriteten av deltagarna försämrad kondition och svårigheter att vara ifrån rökningen i fem timmar eller mer.  Studenternas uppfattningar om hur rökning påverkar oral hälsa var att det medförde främst gula tänder och dålig andedräkt. Slutsats: Studenterna hade en positiv syn på sin cigarettrökning där de upplevde främst avslappnande och lugnande känslor. Deras uppfattningar om rökningens effekter på orala hälsan var bristande där främst missfärgningar och dålig andedräkt framgick. 

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  • 162.
    Meisner, Anne
    Icakuriren, Stockholm.
    Dålig andedräkt: vad gör man?2009Ingår i: Ica-kuriren, ISSN 0345-5068, Vol. 68, nr 36, s. 46-47Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 163.
    Mohamed, Seif
    et al.
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    Polyzois, Ioannis
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Claffey, Noel
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects2010Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, nr 5, s. 513-519Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective This study was designed to evaluate the effect of surface contamination on osseointegration of dental implants surrounded by a circumferential bone defect and to compare osseointegration around Osseotite (R) with that around Nanotite (TM) implants. Materials and methods The premolars on both sides of the mandible in four beagle dogs were extracted. Following 4 months healing, two Nanotite (TM) implants and two Osseotite (R) implants were partially inserted in the left side of each mandible. Some threads protruded from the tissues into the oral cavity. Following a 5 week healing period, the implants were removed and the contaminated part of each implant was cleaned. They were then installed to the full implant length on the contra lateral side of the mandibles. The coronal 5 mm of each implant was surrounded by 1 mm circumferential bone defect. Following 12 weeks of healing period, the dogs were sacrificed and biopsies were obtained. Ground sections were prepared for histomorphometric analysis. Results All implants were associated with direct bone-to-implant contact on the portion of the implant surface contaminated previously and surrounded by bone defect. Nanotite (TM) implants performed better than Osseotite (R) implants. Conclusions The results demonstrated that implant surfaces, which were contaminated previously and were surrounded by bone defects, can osseointegrate. To cite this article:Mohamed S, Polyzois I, Renvert S, Claffey N. Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects.

  • 164.
    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.2002Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, nr 6, s. 531-539Artikel i tidskrift (Refereegranskat)
    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.

  • 165.
    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
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, 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 disease2013Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 40, nr 6, s. 583-590Artikel i tidskrift (Refereegranskat)
    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.

  • 166.
    Mårtensson, Carina
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Promoting oral health: knowledge of periodontal disease and satisfaction with dental care2012Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The general aims of this thesis were to evaluate if a mass media campaign, aimed as a health promoting campaign, and visits to a specialist clinic in periodontology could increase the knowledge of periodontitis, symptoms and treatment. A further aim was to analyse expectations and satisfaction with care among patients referred for comprehensive treatment to specialist clinics. Paper I and II evaluating if a nationwide mass media campaign increased the knowledge of periodontitis (paper I) and factors associated with knowledge (paper II). The evaluations were done using a mail questionnaire in a before and after design. The questionnaireswere sent out to 50-75 years old people in Sweden, randomly sampled from the population register. Paper I showed an improvement of correct answers about symptoms and treatment of periodontitis after the media campaign. In paper II, it was shown that education, utilization and perceived importance of oral health were related to knowledge both before and after the mass media campaign. Age and information about periodontitis from dental clinics were associated with knowledge before the mass media campaign. Paper III and IV evaluated the knowledge of periodontitis, and analysed self-perceived oral health (paper III), expectations on and satisfaction with care (paper IV), and evaluations were also done using a questionnaire in a before and after design. Patients referred to specialist clinics in periodontology for comprehensive periodontal treatment were consecutively sampled for the study. The results in 9 paper III showed an improvement in correct answers to the knowledge questions after visiting the specialist clinic. The most common self-perceived troubles were bleeding gums and sensitive teeth. Many of the patients experienced their oral health as rather good. In paper IV, the patients expected it to be very important or important to achieve healthy teeth and improved well-being after treatment. In general, many of the patients were satisfied with their dental visits. The patients also appeared be satisfied with the relationship to and the perception of the caregiver. In conclusion, there was an improvement of knowledge about periodontitis, possibly due to the media campaign and also after visiting a specialist clinic in periodontology. Even if the patients reported troubles from their mouths, they rated their self-perceived oral health as rather good. Achieving healthy teeth and improved wellbeing were important issues for the patients. Having a good relationship with and confidence in the caregiver seems to indicate satisfied patients.

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  • 167.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Andersson, Pia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Söderfeldt, Björn
    Axtelius, Björn
    Patienters kunskap om parodontit granskas2009Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 101, nr 7, s. 64-65Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    En studie har påbörjats för att ge ökad insikt om patienters kunskap om parodontit före och efter parodontal behandling. Patienternas förväntningar inför och upplevelser av behandlingen ska också analyseras.

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  • 168.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Söderfeldt, Björn
    Department of Oral Public Health, Faculty of Odontology, Malmö University.
    Andersson, Pia
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Factors behind change in knowledge after a mass media campaign targeting periodontitis2006Ingår i: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 4, nr 1, s. 8-14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate changes in knowledge before and after a mass media campaign, in relation to social attributes, care system attributes and oral health aspects. The study was based on a questionnaire in a cohort design, sent out to 900 randomly sampled people aged 50–75 in Sweden. The response rate to the questionnaire before and after the campaign was 70% and 65% respectively. Sixty-four percent answered both questionnaires. Two questions addressed knowledge, while 10 questions aimed to measure social attributes, care system attributes and oral health aspects. Data were analysed for bivariate relations as to change in knowledge and social attributes, care system attributes and oral health aspects. Data were also analysed in multiple regression analysis with knowledge before, knowledge after and knowledge differences as dependent variables. The results showed that there were a number of independent variables with influence on the dependent variables. Of the social attributes, secondary education gave almost 10% (P < 0.001) better knowledge both before and after the campaign. Among care system attributes, high care utilization was related to knowledge both before and after the campaign. The most important factors for knowledge about periodontitis were education, care utilization and perceived importance of oral health. In conclusion, this study demonstrates that mass media might increase knowledge about periodontitis as a health promotion strategy.

  • 169.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Söderfeldt, Björn
    Department of Oral Public Health, Faculty of Odontology, Malmö University.
    Axtelius, Björn
    Department of Oral Public Health, Faculty of Odontology, Malmö University.
    Andersson, Pia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Expectations and satisfaction with care for periodontal specialist patients2013Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, nr 3-4, s. 799-806Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The aim of this study was to investigate expectations on and satisfaction with treatment among patients referred for comprehensive treatment to specialist clinics in periodontology and to explore factors associated with satisfaction in regression analysis.

    Materials and methods. Patients referred for comprehensive periodontal treatment were sampled for the study. The study was based on a questionnaire in a before-and-after design. The first questionnaire was sent to the patients before their first appointment at the specialist clinic. The second questionnaire was sent after  6 months. Three questions were used to measure expectations and four questions to measure satisfaction. The first questionnaire was sent to 273 patients with a response rate of 31% and the second questionnaire was sent to 85 patients with a response rate of 73%. In non-response analysis, no difference between respondents and non-respondents were detected as to age and gender.

    Results. Many of the patients viewed it as important or very important to have healthy teeth (98%) and improved well-being (93%) after periodontal treatment. More than 50% of the patients were satisfied with the relation to the caregiver. When measuring the satisfaction in general, 42% indicated the highest score on the summarized Dental Visit Satisfaction Scale. Having confidence (p ≤ 0.001) and a good relation (p = 0.001) to the caregiver indicated higher satisfaction.

    Conclusion. Having a good relation to the caregiver and having confidence in the caregiver seems to indicate satisfied patients receiving periodontal treatment at periodontal clinics.

  • 170.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Söderfeldt, Björn
    Malmö University.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Knowledge on periodontal disease before and after a mass media campaign2004Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 28, nr 4, s. 165-171Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate if a mass media campaign regarding periodontal disease could increase the knowledge in the general population of diagnoses, symptoms and treatment options of periodontal disease. More specifically, the aim was to investigate the number of correct answers to knowledge questions before and after the campaign. The Swedish Association of Periodontology conducted the campaign through brochures, newspapers, radio and TV. The effect of the campaign was evaluated by a pre- and post campaign questionnaire with a cohort design. From a national population register of 50-75 year olds in Sweden, 900 persons were randomly sampled for the study. A total of 64% of the sample answered both questionnaires. The result of the study showed an improvement among the respondents. There was a significant increase in the number of correct answers regarding diagnoses, symptoms and treatments of periodontitis. In the questionnaire, correct answers regarding "Mobile teeth" increased from 57% to 65% (p=0.003) and "careful dental hygiene" from 65% to 73% (p=0.001). Kappa value's were calculated for consistency in the reply and all kappa values were low especially for the questions "X-ray" (0.36) and "Cleaning between the teeth" (0.38). It was concluded that the campaign probably was successful from a public health knowledge standpoint.

  • 171.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Söderfeldt, Björn
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Kunskap om parodontal sjukdom före och efter en massmediakampanj2005Ingår i: Tandhygienisttidningen. 25(3), 2005, Vol. 25, s. 63-Konferensbidrag (Övrigt vetenskapligt)
  • 172.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Söderfeldt, C.
    Axtelius, B.
    Andersson, Pia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Knowledge of periodontitis and self-perceived oral health: a survey of periodontal specialist patients2013Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, nr 1, s. 49-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate changes in knowledge of periodontal disease among patients referred to periodontal specialist clinics. A further aim was to investigate the patients' self- perceived oral health before the treatment. Patients referred to five specialist clinics in periodontology for comprehensive periodontal treatment were consecutive sampled. The study was based on a questionnaire in a before and after design. The first questionnaire was sent to the patients before visiting the specialist clinic and the second was sent after six months. Four questions were analysed, two to measure knowledge about periodontitis and two to measure the patients self- perceived oral health. The first questionnaire was sent by post to 273 patients with a response rate of 31%. The second questionnaire was sent to 85 patients with a response rate of 73%. The results of the study showed a statistically significant improvement of correct answers on the knowledge questions after six months was found for scaling (p = 0.006), X-ray examination (p = 0.001) and increased space between the teeth (p = 0.001). The most frequent self-perceived trouble from the mouth was bleeding gum (70%) and sensitive teeth (51%). In conclusion knowledge of periodontitis improved after visiting the specialist clinic of periodontology. Many of the patients experienced some problems of the mouth.

  • 173.
    Mårtensson, Carina
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Söderfelt, Björn
    Avd. för samhällsodontologi, Malmö Högskola.
    Axtelius, Björn
    Avd. för samhällsodontologi, Malmö Högskola.
    Andersson, Pia
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Kunskap om parodontit och självupplevd munhälsa hos patienter remitterade till specialistklinik i parodontologi2011Ingår i: Tandhygienisttidningen, ISSN 1102-6146, Vol. 31, nr 3, s. 36-Artikel i tidskrift (Övrigt vetenskapligt)
  • 174.
    Neziri, Valentina
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Veseli, Qendresa
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Munhygien- och kostvanor hos gymnasieelever i Prishtina, Kosovo2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Kosovo saknar ett fungerande tandvårdssystem och det ges inga förebyggande åtgärder vilket påverkar munhälsan. För att upprätthålla en god munhälsa krävs en god munhygien och goda kostvanor. Idag finns det många barn och ungdomar som kommer från Kosovo till Sverige, och därför är det intressant att ta reda på om hur ungdomarnas munhygien-, kost- och tandvårdsvanor ser ut i Kosovo.

    Syfte med studien var att undersöka munhygien- och kostvanor samt tandvårdsvanor hos 16-19 åringar i Prishtina, Kosovo. Material och metod: Studien är en kvantitativ empirisk studie som utfördes med en enkät som innehöll 17 frågor med fasta svarsalternativ. I studien ingick 150 elever i åldrarna 16-19 från två utvalda gymnasieskolor i Prishtina, Kosovo. Resultatet visade att mer än hälften av respondenterna borstade tänderna två gånger per dag, morgon och kväll med tandborste och tandkräm och cirka 80 % använde något approximalt hjälpmedel. Knappt hälften av respondenterna (43 %) intog 5 mål om dagen och de flesta av respondenterna åt frukost, lunch och middag varje dag. Respondenterna hade ett högt intag av sötsaker. Vad gäller tandvårdsvanor var det 70 % som inte besökte tandläkaren regelbundet. Slutsats: Respondenterna hade relativt goda munhygien- och kostvanor men dåliga tandvårdsvanor.

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  • 175.
    Nilsson, Emelie
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Holmberg, Josephine
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Knowledge and experiences of oral health among teacher students in Livingstone, Zambia: a questionnaire study2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med studien var att undersöka erfarenheten av tandvård och oral hygien samt kunskap om gingivit, parodontit och karies bland lärarstudenter i Livingstone, Zambia. Ett annat syfte var att undersöka om oral hälsa var en del utav läroplanen. Studien utfördes bland lärarstudenter vid David Livingstone College of Education. Enkäten bestod av 32 frågor. 150 enkäter delades ut, ett externt bortfall på 15 enkäter förekom och sammanlagt deltog 135 lärarstudenter i studien. Resultaten visade att 74 av lärarstudenterna aldrig hade fått tandvård medan 59 hade fått tandvård. Det huvudsakliga skälet till att de hade uppsökt tandvård var tandvärk. Tandborste och tandkräm var de vanligaste hjälpmedlen vid tandrengöring. Kunskapen om orala sjukdomar var i det stora hela god. De flesta lärarstudenterna hade fått information om oral hälsa i tidigare skolor. Lärarstudenterna var positivt inställda till att informera om oral hälsa när de börjar praktisera som lärare, men de efterfrågade mer information och kunskap om ämnet.

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  • 176.
    Nilsson, Helena
    et al.
    Halland Hospital, Halmstad.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Tooth loss and cognitive functions among older adults2014Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, nr 8, s. 639-644Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the association between the number of teeth and cognitive functions adjusted for age and education level in a cohort of older adults living in Sweden.

    Materials and methods: The study employed a cross-sectional design in which 1147 individuals between 60-96 years underwent a clinical oral examination. The cognitive functions were assessed using Mini-Mental State Examination (MMSE) and Clock-test. The level of education was obtained from a questionnaire. Data were subjected to Chi-square tests and multivariate logistic regression analyses were employed, grouping the different variables into pre-determined categories.

    Results: The co-variables age and education were significantly associated with the number of teeth (p < 0.05). The multivariate logistic regression analysis revealed that the association between the number of teeth and the cognitive functions persisted even after adjusting for age and level of education.

    Conclusions: The findings suggest that the presence of teeth may be of importance for cognitive abilities in older adults.

  • 177.
    Nilsson, Helena
    et al.
    Specialisttandvården Region Halland .
    Berglund, Johan Sanmartin
    Blekinge Institute of Technology & Lund University.
    Renvert, Stefan
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Longitudinal evaluation of periodontitis and development of cognitive decline among older adults2018Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, nr 10, s. 1142-1149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: to determine whether having periodontitis is associated with cognitive decline among older adults.

    MATERIAL AND METHODS: A prospective population study of older adults, Swedish National Study on Ageing and Care, (SNAC) provided repeated registrations of cognitive functions. Cognitive decline was defined as ≥ 3-points deterioration from a predetermined level at baseline, using the Mini-Mental State Examination (MMSE). Between 2001 and 2003, 715 individuals had a medical as well as a clinical and radiographic dental examination. The individuals were re-examined after 6 years. Periodontitis was defined as ≥ 4mm bone loss at ≥ 30% of tooth sites. Social variables were captured from questionnaires.

    RESULTS: The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of periodontitis and cognitive decline after adjustments of confounding factors of importance.

    CONCLUSIONS: A history of periodontitis may be of importance for cognitive functions among older adults. This article is protected by copyright. All rights reserved.

  • 178.
    Nilsson, Helena
    et al.
    Halland Hospital.
    Berglund, Johan Sanmartin
    Blekinge Institute of Technology & Lund University.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Periodontitis, tooth loss and cognitive functions among older adults2018Ingår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 22, nr 5, s. 2103-2109Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This study aims to evaluate the potential association between periodontitis, the number of teeth and cognitive functions in a cohort of older adults in Sweden.

    MATERIAL AND METHODS: In total, 775 individuals from 60 to 99 years of age were selected for the study. A clinical and radiographic examination was performed. The number of teeth and prevalence of periodontal pockets and bone loss was calculated and categorised. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and clock test. The education level was obtained from a questionnaire. Data were analysed using chi-square tests and multivariate logistic regression.

    RESULTS: Age and gender were associated with the prevalence of bone loss. Age and education were associated with lower number of teeth. Gender was also associated with the presence of pockets. The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of bone loss, the number of teeth and the outcome on MMSE test. This association remained even after adjustment for age, education and gender. Tooth loss was also associated with lower outcome on clock test. Presence of periodontal pockets ≥ 5 mm was not associated with cognitive test outcome.

    CONCLUSIONS: A history of periodontitis and tooth loss may be of importance for cognitive functions among older adults.

    CLINICAL RELEVANCE: Diseases with and inflammatory profile may have an impact on cognitive decline.

  • 179.
    Nilsson, Helena
    et al.
    Halland hospital.
    Sanmartin Berglund, Johan
    Lunds universitet & Blekinge tekniska högskola.
    Renvert, Stefan
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa. Irland, Blekinge tekniska högskola, USA, Kina.
    Longitudinal evaluation of periodontitis and tooth loss among older adults2019Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 46, s. 1041-1049Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To evaluate pattern of change in periodontal variables and tooth loss in a twelve-year follow-up study of older adults living in Sweden.

    METHODS: In a prospective population study of older adults, a clinical examination and radiographic dental examination were performed at baseline (2001-2003) and after 12 years (2013-2015). In 375 individuals, the number and proportion of sites with a distance ≥4 mm and ≥5 mm from cemento-enamel junction to the bone level, the number and proportion of teeth with pockets ≥5 mm and number of teeth lost were calculated. Dental caries was registered. Periodontitis was defined as having ≥2 sites with ≥5 mm distance from cemento-enamel junction to the marginal bone level and ≥1 tooth with pockets ≥5 mm.

    RESULTS: A diagnosis of periodontitis was evident in 39% of the individuals, and 23% of the individuals lost ≥3 teeth over the study period. The proportion of sites with ≥4 mm and ≥5 mm bone loss increased with age, while the proportion of teeth with pockets remained stable. Periodontitis was the strongest predictor for losing ≥3 teeth, OR 2.9 (p < .001) in the final model.

    CONCLUSIONS: Periodontitis is a risk factor for future tooth loss among older adults.

  • 180.
    Nordin, Caroline
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Rasmusson, Lina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Kariesprevalensen hos barn och ungdomar 3-19 år i de nordiska länderna2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Aim: The aim of this present study was to assess the dental caries prevalence in children and adolescents aged 3-19 in the Nordic countries, and to examine if the caries prevalence is affected by socioeconomic and cultural differences.

    Method: The study is a literature review based on 20 scientific medical reports based on the aim of this study.

    Result: Decayed missed filled surfaces (dmfs) of the 3-year-olds varies from 0.3 to 0.99 and from 0.9 to 7.3 in 5-year-old children. The Nordic 12-year-olds have similar numerical values. In Nordic 14-year-olds caries prevalence increases. In the late teens there is a reduction in caries prevalence. Children at Greenland have five times more teeth decayed than other Danish children. Socioeconomic and cultural differences can affect the caries prevalence negatively.

    Conclusions: The caries prevalence in 3-19-year-olds in the Nordic countries, exceptGreenland, does not differ significantly between the countries. It is difficult to determine if the caries prevalence generally has decreased or increased in the Nordic countries. A higher caries prevalence can be seen in children with an immigrant background.

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  • 181.
    Nydrén, Sara
    Mediaplanet, Stockholm.
    Så håller du din andedräkt fräsch2009Ingår i: Munhälsa, nr 4, s. 11-Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Var tredje person kan lida av dålig andedräkt. Problemet ökar med åldern, mycket på grund av en försämrad tandkondition med bakterier som luktar illa i munnen. Stefan Renvert, professor i oral hälsovetenskap vid Högskolan i Kristianstad, tipsar om hur du håller din andedräkt på topp.

  • 182.
    Olsson, Hanna
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Benjaminsson, Madelene
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Före detta tandhygieniststuderandes uppfattning om utbildningen vid Högskolan Kristianstad2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Aim: The aim of this study was to investigate former dental hygienist students’ view regarding their education at Kristianstad University.Material and methods: This quantitative study was descriptive and the data collection method was used by a questionnaire. This was sent by post to former dental hygienist students at Kristianstad University. In total, 57 dental hygienists participated in the study.Result: The majority of the respondents (94 %, n=54) were content with their education. The education’s primary strength turned out to be the clinical activity that is conducted while at the same time there was a wish for more practice. The content in the dental hygienist education at Kristianstad University is corresponding to the requirements in the profession including oral health science according to the majority of the respondents.Conclusion: The clinical activity that is conducted both at external dental clinics and at the dental clinic at the college has a high significance for the prospective dental hygienist’s career.Keywords: alumnus, dental hygienist, dental hygienist education, knowledge, skills description

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  • 183. 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.2007Ingår i: Oral Microbiology and Immunology, ISSN 0902-0055, E-ISSN 1399-302X, Vol. 22, nr 3, s. 162-8Artikel i tidskrift (Refereegranskat)
    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.

  • 184.
    Paulsson, Gun
    et al.
    School of Social and Health Sciences, Halmstad University.
    Wårdh, I.
    Karolinska Institutet.
    Andersson, Pia
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Öhrn, K.
    Department of Health and Social Sciences, Dalarna University.
    Comparison of oral health assessments between nursing staff and patients on medical wards2008Ingår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 17, nr 1, s. 49-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The maintenance of good oral health is essential for nutrition, recovery and well-being. This requires the involvement of the nursing staff, especially in cases where oral care and any necessary dental treatment are vital to ensure medical treatment. The aim of this study was to evaluate the validity of oral assessments performed by nursing staff using the revised oral assessment guide (ROAG), using comparisons with patients' self-assessment of oral problems. When a comparison was made of how the staff and patients assessed their oral status, a high level of agreement was found. In these assessments, with the exception of oral mucosa and teeth, the percentage agreement was >80. The kappa coefficient revealed slight to moderate agreement. When there was a disagreement, the staff assessed the oral health as being significantly poorer than the patients did. In the present study, it was shown that few oral assessments performed by the nursing staff and patient disagreed. The ROAG may therefore be useful for the nursing staff to make the patients' oral health problems visible.

  • 185.
    Persson, Anitha
    et al.
    Department of Odontology, University of Umeå.
    Lingström, Peter
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Bergdahl, Maud
    Institute of Clinical Dentistry, University of Tromsö.
    Claesson, Rolf
    Department of Odontology, University of Umeå.
    van Dijken, Jan W. V.
    Department of Odontology, University of Umeå.
    Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly2007Ingår i: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 24, nr 2, s. 98-104Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The effect of multiple daily applications of a prophylactic gel, with buffering substances, on plaque acidogenicity in elderly institutionalised individuals was evaluated. BACKGROUND: Many elderly suffer from reduced salivary flow, poor oral hygiene and increased levels of cariogenic bacteria and are considered to be at an increased risk for coronal and root caries. Reinforcing the buffering capacity of dental plaque by the addition of substances such as bicarbonate and phosphates may decrease their caries activity. MATERIALS AND METHODS: Fourteen elderly, with subjective dry mouth, were treated for 16-day-periods at random with: (i) Profylin fluoride gel with buffering components; (ii) Profylin fluoride gel without buffering components and (iii) rinsing with water. Applications were made four times a day and each period was followed by a 2-week wash-out period. The plaque pH was registered after a carbohydrate challenge and the following were recorded before and after each test period: stimulated salivary secretion rate, buffer capacity, number Colony Farming Units (CFU) mutans streptococci, lactobacilli and a sample of Candida albicans on oral mucosa. RESULTS: Eleven participants (mean age 76.6 years) fulfilled the study. Changes in plaque pH measurements, when calculated as area under the curve (AUC(6.2) and AUC(5.7)) values (pH x min), before and after each of the three treatments, showed no significant differences. A tendency to a higher plaque acidogenicity and amount of cariogenic microorganisms was found after the gel treatments. C. albicans was found in low levels. CONCLUSION: Frequent applications of the gel did not result in an improved neutralising effect in the elderly. This may be caused by a combination of several factors, such as the level of oral dryness of the individuals and low solubility, release and retention of the gel substances in plaque. Instead, an increased plaque acidogenicity was noted.

  • 186.
    Persson, G. Rutger
    University of Washington, Seattle & University of Bern, Switzerland.
    Diabetes and periodontal disease: an update for health care providers2011Ingår i: Diabetes Spectrum, ISSN 1040-9165, E-ISSN 1944-7353, Vol. 24, nr 4, s. 195-198Artikel i tidskrift (Refereegranskat)
    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.

  • 187.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Rheumatoid arthritis and periodontitis - inflammatory and infectious connections: review of the literature2012Ingår i: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 4, s. 11829-Artikel i tidskrift (Refereegranskat)
    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.

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  • 188.
    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.2008Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, nr 3, s. 508-516Artikel i tidskrift (Refereegranskat)
    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.

  • 189.
    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 gingivitis2009Ingår i: BMC infectious diseases, ISSN 1471-2334, Vol. 9, s. 6-Artikel i tidskrift (Refereegranskat)
    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.

  • 190.
    Persson, G. Rutger
    et al.
    University of Washington, Seattle, WA, USA.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Pettersson, Thomas
    Department of Medicine, Kristianstad Central Hospital, Kristianstad, Sweden.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Chronic periodontitis, a significant relationship with acute myocardial infarction.2003Ingår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 24, nr 23, s. 2108-15Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Chronic periodontitis (CP) has been associated with cardiovascular diseases. The study purposes were to identify the odds of acute myocardial infarction (AMI) and CP defined at different thresholds.

    METHODS AND RESULTS: We studied 80 subjects with clinically confirmed AMI and 80 matched control subjects with no evidence of cardiovascular disease all receiving a comprehensive periodontal examination. Statistical analysis demonstrated a difference in the proportion of sites with a periodontal probing depth >/=6.0mm (2.7% for non-AMI and 12.1% for AMI group, 95% CI: -2.8 to 0.01, P<0.05) but no difference in the extent of gingival bleeding was found between groups. The odds ratio of having AMI and periodontitis varied between 9.2:1 to 14.1:1 with the greatest odds ratio if bone loss exceeded 4mm at >/=50% of the teeth (OR: 14.1:1, 95% CI: 5.5 to 28.2, P<0.0001). The odds ratio remained significant also when only non-smokers were considered (51 subjects) (OR: 7.0:1, 95% CI: 2.0 to 24.3, P<0.01).

    CONCLUSIONS: Our findings suggest that patients who at routine dental visits demonstrate evidence of bone loss around several teeth can predictably be identified as being at risk for future AMI. Such subjects should be referred for medical and periodontal examinations and treatments.

  • 191.
    Persson, G. Rutger
    et al.
    University of Washington, Seattle, WA, USA.
    Persson, R E
    University of Washington, Seattle, WA, USA.
    MacEntee, C I
    University of British Columbia, Vancouver, BC, Canada.
    Wyatt, C C I I
    University of British Columbia, Vancouver, BC, Canada.
    Hollender, L G
    University of Washington, Seattle, WA, USA.
    Kiyak, H A
    University of Washington, Seattle, WA, USA.
    Periodontitis and perceived risk for periodontitis in elders with evidence of depression.2003Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 8, s. 691-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Depression and periodontitis are common conditions in older adults. There is some evidence that these two conditions may be related.

    AIMS: To study a population of dentate elders and assess the prevalence of depression, self-assessment of risk for periodontitis and tooth loss, in relation to periodontal disease status.

    MATERIAL AND METHODS: Data were obtained from 701 older subjects (mean age 67.2 years (SD+/-4.6), of whom 59.5% were women. Self-reports of a diagnosis of depression, scores of the Geriatric Depression Scale (GDS), and self-assessment of risk for future tooth loss and periodontitis were compared with a diagnosis of periodontitis based on probing depth, and bone loss assessed from panoramic radiographs. Other systemic diseases and smoking habits were also determined and studied in relation to depression.

    RESULTS: A history of depression was reported by 20% of the subjects. GDS scores >/=8 were reported by 9.8% of the elders. Periodontitis was identified in 48.5% of the subjects. Depression was associated with heart attack (p<0.05), stroke (p<0.01), high blood pressure (p<0.02), all combined cardiovascular diseases (p<0.001), chronic pain (p<0.01), osteoarthritis (p<0.001), and osteoporosis (p< 0.001) but not with periodontitis (p=0.73). Subjects with depression had a higher self-reported risk score for future tooth loss (p<0.02). No group difference emerged for self-perceived risk for periodontitis. Logistic regression analysis demonstrated that a past history of tooth loss (p<0.001), self-perceived risk for periodontitis (p<0.02), the number of years with a smoking habit (p<0.02), and male gender (p<0.02) were associated with a diagnosis of periodontitis but neither measure of depression could be included in an explanatory model for periodontitis.

    CONCLUSIONS: Evidence of depression (self-report or by GDS) is not associated with risk for periodontitis in older subjects but is associated with tooth loss and chronic conditions associated with pain.

  • 192.
    Persson, G. Rutger
    et al.
    Department of Periodontics, University of Washington, Seattle, WA.
    Persson, Rigmor E
    Department of Oral Medicine, University of Washington.
    Hollender, Lars G
    Department of Oral Medicine, University of Washington.
    Kiyak, H Asuman
    Department of Oral and Maxillofacial Surgery, University of Washington.
    The impact of ethnicity, gender, and marital status on periodontal and systemic health of older subjects in the Trials to Enhance Elders' Teeth and Oral Health (TEETH).2004Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 75, nr 6, s. 817-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Few studies have examined the association between periodontitis risk, gender, and marital status in older adults. The purpose of this study was to assess if the oral health status of older subjects could be explained by differences in: 1) marital status; 2) gender; and 3) ethnicity.

    METHODS: Clinical and radiographic periodontal oral conditions were studied in 701 older subjects from the TEETH clinical trial. Medical conditions as well as ethnic and marital status and smoking habits were considered.

    RESULTS: A total of 89 married couples were identified; 40.7% of these were of European descent and 48.1% of Chinese descent. The mean age was 67.7 years (SD +/- 4.7). The men were older than the women (mean difference: 1.5 years, SD +/- 4.6, 95% confidence interval [CI]: 0.5 to 2.5, P<0.01). No significant differences in periodontal conditions were found between spouses or by marital status. Chinese descent was associated with a higher risk for periodontitis, regardless of marital status (odds ratio: 1.5, 95% CI: 1.05 to 2.04, P<0.03).

    CONCLUSIONS: 1) Married couples have similar social habits, similar oral health perceptions, and similar patterns of periodontal disease. 2) Dental studies including married couples do not bias data for married subjects as such. 3) Marital status has a limited impact on periodontal health but may have a greater impact on several systemic conditions, especially in widowed, divorced, or never married women. 4) Older Chinese subjects perceive themselves as being at lower risk for periodontitis but have more objective signs of periodontitis than older subjects of European descent.

  • 193.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Persson, Rigmor Elisabeth
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Cardiovascular disease and periodontitis: an update on the associations and risk2008Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, nr 8 Suppl, s. 362-379Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Associations between periodontitis and cardiovascular diseases have been recognized.

    MATERIAL AND METHODS: New literature since the last European Workshop on Periodontology has been reviewed.

    RESULTS: The lack of reliable epidemiological data on disease prevalence makes an assessment of the associations and risks between periodontitis and cardiovascular diseases difficult. Two recent meta-analysis reports have identified associations between periodontitis and cardiovascular diseases (odds ratios: 1.1-2.2). Different surrogate markers for both disease entities, including serum biomarkers, have been investigated. Brachial artery flow-mediated dilatation, and carotid intima media thickness have in some studies been linked to periodontitis. Studies are needed to confirm early results of improvements of such surrogate markers following periodontal therapy. While intensive periodontal therapy may enhance inflammatory responses and impair vascular functions, studies are needed to assess the outcome of periodontal therapies in subjects with confirmed cardiovascular conditions. Tooth eradication may also reduce the systemic inflammatory burden of individuals with severe periodontitis. The role of confounders remain unclear.

    CONCLUSIONS: Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case-control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.

  • 194.
    Persson, G. Rutger
    et al.
    University of Bern.
    Pettersson, T.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Periodontitis a future risk for acute coronary syndrome?: a follow up study over 3 years2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 33-33Konferensbidrag (Refereegranskat)
    Abstract [en]

    Aims: To assess whether recurrence of acute coronary syndrome (ACS) can be linked to periodontitis in subjects followed over a 3 year period. Methods and results: Consecutive 163 hospital admitted subjects with ACS, and 158 medically healthy matched control subjects were followed through medical records review over 3 years. At baseline, subjects received medical and dental examinations. Periodontitis was defined as alveolar bone loss (ABL) > 2 S.D. above normal mean values. Subgingival bacterial samples were collected and processed by checkerboard DNA–DNA hybridization. ACS recurrence was found in 66/163 (40.5%) subjects, and a first ACS event in 7/158 (4.4%) control subjects. ABL was a risk marker of future ACS with OR: 3.6 (95%CI: 2.0-6.5, P < 0.001). Subject age was also an explanatory factor for a new ACS event (P < 0.001). Significantly higher subgingival bacterial counts for 20/37 species (i.e., Streptococcus anginosus, Streptococcus mitis, Tannerella forsythia) in ACS cases than in healthy controls. None of traditional serum markers (CRP, high and low density lipoprotein, cholesterol, triglycerides) were explanatory. Conclusions: Age, and periodontitis (ABL) are robust markers of risk for future ACS. Subgingival bacterial counts are elevated in subjects with ACS.

  • 195.
    Persson, G. Rutger
    et al.
    Departments of Periodontics and Oral Medicine, University of Washington, Seattle, WA, USA & Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Pettersson, Thomas
    Department of Medicine, Kristianstad Central Hospital, Kristianstad, Sweden.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Department of Medicine, Kristianstad Central Hospital, Kristianstad, Sweden.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    High-sensitivity serum C-reactive protein levels in subjects with or without myocardial infarction or periodontitis.2005Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, nr 3, s. 219-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Serum high-sensitivity C-reactive protein (hsC-rp) is a non-specific marker of inflammation. Elevated hsC-rp levels are found in subjects with cardiovascular diseases (CVDs). Periodontitis may influence hsC-rp levels.

    OBJECTIVES: To assess periodontal status and hsC-rp serum levels in consecutive subjects hospitalized and diagnosed with acute myocardial infarction (AMI) (n=85) and in a group of carefully matched subjects (gender, age social, ethnic, and smoking habits) without clinical evidence of CVD (n=63).

    METHODS: hsC-rp levels, other routine serum values, and clinical periodontal conditions were studied.

    RESULTS: Subjects with AMI had higher hsC-rp levels than control subjects (p<0.001, Mann-Whitney U-test). The odds that subjects in the control group with periodontitis (30% or more sites with>4.0 mm loss of alveolar bone) had serum hsC-rp>1.8 mg/l was 1.5 (95% CI: 1.1-7.3, p<0.05). Stepwise linear regression analysis failed to include periodontal parameters in an explanatory model to hsC-rp values. Only the serum leucocyte (white blood cell (WBC)) counts were explanatory to hsC-rp values (beta standard coefficient=0.45, t=3.2, p<0.001). Serum WBC counts were significantly higher in control subjects with periodontitis (p<0.03) but not in subjects in the AMI group (p<0.57).

    CONCLUSIONS: (1) As expected, elevated serum hsC-rp concentration and serum WBC counts are associated with acute coronary heart disease. (2) Elevated serum hsC-rp values are associated with radiographically defined periodontitis in subjects with no evidence of CVD. (3) Periodontal parameters are not explanatory to elevated serum hsC-rp values if serum WBC and low-density lipoprotein counts are included in the regression model.

  • 196.
    Persson, G. Rutger
    et al.
    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.
    Cluster of bacteria associated with peri-implantitis2014Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 16, nr 6, s. 783-793Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Information on the microbiota in peri-implantitis is limited. We hypothesized that neither gender nor a history of periodontitis/smoking or the microbiota at implants differ by implant status.

    Materials and Methods Baseline microbiological samples collected at one implant in each of 166 participants with peri-implantitis and from 47 individuals with a healthy implant were collected and analyzed by DNA–DNA checkerboard hybridization (78 species). Clinical and radiographic data defined implant status.

    Results Nineteen bacterial species were found at higher counts from implants with peri-implantitis including Aggregatibacter actinomycetemcomitans, Campylobacter gracilis, Campylobacter rectus, Campylobacter showae, Helicobacter pylori, Haemophilus influenzae, Porphyromonas gingivalis, Staphylococcus aureus, Staphylococcus anaerobius, Streptococcus intermedius, Streptococcus mitis, Tannerella forsythia, Treponema denticola, and Treponema socranskii (p < .001). Receiver operating characteristic curve analysis identified T. forsythia, P. gingivalis, T. socranskii, Staph. aureus, Staph. anaerobius, Strep. intermedius, and Strep. mitis in peri-implantitis comprising 30% of the total microbiota. When adjusted for gender (not significant [NS]), smoking status (NS), older age (p = .003), periodontitis history (p < .01), and T. forsythia (likelihood ratio 3.6, 95% confidence interval 1.4, 9.1, p = .007) were associated with peri-implantitis.

    Conclusion A cluster of bacteria including T. forsythia and Staph. aureus are associated with peri-implantitis.

  • 197.
    Persson, G. Rutger
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Roos-Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Microbiologic results after non-surgical erbium-doped yttrium, aluminum, and garnet laser or air-abrasive treatment of peri-implantitis2011Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 82, nr 9, s. 1267-1278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The purpose of this study is to assess clinical and microbiologic effects of the non-surgical treatment of peri-implantitis lesions using either an erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser or an air-abrasive subgingival polishing method. Methods: In a 6-month clinical trial, 42 patients with peri-implantitis were treated at one time with an Er: YAG laser or an air-abrasive device. Routine clinical methods were used to monitor clinical conditions. Baseline and 6-month intraoral radiographs were assessed with a software program. The checkerboard DNA-DNA hybridization method was used to assess 74 bacterial species from the site with the deepest probing depth (PD) at the implant. Non-parametric tests were applied to microbiology data. Results: PD reductions (mean +/- SD) were 0.9 +/- 0.8 mm and 0.8 +/- 0.5 mm in the laser and air-abrasive groups, respectively (not significant). No baseline differences in bacterial counts between groups were found. In the air-abrasive group, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus anaerobius were found at lower counts at 1 month after therapy (P<0.001) and with lower counts in the laser group for Fusobacterium nucleatum naviforme (P=0.002), and Fusobacterium nucleatum nucleatum (P=0.002). Both treatments failed to reduce bacterial counts at 6 months. Porphyromonas gingivalis counts were higher in cases with progressive peri-implantitis (P<0.001). Conclusions: At 1 month, P. aeruginosa, S. aureus, and S. anaerobius were reduced in the air-abrasive group, and Fusobacterium spp. were reduced in the laser group. Six-month data demonstrated that both methods failed to reduce bacterial counts. Clinical improvements were limited.

  • 198.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Salvi, Giovanni E
    University of Berne, Berne, Switzerland.
    Heitz-Mayfield, Lisa J A
    University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    University of Berne, Berne, Switzerland.
    Antimicrobial therapy using a local drug delivery system (Arestin) in the treatment of peri-implantitis. I: Microbiological outcomes2006Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 17, nr 4, s. 386-393Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To assess the microbiological outcome of local administration of minocycline hydrochloride microspheres 1 mg (Arestin) in cases with peri-implantitis and with a follow-up period of 12 months.

    MATERIAL AND METHODS: After debridement, and local administration of chlorhexidine gel, peri-implantitis cases were treated with local administration of minocycline microspheres (Arestin). The DNA-DNA checkerboard hybridization method was used to detect bacterial presence during the first 360 days of therapy.

    RESULTS: At Day 10, lower bacterial loads for 6/40 individual bacteria including Actinomyces gerensceriae (P<0.1), Actinomyces israelii (P<0.01), Actinomyces naeslundi type 1 (P<0.01) and type 2 (P<0.03), Actinomyces odontolyticus (P<0.01), Porphyromonas gingivalis (P<0.01) and Treponema socranskii (P<0.01) were found. At Day 360 only the levels of Actinobacillus actinomycetemcomitans were lower than at baseline (mean difference: 1x10(5); SE difference: 0.34x10(5), 95% CI: 0.2x10(5) to 1.2x10(5); P<0.03). Six implants were lost between Days 90 and 270. The microbiota was successfully controlled in 48%, and with definitive failures (implant loss and major increase in bacterial levels) in 32% of subjects.

    CONCLUSIONS: At study endpoint, the impact of Arestin on A. actinomycetemcomitans was greater than the impact on other pathogens. Up to Day 180 reductions in levels of Tannerella forsythia, P. gingivalis, and Treponema denticola were also found. Failures in treatment could not be associated with the presence of specific pathogens or by the total bacterial load at baseline. Statistical power analysis suggested that a case control study would require approximately 200 subjects.

  • 199.
    Persson, G. Rutger
    et al.
    Department of Periodontology, Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Samuelsson, Emelie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Mechanical non-surgical treatment of peri-implantitis: a single-blinded randomized longitudinal clinical study. II. Microbiological results2010Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, nr 6, s. 563-573Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    P>Background Peri-implantitis is common in patients with dental implants. We performed a single-blinded longitudinal randomized study to assess the effects of mechanical debridement on the peri-implant microbiota in peri-implantitis lesions. Materials and Methods An expanded checkerboard DNA-DNA hybridization assay encompassing 79 different microorganisms was used to study bacterial counts before and during 6 months following mechanical treatment of peri-implantitis in 17 cases treated with curettes and 14 cases treated with an ultrasonic device. Statistics included non-parametric tests and GLM multivariate analysis with p < 0001 indicating significance and 80% power. Results At selected implant test sites, the most prevalent bacteria were: Fusobacterium nucleatum sp., Staphylococci sp., Aggregatibacter actinomycetemcomitans, Helicobacter pylori, and Tannerella forsythia. 30 min. after treatment with curettes, A. actinomycetemcomitans (serotype a), Lactobacillus acidophilus, Streptococcus anginosus, and Veillonella parvula were found at lower counts (p < 0.001). No such differences were found for implants treated with the ultrasonic device. Inconsistent changes occurred following the first week. No microbiological differences between baseline and 6-month samples were found for any species or between treatment study methods in peri-implantitis. Conclusions Both methods failed to eliminate or reduce bacterial counts in peri-implantitis. No group differences were found in the ability to reduce the microbiota in peri-implantitis.

  • 200.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA & University of Washington.
    Weibel, Marianne
    University of Bern, Bern, Switzerland.
    Hirschi, Regula
    University of Bern, Bern, Switzerland.
    Katsoulis, Joannis
    University of Bern.
    Similarities in the subgingival microbiota assessed by a curet sampling method at sites with chronic periodontitis.2008Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, nr 12, s. 2290-2296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The goal of this study was to determine whether site-specific differences in the subgingival microbiota could be detected by the checkerboard method in subjects with periodontitis.

    METHODS: Subjects with at least six periodontal pockets with a probing depth (PD) between 5 and 7 mm were enrolled in the study. Subgingival plaque samples were collected with sterile curets by a single-stroke procedure at six selected periodontal sites from 161 subjects (966 subgingival sites). Subgingival bacterial samples were assayed with the checkerboard DNA-DNA hybridization method identifying 37 species.

    RESULTS: Probing depths of 5, 6, and 7 mm were found at 50% (n = 483), 34% (n = 328), and 16% (n = 155) of sites, respectively. Statistical analysis failed to demonstrate differences in the sum of bacterial counts by tooth type (P = 0.18) or specific location of the sample (P = 0.78). With the exceptions of Campylobacter gracilis (P <0.001) and Actinomyces naeslundii (P <0.001), analysis by general linear model multivariate regression failed to identify subject or sample location factors as explanatory to microbiologic results. A trend of difference in bacterial load by tooth type was found for Prevotella nigrescens (P <0.01). At a cutoff level of > or = 1.0 x 10(5), Porphyromonas gingivalis and Tannerella forsythia (previously T. forsythensis) were present at 48.0% to 56.3% and 46.0% to 51.2% of sampled sites, respectively.

    CONCLUSIONS: Given the similarities in the clinical evidence of periodontitis, the presence and levels of 37 species commonly studied in periodontitis are similar, with no differences between molar, premolar, and incisor/cuspid subgingival sites. This may facilitate microbiologic sampling strategies in subjects during periodontal therapy.

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