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  • 201.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Yeates, Justin
    Persson, Rigmor E
    Hirschi-Imfeld, Regula
    Weibel, Marianne
    Kiyak, H Asuman
    The impact of a low-frequency chlorhexidine rinsing schedule on the subgingival microbiota (the TEETH clinical trial).2007In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 78, no 9, p. 1751-1758Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Information on the efficacy of chlorhexidine (CHX) rinsing on the subgingival microbiota is limited. This study tested if intermittent CHX rinsing over 5 years had an impact on the subgingival microbiota.

    METHODS: Subgingival plaque samples were analyzed by the checkerboard DNA-DNA hybridization method in a double-blind randomized CHX rinse study.

    RESULTS: A total of 210 subjects were included. The mean age of the subjects was 71.7 (+/- 4.1) years, and 56.2% were women. Evidence of alveolar bone loss was found in 39% of subjects. Bacterial loads were not correlated significantly with probing depth. At year 5, subjects in the CHX rinse group with no evidence of bone loss presented with lower total bacterial counts than control subjects with no bone loss. The levels of the following bacteria were significantly lower in the CHX group: Lactobacillus acidophilus (P <0.05), Eikenella corrodens (P <0.05), Fusobacterium nucleatum sp. nucleatum (P <0.01), Treponema denticola (P <0.05), Leptotrichia buccalis (P <0.05), and Eubacterium saburreum (P <0.05). No differences in bacterial loads were found between CHX and control rinse subjects with alveolar bone loss.

    CONCLUSIONS: Older subjects with or without periodontitis carry a large variety of bacteria associated with periodontitis. Intermittent rinsing with CHX may provide a preventive benefit in reducing levels of bacteria but only in subjects without alveolar bone loss.

  • 202.
    Persson, G.Rutger
    Kristianstad University, School of Health and Society.
    The significance of periodontal inflammation on systemic health in old age2012In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 29, no 3, p. 169-170Article in journal (Other academic)
  • 203.
    Persson, Maja
    Kristianstad University, School of Health and Society.
    Probiotikas påverkan på parodontala sjukdomar: en allmän litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna litteraturstudie var att undersöka vilka effekter probiotika kan ha vid behandling av parodontala sjukdomar.  Metoden som användes var en kvantitativ allmän litteraturstudie.  Sökningar till litteraturstudien gjordes i databasen PubMed under mars månad 2015.  Litteraturstudiens resultat sammanställdes utifrån åtta vetenskapliga artiklar.  Litteraturstudien visar att behandling av gingivit med hjälp av mekanisk parodontal behandling i kombination med probiotika hade positiva effekter i form av minskning av inflammatoriska mediatorer, reduktion av mängd gingival vätska och reduktion av blödningsindex.  Vid kronisk parodontit visade behandling med probiotika i kombination med mekanisk behandling positiva effekter på reduktion av plackindex, minskning av blödningsindex och fickdjupreduktion.  Probiotika i kombination med parodontal behandling skulle kunna ge goda behandlingsresultat.  Kunskapen om effekten av probiotika som tillägg till mekanisk parodontal behandling är allt för begränsad och delvis motstridig för att kunna ge patienterna någon behandlingsrekommendation.  Det krävs mer forskning. 

  • 204.
    Persson, Malin
    et al.
    Kristianstad University, School of Health and Society.
    Bölja, Lina
    Kristianstad University, School of Health and Society.
    Vet personer som besöker en folktandvårdsklinik vad en tandhygienist gör?: – en kvantitativ studie2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Dental hygienist is a relatively new profession and the profession has existed in Sweden for about 40 years. During this time it has gone through major changes. In the beginning, dental hygienists only treated people who were referred by a dentist. These factors may have resulted in that visitors to public dental clinics not always knowing what a dental hygienist does.

    The aim of this study was to investigate if people who visited public dental clinics know what a dental hygienist does.

    An empirical study was carried out using a questionnaire containing 22 multiple-choice questions. In total 150 questionnaires were answered by visitors to three public dental clinics within Blekinge county. The sample method used was consecutive. The authors asked people 16 years and older, in the order in which they arrived at the clinic, if they would participate in the study.

    The majority of the participants were aware that dental hygienists carry out examinations independently, inform and work preventively. The participants were unclear that dental hygienists could diagnose and treat periodontal disease.

    The conclusion of the study is that visitors to public dental clinics do not know entirely what a dental hygienist does.

  • 205.
    Persson, Rigmor E
    et al.
    University of Washington, Seattle, WA, USA.
    Hollender, L G
    University of Washington, Seattle, WA, USA.
    MacEntee, M I
    University of British Columbia. Vancouver B.C., Canada.
    Wyatt, C C L
    University of British Columbia. Vancouver B.C., Canada.
    Kiyak, H A
    University of Washington, Seattle, WA, USA.
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA.
    Assessment of periodontal conditions and systemic disease in older subjects.: Focus on diabetes mellitus2003In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, no 3, p. 207-13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An increased risk for periodontitis has been associated both with type-1 or insulin dependent diabetes (IDDM) and with type-2 or non-insulin dependent diabetes (NIDDM).

    AIMS: 1) To describe and analyze periodontal conditions in older low-income ethnic diverse subjects with or without a diagnosis of diabetes. 2) To assess to what extent diabetes mellitus is associated with periodontal status, and 3) how periodontitis ranks as a coexisting disease among other diseases in subjects with diabetes mellitus.

    MATERIAL AND METHODS: Radiographic signs of alveolar bone loss were studied in 1101 older subjects 60-75 years old (mean age 67.6, SD+/-4.7). The number of periodontal sites and the proportions of teeth with probing depth (PD) > or =5 mm, clinical attachment levels (CAL) > or =4 mm were studied in a subset of 701 of the subjects.

    RESULTS: IDDM was reported by 2.9% and NIDDM by 9.2% of the subjects. The number of remaining teeth did not differ by diabetic status. The number of sites with PD > or =5 mm and the proportion of PD with > or =5 mm was significantly smaller in the non-diabetic group (chi2=46.8, p<0.01, and chi2=171.1, p<0.001, respectively). Statistical analysis failed to demonstrate group differences for the number and proportions of sites with CAL > or =4 mm and for radiographic findings of alveolar bone loss. Combining all periodontal parameters revealed that the Mantel-Haenszel common odds of having IDDM/NIDDM and periodontitis was 1.8 : 1 (95% CI: 1.1-3.1, p<0.03). The common odds ratio estimate of an association between heart disease and diabetes was 3.6 : 1 (95% CI: 2.1-2.6, p<0.001).

    CONCLUSIONS: Probing depth differences between IDDM/NIDDM vs. non-diabetic subjects may reflect the presences of pseudo-pockets and not progressive periodontitis in many subjects with diabetes mellitus. Periodontitis is not a predominant coexisting disease in older subjects with diabetes mellitus.

  • 206. Persson, Rigmor E
    et al.
    Hollender, L G
    Powell, L V
    MacEntee, M I
    Wyatt, C C L
    Kiyak, H A
    Persson, G. Rutger
    University of Washington.
    Assessment of periodontal conditions and systemic disease in older subjects. I. Focus on osteoporosis.2002In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 9, p. 796-802Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Osteoporosis (OPOR) is a common chronic disease, especially in older women. Patients are often unaware of the condition until they experience bone fractures. Studies have suggested that OPOR and periodontitis are associated diseases and exaggerated by cytokine activity. Panoramic radiography (PMX) allows studies of mandibular cortical index (MCI), which is potentially diagnostic for OPOR.

    AIMS: i). To study the prevalence of self-reported history of OPOR in an older, ethnically diverse population, ii). to assess the agreement between PMX/MCI findings and self-reported OPOR, and iii). to assess the likelihood of having both a self-reported history of OPOR and a diagnosis of periodontitis.

    MATERIALS AND METHODS: PMX and medical history were obtained from 1084 subjects aged 60-75 (mean age 67.6, SD +/- 4.7). Of the films, 90.3% were useful for analysis. PMXs were studied using MCI. The PMXs were used to grade subjects as not having periodontitis or with one of three grades of periodontitis severity.

    RESULTS: A positive MCI was found in 38.9% of the subjects, in contrast to 8.2% self-reported OPOR. The intraclass correlation between MCI and self-reported OPOR was 0.20 (P < 0.01). The likelihood of an association between OPOR and MCI was 2.6 (95%CI: 1.6, 4.1, P < 0.001). Subjects with self-reported OPOR and a positive MCI had worse periodontal conditions (P < 0.01). The Mantel-Haentzel odds ratio for OPOR and periodontitis was 1.8 (95%CI: 1.2, 2.5, P < 0.001).

    CONCLUSIONS: The prevalence of positive MCI was high and consistent with epidemiological studies, but only partly consistent with a self-reported history of osteoporosis with a higher prevalence of positive MCI in Chinese women. Horizontal alveolar bone loss is associated with both positive self-reported OPOR and MCI.

  • 207.
    Persson, Rigmor E
    et al.
    University of Washington, Seattle, WA, USA,.
    Hollender, L G
    University of Washington, Seattle, WA, USA,.
    Powell, V L
    Private practice Ukia, CA, USA.
    MacEntee, M
    University of British Columbia, Vancouver B.C., Canada.
    Wyatt, C C L
    University of British Columbia, Vancouver B.C., Canada.
    Kiyak, H A
    University of Washington, Seattle, WA, USA,.
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA,.
    Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases.2002In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 9, p. 803-10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Panoramic radiographs (PMX)s may provide information about systemic health conditions.

    AIMS: i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters.

    MATERIAL AND METHODS: PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs.

    RESULTS: The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P < 0.01). Heart attacks were reported by 12% of men in Seattle and 7.2% in Vancouver (N.S.). PMX evidence of periodontitis was found in 48.5% of the subjects, with carotid calcification in 18.6%. The intraclass correlation score for PMX findings of carotid calcification and stroke was 0.24 (95% CI: 0.10-0.35, P < 0.001). The odds ratio for PMX carotid calcification and periodontitis was 2.1 (95% CI: 1.3-3.2, P < 0.001), and for PMX carotid calcification and stroke 4.2 (95% CI: 1.9-9.1, P < 0.001). The associations disappeared when smoking was accounted for. A history of a heart attack was associated with stroke, gender, age, and PMX scores of alveolar bone loss.

    CONCLUSIONS: PMXs may provide valuable information about both oral conditions and signs of carotid calcification, data that are consistent with self-reported health conditions. Alveolar bone loss as assessed from PMXs is associated with cardiovascular diseases.

  • 208. Persson, Rigmor E
    et al.
    Kiyak, Asuman H
    Wyatt, Chris C I
    Macentee, Michael
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA & University of Berne, Berne, Switzerland.
    Smoking, a weak predictor of periodontitis in older adults.2005In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, no 5, p. 512-517Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The impact of smoking habits on periodontal conditions in older subjects is poorly studied.

    AIMS: To assess if a history of smoking is associated with chronic periodontitis and medical history in older subjects.

    MATERIAL AND METHODS: The medical and dental history was collected from 1084 subjects 60-75 years of age. Smoking history information was obtained from self-reports. Periodontal variables [clinical probing depth (PD)>/=5.0 mm, clinical attachment levels (CALs) >/=4.0 mm], and radiographic evidence of alveolar bone loss were assessed.

    RESULTS: 60.5% had never smoked (NS), 32.0% were former smokers (FS) (mean smoke years: 26.1 years, SD+/-13.1), and 7.5% were current smokers (CS) (mean smoke years 38.0 years, (SD+/-12.1). The proportional distribution of CAL >/=4.0 mm differed significantly by smoking status (NS and CS groups) (mean difference: 12.1%, 95% confidence interval (CI): 1.5-22.6, p<0.02). The Mantel-Haenszel common odds ratio between smoking status (CS+FS) and periodontitis (>20% bone loss) was 1.3 (p<0.09, 95% CI: 0.9-2.0) and changed to 1.8 (p<0.02, 95% CI: 1.3-2.7) with 30 years of smoking as cutoff. A weak correlation between number of years of smoking and CAL>/=4.0 mm was demonstrated (r(2) values 0.05 and 0.07) for FS and CS, respectively. Binary logistic forward (Wald) regression analysis demonstrated that the evidence of carotid calcification, current smoking status, gender (male), and the number of remaining teeth were explanatory to alveolar bone loss.

    CONCLUSIONS: A clinically significant impact on periodontal conditions may require 30 years of smoking or more. Tooth loss, radiographic evidence of carotid calcification, current smoking status, and male gender can predictably be associated with alveolar bone loss in older subjects.

  • 209.
    Persson, Rutger G
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Washington University, USA.
    Dental geriatrics and periodontitis2017In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 74, no 1, p. 102-115Article, review/survey (Refereed)
    Abstract [en]

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

  • 210.
    Petersson, Sara
    Kristianstad University, School of Health and Society.
    Oral hälsa hos personer som tidigare drabbats av stroke2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Stroke is the third most common cause of death, and in Sweden approximately 30 000 people are affected every year. Worldwide, about 6.2 million people die each year by the cause of stroke. The purpose of this literature study was to investigate the occurrence of problems related to oral health in individuals with a history of stroke. The study was carried out as a literature review. The data was collected through searches in the databases “PubMed” and “Science Direct”. There has also been a manual search and the final result was based on a statement made from ten scientific articles.

    The result showed that many studies have found an association between increased occurrences of periodontitis in individuals with a history of stroke. There is no statistically significant association of increased caries reported. Difficulties in chewing, eating, swallowing, speaking clearly and maintaining good oral hygiene was a problem related to oral health which often occurred. Individuals with stroke were unhappy with the appearance of their teeth and considered themselves to have poorer oral health-related quality of life compared to the control group.

    The conclusion of this study is that problems with oral health are common in individuals who suffered a stroke. More research is needed to determine if there is a relationship between individuals who suffered a stroke and dental caries and periodontal disease.

  • 211.
    Pezoa, Marcello
    Kristianstad University, School of Health and Society.
    Kostvanor som har betydelse för karies: en jämförelse mellan elever vid yrkesinriktade och högskoleförberedande gymnasieprogram2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to examine differences in dietary habits that have significance for the development of caries between youths at professional- respectively higher educational preparatory high school programs. A survey with 32 questions was conducted at two high schools in southern Sweden. The schools should have hade professional- and higher educational preparatory high school programs. Sixty students from each high school orientation would be included in the study. A total of 143 students >16 yearswere invited to participate from two schools. The result is based on 118 answered surveys, 60 from the professional- and 58 from the higher educational preparatory high school programs. Individuals that studied at the higher educational preparatory high school programs ate in greater numbers breakfast (p=0.009) and school lunch (p=0.003) daily and shopped more rarely at the school kiosk or nearby grocery store (p=0.000). They also drank coffee with sugar more rarely under school time, (p=0.006), drank juice more rarely at home (p=0.009) and ate potato chips or cheese doodles more rarely at home (p=0.044).The conclusion of this study is that there were differences between high school students at the professional- and higher educational preparatory high school programs with regards to breakfast- and school lunch habits. Few differences existed otherwise between both high school orientations regarding consumption of products that could have significance for the development caries. 

  • 212.
    Polyzois, Ioannis
    et al.
    Department of Periodontology, Dublin Dental Hospital.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Bosshardt, Dieter D.
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne.
    Lang, Niklaus P.
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne.
    Claffey, Noel
    Department of Periodontology, Dublin Dental Hospital.
    Effect of Bio-Oss (R) on osseointegration of dental implants surrounded by circumferential bone defects of different dimensions: an experimental study in the dog2007In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 18, no 3, p. 304-310Article in journal (Refereed)
    Abstract [en]

    Objectives: This study was designed to evaluate the effect of gap width and graft placement on bone healing around implants placed in simulated extraction sockets of various widths in four Labrador dogs. Materials and Methods: Five Osseotite (R) implants per dog were placed in the mandible of four dogs. Two implants were inserted into sites with a 2.37 mm and two with a 1 mm gap present between the implants and bone around the coronal 6 mm of the implants in each dog. For one of each gap sizes, the gap was filled with Bio-Oss (R), and the other two with blood alone. A fifth implant was inserted without a gap and used as a control. Ground sections were prepared from biopsies taken at 4 months and histometric measurements of osseointegration and bone between the threads made for the coronal 6 mm. Results: The medians for osseointegration ranged from 5.2 mm for control to 1-2.6 mm for the test modalities. There were significant differences for linear measurements of osseointegration ((2)(chi) 18.27; df 4; P = 0.0011) and bone area within threads (chi(2) 23.4; df 4; P = 0.0001) between test modalities. Conclusions: The results suggest that the wider the gap around the implants, the less favourable the histological outcome at short time intervals following treatment. They also infer that bone grafting with anorganic bovine bone xenograft seems to lead to a more favourable histological outcome for wider circumferential defects but not for narrower defects.

  • 213. Pradhan-Palikhe, Pratikshya
    et al.
    Mäntylä, Päivi
    Paju, Susanna
    Buhlin, Kåre
    Persson, G. Rutger
    University of Washington, Seattle, WA & University of Bern, Bern, Switzerland.
    Nieminen, Markku S
    Sinisalo, Juha
    Pussinen, Pirkko J
    Subgingival bacterial burden in relation to clinical and radiographic periodontal parameters.2013In: Journal of periodontology, ISSN 1943-3670, Vol. 84, no 12, p. 1809-1817Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This cross-sectional study characterizes the association between subgingival bacterial profile and periodontal parameters in patients assigned to coronary angiography because of cardiologic problems, which may affect the oral microbiota.

    METHODS: Pooled subgingival bacterial samples were collected from 477 dentate individuals during the oral examinations, along with periodontal probing depth (PD) and assessments of bleeding on probing (BOP) and radiographic alveolar bone loss (ABL). The checkerboard DNA-DNA hybridization assay was used to determine the levels of 29 oral bacteria, which were divided into three bacterial complexes.

    RESULTS: All bacterial combinations from the etiologic bacterial group and each species from the red complex were significantly associated (P <0.001) with grade of ABL. The prevalence of the etiologic bacterial group and the level of each species were also associated strongly with the proportion of sites with PD 4 to 5 mm and ≥ 6 mm, BOP, and ABL, except Aggregatibacter actinomycetemcomitans. Levels of Gram-negative oral bacteria correlated significantly with those of Gram-positive species (r = 0.840, P <0.001). In multiple logistic regression analysis, the prevalence of the etiologic bacterial group, levels of Gram-negative bacteria and Treponema denticola, and the prevalence of Porphyromonas gingivalis and T. denticola associated significantly with ABL, whereas other bacterial complexes and levels of Gram-positive species did not.

    CONCLUSIONS: Although levels of Gram-negative and -positive species paralleled periodontal parameters, only the species considered etiologic were associated with ABL.

  • 214.
    Prekadini, Njomze
    et al.
    Kristianstad University, School of Health and Society.
    Beciri Haziri, Lindita
    Kristianstad University, School of Health and Society.
    Patienters rökvanor, deras motivation till rökavvänjning samt om de har blivit tillfrågade om sina rökvanor av tandvårdspersonal2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    The aim of the present study was to examine smoking behaviour and motivation for smoking cessation in patients at a dental clinic. Another aim was to examine if the patients had been asked by the dental staff regarding their smoking habits.

    Twenty-two patients from a student clinic and twenty-one patients from a Swedish Public Dental Service Clinic in southern of Sweden participated in the study. Participants consisted of eighteen women and twenty-five men. Data collection was carried out using a questionnaire that was directed at smokers. The questionnaire was answered in connection with the visit to the dental hygienist.

    The patients smoked between eight and twelve cigarettes per day and had on average smoked between 5 -15 years. More than half of the patients started smoking because of pressure from friends. In the future the patients would consider quitting smoking to avoid oral health diseases. Most of the patients wanted to try without external aid. The general health and oral health was perceived as good, or very good by 43 respondents. The most common oral health problems were dry mouth, dark brown coating on the teeth and gingivitis.

    This survey shows that many of those who currently smoke started smoking because of their surroundings. Giving up smoking to avoid oral health diseases was very important / important to the respondents. The motivation for smoking cessation was different among the patients. It was difficult for many patients to stop smoking. The survey also showed that more dental hygienists than dentists asked their patients about smoking habits and informing them about smoking cessation.

  • 215.
    Prendergast, Virginia
    et al.
    Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix.
    Jakobsson, Ulf
    Center of Primary Health Care Research, Faculty of Medicine, Lund University.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Lund University.
    Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: results of a randomized controlled trial2012In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 44, no 3, p. 134-146Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n = 25) in intubated patients in a neuroscience ICU in a 2-year randomized clinical trial. Oral health was evaluated based on the Oral Assessment Guide (OAG) on enrollment, the day of extubation, and 48 hours after extubation. There were no significant differences in the frequency of the oral care protocol. Protocol compliance exceeded 91% in both groups. The total OAG score and all eight categories significantly deteriorated (Friedman test, p < .001, Bonferroni corrected) in the standard oral care group and did not return to baseline after extubation. Large effect sizes were present at all three points in this group. The total OAG score deteriorated during intubation within the comprehensive protocol group (Friedman test, p < .004) but returned to baseline status after extubation. In four categories, the ratings on tongue, mucous membranes, gingiva, and teeth did not deteriorate significantly over time. Published oral care protocols are substandard in promoting and maintaining oral health in intubated patients. A comprehensive oral care protocol, using a tongue scraper, an electrical toothbrush, and pharmacological moisturizers, was more effective for oral hygiene throughout intubation and after extubation than manual toothbrushing alone.

  • 216.
    Rantzow, Veronica
    et al.
    Vocational Education Helsingborg.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Research Platform for Collaboration for Health.
    Lindmark, Ulrika
    Jönköping University.
    Occurrence of oral health problems and planned measures in dependent older people in nursing care2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 23-24, p. 4381-4389Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE: The aim of the study was to describe oral health problems and planned measures in older people receiving nursing care.

    BACKGROUND: Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities.

    METHODS: Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014 and June 2015 were included. The Revised Oral Assessment Guide - the Jönköping (ROAG-J), was used routinely by nursing staff in nursing care facilities to measure oral health status.

    RESULTS: Oral assessments were made on 2567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%).

    CONCLUSION: Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care.

    RELEVANCE TO CLINICAL PRACTICE: The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes. This article is protected by copyright. All rights reserved.

  • 217.
    Ravon, Nicolas A
    et al.
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Hollender, Lars G
    School of Dentistry, University of Washington, Seattle, WA, USA.
    McDonald, Vanessa
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Persson, G. Rutger
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Signs of carotid calcification from dental panoramic radiographs are in agreement with Doppler sonography results.2003In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, no 12, p. 1084-1090Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Duplex ultrasonography (DS) is a frequently used noninvasive method for assessing carotid artery stenosis. The level of agreement between panoramic radiographs (PMX) findings of radiopacities in the area of C3-C4 and DS results has not been established.

    AIMS: (1) to examine the level of agreement between DS results and PMX signs of carotid calcification and (2) to evaluate the association between periodontitis and DS results.

    MATERIAL AND METHODS: Eighty-three subjects who had received a DS assessment at the University of Washington Medical Center within 36 months volunteered for a periodontal examination, including assessments of probing pocket depth (PPD), attachment level (PAL), evidence of bleeding on probing and bone loss from PMX. Two examiners independently analyzed the radiographs for evidence of carotid calcifications. The distance between the cemento-enamel junction (CEJ) to bone level (BL) CEJ-BL was used to assess alveolar bone loss as a criteria for periodontitis.

    RESULTS: Twenty-nine subjects (34.9%) presented with positive DS readings. The Mantel-Haentszel common odds ratio estimate for a positive DS score and periodontitis (> 30% of teeth with distance CEJ-BL > or = 4.0 mm) was 38.4 (95% CI: 10.6-138.7, p < 0.0001). For nonsmokers only (n = 72) the odds ratio was 43.0 (95% CI: 16.7-1178.0, p < 0.0001). Evidence of bleeding on probing was 16% of sites both in the DS-positive and -negative subjects. Subjects with a positive DS result had significantly more teeth with clinical evidence of attachment loss > or = 5.0 mm (p < 0.001). The odds ratio of having periodontitis (CEJ-BL > or = 4.0 mm at > or = 30% of the teeth) and medical records confirmed diagnosis of either a stroke or an infarct or both was 7.8 (95% CI: 2.6-23.8, p < 0.001).

    CONCLUSIONS: Subjects with positive DS readings of the carotid arteries due to calcified arterial plaque are accurately detected by means of conventional PMX. The likelihood of being DS positive and having radiographic evidence of periodontitis is high. A dose-response relationship between the extent of carotid calcification and severity of periodontitis was demonstrated, supporting the hypothesis of an association between periodontitis and cardiovascular diseases.

  • 218.
    Rejnefelt, Ingrid
    et al.
    Kristianstad University, School of Health and Society.
    Andersson, Pia
    Kristianstad University, Department of Health Sciences.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Oral health status in individuals with dementia living in special facilities2006In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 4, no 2, p. 67-71Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this review was to retrieve data describing the oral health status of individuals with dementia living in special facilities. MATERIALS AND METHODS: A literature search on the MEDLINE database (Entrez PubMed) was performed. The literature search yielded 208 papers, of which seven publications were selected for evaluation. Results: From the available studies poorer oral hygiene, decreased saliva flow rates and a higher caries incidence were reported in individuals with dementia living in special facilities when compared with healthy individuals. Oral health problems were more pronounced in the severe stage of the disease. CONCLUSIONS: There is limited scientific data describing the oral health status of individuals with dementia living in special facilities. However, available data indicate that individuals with dementia living in special facilities have more oral health problems than individuals without dementia.

  • 219.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Destructive periodontal disease in relation to diabetes mellitus, cardiovascular diseases, osteoporosis and respiratory diseases2003In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 1, no Suppl 1, p. 341-57; discussison 358Article in journal (Refereed)
  • 220.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och Folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Halitosis (Dålig andedräkt)2016Other (Other academic)
  • 221.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Infektioner vid implantat: mukosit och peri-implantit : diagnostik och behandling2009In: Aktuel nordisk odontologi, Köpenhamn: Munksgaard Forlag, 2009, p. 205-220Chapter in book (Other academic)
  • 222.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Infektioner vid implantat: mukosit och peri-implantit: diagnostik och behandling2009In: Aktuel nordisk odontologi 2009 / [ed] Holmstrup, Palle, København: Munksgaard , 2009, p. 205-220Chapter in book (Other academic)
  • 223.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Aghazadeh, Ahmad
    Uppsala Käkkirurgiska Centrum.
    Hallström, Hadar
    Hospital of Halland, Halmstad.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Factors related to peri-implantitis: a retrospective study2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 4, p. 522-529Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Retrospectively, we assessed the likelihood that peri-implantitis was associated with a history of systemic disease, periodontitis, and smoking habits.

    METHODS: Data on probing pocket depth (PPD), bleeding on probing (BOP), and radiographic bone levels were obtained from individuals with dental implants. Peri-implantitis was defined as described by Sanz & Chapple 2012. Control individuals had healthy conditions or peri-implant mucositis. Information on past history of periodontitis, systemic diseases, and on smoking habits was obtained.

    RESULTS: One hundred and seventy-two individuals had peri-implantitis (mean age: 68.2 years, SD ± 8.7), and 98 individuals (mean age: 44.7 years, SD ± 15.9) had implant health/peri-implant mucositis. The mean difference in bone level at implants between groups was 3.5 mm (SE mean ± 0.4, 95% CI: 2.8, 4.3, P < 0.001). A history of cardiovascular disease was found in 27.3% of individuals with peri-implantitis and in 3.0% of individuals in the implant health/peri-implant mucositis group. When adjusting for age, smoking, and gender, odds ratio (OR) of having peri-implantitis and a history of cardiovascular disease was 8.7 (95% CI: 1.9, 40.3 P < 0.006), and odds ratio of having a history of periodontitis was 4.5 (95% CI 2.1, 9.7, P < 0.001). Smoking or gender did not significantly contribute to the outcome.

    CONCLUSIONS: In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was expressed by a history of periodontitis and a history of cardiovascular disease.

  • 224.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Berglund, J.
    University of Blekinge.
    Opalinska, T.
    University of Blekinge.
    Persson, R. E.
    University of Bern.
    Persson, G. Rutger
    University of Bern.
    Heel DXA T-scores and panoramic radiographs in the prediction of hip and hand fractures2009In: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, p. 9-Conference paper (Refereed)
    Abstract [en]

    Introduction: We assessed if DXA (Dual Energy X-ray Absorptiometry) and panoramic radiographs were predictive of hip and or hand fractures over 3 years in older subjects. Methods: DXA heel measurements and mandibular panoramic bone scores (MPBS) from panoramic radiographs were performed in 418 women (mean age: 77.5 years, S.D ± 9.3 and 370 men (mean age: 76.4, S.D ± 9.5). Results: 4.5% subjects (34/788) had a hip and 3.7% (27/788) a hand fracture. A DXA T -score < - 2.5 (osteoporosis) in women and men was found in 16.3% and 8.1% respectively. Subjects with osteoporosis had fewer remaining teeth (mean diff: 4.4, 95% CI: 2.3–6.5, P < 0.001). A DXA T-score < -2.5 was predictive of a hip or hand fracture odds ratio 2.6:1(95%CI: 1.3-5.3, P < = 0.008). The odds ratio (OR) that a MPBS = 1 agreed with a DXA T-score <- 2.5 was 5.4:1 (95% CI: 2.6 – 11.4.2, P <0.001; Cochran c2 = 36.5, P < 0.001). The MPBS score = 1 had an OR of 3.3:1 (95%CI: 1.9–5.9, P < 0.001) in fracture prediction. Conclusions: The MPBS scores were consistent with the DXA T scores. Both methods have similar predictive value in assessing risk for future hip and hand fractures in older subjects. Subjects with osteoporosis had fewer remaining teeth.

  • 225.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona.
    Persson, Rigmor E.
    Department of Periodontology, University of Bern.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Osteoporosis and periodontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge)2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 4, p. 201-207Article in journal (Refereed)
    Abstract [en]

    Objective. We assessed the relationships between (I) ultrasonography calcaneus T-scores (PIXI) and mandibular cortex characteristics on oral panoramic radiographs in older subjects; and (II) osteoporosis and periodontitis. Material and methods. We examined 778 subjects (53% women) aged 59-96 years. Periodontitis was defined by alveolar bone loss assessed from panoramic radiographs. Results. PIXI calcaneus T-values <=-2.5 (osteoporosis) were found in 16.3% of women and in 8.1% of men. PIXI calcaneus T-values <-1.6 (osteoporosis, adjusted) were found in 34.2% of women and in 21.4% of men. The age of the subjects and PIXI T-values were significantly correlated in women (Pearson's r = 0.37, P < 0.001) and men (Pearson's r = 0.19, P < 0.001). Periodontitis was found in 18.7% of subjects defined by alveolar bone level >= 5 mm. Subjects with osteoporosis defined by adjusted PIXI T-values had fewer remaining teeth [mean difference 4.1, 95% confidence interval (CI) -1.1 to -6.5, P < 0.001]. The crude odds ratio (OR) of an association between the panoramic assessment of mandibular cortex erosions as a sign of osteoporosis and the adjusted T-value (T-value cut-off <-1.6) was 4.8 (95% CI 3.1-7.2, P < 0.001; Pearson chi(2) = 60.1, P < 0.001). A significant OR between osteoporosis and periodontitis was only found in women for the T-value cut-off <=-2.5 (crude OR 1.8, 95% CI 1.1-3.3, P < 0.03). Conclusions. An association between osteoporosis and periodontitis was only confirmed in women. The likelihood that the mandibular cortex index agrees with adjusted PIXI T-values is significant.

  • 226.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Giovannoli, Jean-Louis
    Peri-implantitis2012Book (Other academic)
  • 227.
    Renvert, Stefan
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. Irland, Blekinge Institute of Technology, Hong Kong.
    Hirooka, Hideaki
    Japan.
    Polyzois, Ioannis
    Irland.
    Kelekis-Cholakis, Anastasia
    Canada.
    Wang, Hom-Lay
    USA.
    Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants: consensus report of working group 32019In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 69 Suppl 2, p. 12-17Article in journal (Refereed)
    Abstract [en]

    The following consensus report is based on four background reviews. The frequency of maintenance visits is based on patient risk indicators, homecare compliance and prosthetic design. Generally, a 6-month visit interval or shorter is preferred. At these visits, peri-implant probing, assessment of bleeding on probing and, if warranted, a radiographic examination is performed. Diagnosis of peri-implant mucositis requires: (i) bleeding or suppuration on gentle probing with or without increased probing depth compared with previous examinations; and (ii) no bone loss beyond crestal bone level changes resulting from initial bone remodelling. Diagnosis of peri-implantitis requires: (i) bleeding and/or suppuration on gentle probing; (ii) an increased probing depth compared with previous examinations; and (iii) bone loss beyond crestal bone level changes resulting from initial bone remodelling. If diagnosis of disease is established, the inflammation should be resolved. Non-surgical therapy is always the first choice. Access and motivation for optimal oral hygiene are key. The patient should have a course of mechanical therapy and, if a smoker, be encouraged not to smoke. Non-surgical mechanical therapy and oral hygiene reinforcement are useful in treating peri-implant mucositis. Power-driven subgingival air-polishing devices, Er: YAG lasers, metal curettes or ultrasonic curettes with or without plastic sleeves can be used to treat peri-implantitis. Such treatment usually provides clinical improvements such as reduced bleeding tendency, and in some cases a pocket-depth reduction of ≤ 1 mm. In advanced cases, however, complete resolution of the disease is unlikely.

  • 228.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Lessem, Jan
    Dahlén, Gunnar
    Lindahl, Christel
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Svensson, Marie
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial2006In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, no 5, p. 362-369Article in journal (Refereed)
    Abstract [en]

    AIM: This randomized clinical trial presents a 12-month follow-up of the clinical and microbiological results after application of minocycline microspheres as an adjunct to mechanical treatment of incipient peri-implant infections compared with an adjunctive treatment using 1% chlorhexidine gel application.

    MATERIAL AND METHODS: Thirty-two subjects with probing depth > or =4 mm, combined with bleeding and/or exudate on probing and presence of putative pathogenic bacteria were given oral hygiene instructions and mechanical treatment of infected areas adjacent to implants. The subjects were then randomly assigned adjunctive subgingival antimicrobial treatment using either chlorhexidine gel or minocycline microspheres. Sixteen patients in the minocycline group and 14 in the chlorhexidine group completed the study. Follow-up examinations were carried out after 10 days, 1, 2, 3, 6, 9 and 12 months.

    RESULTS: The adjunctive use of minocycline microspheres resulted in improvements of probing depths and bleeding scores, whereas the adjunctive use of chlorhexidine only resulted in limited reduction of bleeding scores. For the deepest sites of the treated implants in the minocycline group, the mean probing depth was reduced from 5.0 to 4.4 mm at 12 months. This study could not show any significant difference in the levels of bacterial species or groups at any time point between the two antimicrobial agents tested. The present findings encourage further studies on adjunctive use of minocycline microspheres in the treatment of peri-implant lesions.

    CONCLUSIONS: The use of a local antibiotic as an adjunct to mechanical treatment of incipient peri-implantitis lesions demonstrated improvements in probing depths that were sustained over 12 months.

  • 229.
    Renvert, Stefan
    et al.
    Kristianstad University, Department of Health Sciences.
    Lessem, Jan
    Clinstrat, Newtown, PA USA.
    Dahlén, Gunnar
    University of Gothenburg.
    Renvert, Helena
    Kristianstad University, Department of Health Sciences.
    Lindahl, Christel
    Kristianstad University, Department of Health Sciences.
    Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis: a randomized clinical trial2008In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, no 5, p. 836-844Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Peri-implantitis is an inflammatory process caused by microorganisms affecting the tissues around an osseointegrated implant in function, resulting in a loss of supporting bone. Limited data exist regarding the treatment of peri-implantitis. The aim of this study was to assess the clinical and microbiologic outcome of repeated local administration of minocycline microspheres, 1 mg, in cases of peri-implantitis. METHODS: Thirty-two subjects with at least one implant with a probing depth > or =4 mm combined with bleeding and/or exudate on probing and the presence of putative pathogenic bacteria were included in the study. At baseline, subjects were randomly assigned to receive local minocycline microspheres (17 subjects and 57 implants) or chlorhexidine gel (15 subjects and 38 implants) following debridement. Treatments were performed on three occasions: baseline and days 30 and 90. Follow-up examinations were conducted at 10 days and at 1, 3, 6, 9, and 12 months. RESULTS: The use of minocycline resulted in significant improvements in probing depths compared to chlorhexidine at days 30, 90, and 180 (P = 0.5, P = 0.01, and P = 0.04, respectively). For the deepest sites of the minocycline-treated implants, the mean probing depth reduction was 0.6 mm at 12 months. Regarding bleeding on probing, significant differences between groups, based on all four sites at the implants, were found at days 30, 90, 180, 270, and 360. Both treatments resulted in a marked reduction in the indicator bacteria. CONCLUSIONS: The use of a repeated local antibiotic as an adjunct to the mechanical treatment of peri-implantitis lesions demonstrated improvements in probing depths that were significantly different from controls and were sustained for 6 months. The adjunctive use of minocycline microspheres is beneficial in the treatment of peri-implant lesions, but the treatment may have to be repeated.

  • 230.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Lessem, Jan
    Lindahl, Christel
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Svensson, Mari
    Treatment of incipient peri-implant infections using topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement2004In: Journal of the International Academy of Periodontology, ISSN 1466-2094, Vol. 6, no 4 Suppl, p. 154-159Article in journal (Refereed)
    Abstract [en]

    This report presents the clinical results three months after application of minocycline microspheres as an adjunct to mechanical treatment of incipient peri-implant infections compared to adjunctive treatment employing 1% chlorhexidine gel application. Sixteen patients in the minocycline group and 14 in the chlorhexidine group completed the study. Each patient had one or more implants with probing depth > or = 4 mm combined with bleeding and/or exudate on probing and presence of putative pathogenic bacteria. At baseline, patients were randomly assigned to minocycline or chlorhexidine treatment. Follow-up examinations were carried out after 10, 30, 60 and 90 days. The combined mechanical/antimicrobial treatment for the chlorhexidine group did not result in any reduction in probing depth and only limited reduction of bleeding scores. The adjunctive use of minocycline microspheres, on the other hand, resulted in improvements in both probing depths and bleeding scores. For the deepest sites of the treated implants, mean probing depth was reduced from 5.0 mm to 4.1 mm. The reductions in bleeding scores, although greater than for the chlorhexidine group, were modest. Thus, the question as to what extent the combined mechanical/minocycline treatment could be considered adequate for the treated lesions remains to be answered. The present short-term findings, however, encourage further studies with longer observation intervals on adjunctive use of minocycline microspheres in the treatment of periimplant lesions.

  • 231.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Lindahl, Christel
    Kristianstad University, School of Health and Society.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    The incidence of peri-implantitis for two different implant systems over a period of thirteen years2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 12, p. 1191-1197Article in journal (Refereed)
    Abstract [en]

    Objectives To study the incidence of peri-implantitis over 13 years between two types of dental implants. Materials and methods Peri-implantitis incidence was defined as bone loss ≥ 1.0 mm after 1 year, and with BOP or suppuration. Results Nineteen subjects with TioBlast AstraTech™ (AT) and 22 subjects with machine-etched Brånemark Nobel Biocare® (NB) implants were studied. The incidences of peri-implantitis between years 1 and 7 and between years 7 and 13 were 26.2% and 7.1% for AT implants, and 30.4% and 11.5% for NB implants (NS). A history of periodontitis was a risk for future incidence of peri-implantitis (Likelihood ratio: 4.1, 95% CI: 2.0, 8.4, p < 0.001). Subjects with a history of systemic disease had a higher incidence of peri-implantitis (p < 0.05). Conclusions No difference in the incidence of peri-implantitis over a period of 13 years as an effect implant surface and design was found. Bone loss during the first 7 years after implant installation was greater than thereafter. Microbiological information at year 7 did not predict incidence of peri-implantitis at year 13. Subjects with a previous history of periodontitis and with systemic disease were at higher risk for future incidence of peri-implantitis.

  • 232.
    Renvert, Stefan
    et al.
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Lindahl, Christel
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Persson, Rutger G
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Occurrence of cases with peri-implant mucositis or peri-implantitis in a 21-26 years follow-up study2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 2, p. 233-240Article in journal (Refereed)
    Abstract [en]

    AIM: to determine the prevalence and development of peri-implant mucositis and peri-implantitis and to assess risk factors over time.

    MATERIALS AND METHODS: The study is a longitudinal case series assessing the occurrence and diagnosis of peri-implant mucositis and peri-implantitis.

    RESULTS: 218/294 patients who had received dental implants between 1988-1992 were examined between 2000-2002 (exam II; 9-14 years after the first exam). At exam III (20-26 years after exam I, on average 23.3 years), 86 individuals were re-examined. The diagnosis of peri-implant mucositis and peri-implantitis at exam III was 23.8% and 13.7% respectively. Surgical treatment of peri-implantitis after exam II resulted in a bone gain for 2/12 individuals. Individuals with ≥ 3 implants at exam II were at risk for peri-implantitis at exam III (χ2=7.9, p <0.01, LR: 11.6, 95%CI: 1.5, 92.5, p < 0.01). A history of periodontitis (p=0.07), a diagnosis of peri-implant mucositis (p =0.77), or smoking (p=0.86) at exam II, were not predictive of peri-implantitis at exam III.

    CONCLUSIONS: The diagnosis and occurrence of peri-implantitis and peri-implant mucositis was high. Healthy conditions at implants after 9-14 years were predictive of future implant health. This article is protected by copyright. All rights reserved.

  • 233.
    Renvert, Stefan
    et al.
    Kristianstad University, Department of Health Sciences.
    Lindahl, Christel
    Kristianstad University, Department of Health Sciences.
    Renvert, Helena
    Kristianstad University, Department of Health Sciences.
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics, Division of Oral Microbiology, University of Bern.
    Clinical and microbiological analysis of subjects treated with Brånemark or AstraTech implants: a 7-year follow-up study2008In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 19, no 4, p. 342-7Article in journal (Refereed)
    Abstract [en]

    AIMS: To assess the impact of different implant systems on the clinical conditions and the microbiota at implants, and whether the presence of bacteria at tooth sites was predictive of the presence at implant sites. MATERIALS AND METHODS: Subjects with either AstraTech or Brånemark in function for 7 years were enrolled. Sub-gingival bacterial samples at tooth and implant sites were collected with sterile endodontic paper points, and analyzed by the checkerboard DNA-DNA hybridization method (40 species). RESULTS: Fifty-four subjects, 27 supplied with AstraTech (n=132 implants) and 27 with Brånemark (n=102) implants, were studied. Test tooth sites had significantly less evidence of bleeding on probing (P<0.001) and presence of plaque (P<0.001) than implant test sites. Implant sites presented with deeper probing pocket depth than tooth sites (mean difference: 1.1 mm, standard error of differences: 0.08, 95% confidence intervals (CI): 0.9-1.3, P<0.001). Tannerella forsythia (P<0.05), Capnocytophaga sputigena (P<0.05), Actinomyces israelii (P<0.05) and Lactobacillus acidophilus (P<0.05) were found at higher levels at tooth surfaces. No differences in bacterial load for any species were found between the two implant systems. The odds of being present/absent at tooth and implants sites were only significant for Staphylococcus aureus [odds ratio (OR): 5.2 : 1, 95% CI: 1.4-18.9, P<0.01]. CONCLUSIONS: After 7 years in function, implants presented with deeper probing depths than teeth. S. aureus was commonly present at both teeth and implants sites. S. aureus at tooth sites was predictive of also being present at implant sites.

  • 234.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Lindahl, Christel
    Kristianstad University, School of Health and Society.
    Roos Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Treatment of peri-implantitis using an Er:YAG laser or an air-abrasive device2011In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, no 1, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Background

    Non-surgical peri-implantitis therapies appear to be ineffective. Limited data suggest that ER:YAG laser therapy improves clinical conditions. The present study aimed at comparing the treatment effects between air-abrasive (AM) and Er:YAG laser (LM) mono-therapy in cases with severe peri-implantitis.

    Materials and methods

    Twenty-one subjects in each group were randomly assigned to one time intervention by an air-abrasive device or an Er:YAG laser. Clinical data were collected before treatment and at 6 months. Data analysis was performed using repeat univariate analysis of variance controlling for subject factors.

    Results

    No baseline subject characteristic differences were found. Bleeding on probing and suppuration decreased in both the groups (p < 0.001). The mean probing depth (PPD) reductions in the AM and LM groups were 0.9 mm (SD 0.8) and 0.8 mm (SD +/- 0.5), with mean bone-level changes (loss) of -0.1 mm (SD +/- 0.8) and -0.3 mm (SD +/- 0.9), respectively (NS). A positive treatment outcome, PPD reduction >= 0.5 mm and gain or no loss of bone were found in 47% and 44% in the AM and LM groups, respectively.

    Conclusions

    The clinical treatment results were limited and similar between the two methods compared with those in cases with severe peri-implantitis.

  • 235.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Lindahl, Christel
    Kristianstad University, School of Health and Society.
    Roos-Jansaker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Lessem, Jan
    CombinatoRx, USA.
    Short-term effects of an anti-inflammatory treatment on clinical parameters and serum levels of C-reactive protein and proinflammatory cytokines in subjects with periodontitis2009In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 80, no 6, p. 892-900Article in journal (Refereed)
    Abstract [en]

    Background: Periodontal disease is the most common multifactorial disease, afflicting a very large proportion of the adult population. Periodontal disease secondarily causes increases in the serum levels of C-reactive protein (CRP) and other markers of inflammation. An increased level of CRP reflects an increased risk for cardiovascular disease. The aim of the current randomized clinical trial was to evaluate the short-term effect of a combination of dipyridamole and prednisolone (CRx-102) on the levels of high-sensitivity (hs)-CRP, proinflammatory markers in blood, and clinical signs of periodontal disease. Methods: Fifty-seven patients with >= 10 pockets with probing depths >= 5 mm were randomized into two groups in this masked single-center placebo-controlled study: CRx-102 (n = 28) and placebo (n = 29). hs-CRP levels, inflammatory markers (interleukin [IL]-6, -1 beta, -8, and -12, tumor necrosis factor-alpha, and interferon-gamma [IFN-gamma]), bleeding on probing (BOP), and changes in probing depths were evaluated. The subjects received mechanical non-surgical therapy after 42 days, and the study was completed after 49 days. Results: At day 42, the differences in the hs-CRP, IFN-gamma, and IL-6 levels between the two groups were statistically significant (P<0.05), whereas no difference was found for the other inflammatory markers. There was no change in probing depth or BOP between the two groups. Conclusion: The administration of CRx-102 resulted in significant decreases in hs-CRP, IFN-gamma, and IL-6, but it did not significantly change BOP or probing depths.

  • 236.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Lindahl, Christel
    Kristianstad University, School of Health and Society.
    Roos-Jansåker, A.-M.
    Kristianstad University, School of Health and Society.
    Lessem, J.
    CombinatoRx Inc, USA.
    Effects of an anti-inflammatory treatment on clinicalparameters and serum levels of CRP and pro-inflammatorycytokines in subjects with periodontitis2009In: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, p. 17-Conference paper (Refereed)
    Abstract [en]

    Background: Periodontal disease affect a large proportion of the adult population and cause an increasein serum levels of C- reactive protein (CRP), and other markers of inflammation. An increased level of CRP reflects an increased risk of cardiovascular disease. The aim of the current randomized clinical trial was to evaluate the short term effect of CRx-102 alone on the levels of hs-CRP, pro-inflammatory markers in blood and clinical signs of periodontal disease. Methods: Fifty seven patients with at least 10 pockets, with a probing depth of 5 mm or more, were randomized into two groups either CRx-102 (n = 28) or placebo (n = 29) in this blinded single-centre placebo controlled study. High sensitivity CRP (Hs-CRP) levels, inflammatory markers (IL-6, Il-1b, TNFa, IL12, IL-8, IFN c), bleeding on probing (BOP) and change in probing depths were evaluated. After 42 days the subjects received mechanical non-surgical therapy and the study was completed after 49 days. Results: At day 42 the difference in hs-CRP and IFN c levels between the two groups was statistically significant (P = 0.02 and P = 0.03, respectively) whereas no difference was found for the other inflammatory markers. There was no change in periodontal probing depth or BOP between the two groups. Conclusion: The current study demonstrated that the administration of CRx-102, resulted in significant decreases in hs- CRP and IFN c, but did not significantly change BOP or probing depths. 10:15–10:30 Ref no: EUABS065318 Anti TNF-a therapy and periodontal parameters in rheumatoid arthritis patients Y. MAYER*, A. GURMAN-BALBIR AND E. E. MACHTEI Unit of Periodontology, Rambam HCC, Haifa, Israel Aim: To evaluate the influence of anti TNF-a therapy on the clinical and immunological parameters of the periodontium. Materials and methods: Ten patients with RA who received infusion of 200 mg infliximab routinely (RA+), 10 patients with RA without anti TNF-a therapy (RA-) and 10 healthy patients (C) were included. Clinical parameters PI, GI, PD, CAL and BOP were assessed and total GCF TNF-a level was determined using ELISA. ANOVA with Fisher’s modification and Pearson correlation test were used for statistical analysis. Results: Patients’ age ranged between 22 and 76 years (mean 50.73 ± 9.1). Mean PI was similar between the groups. However, mean inflammatory parameters in the 3 groups varied significantly; GI was greater in the RA- compared with RA+ and C (P = 0.0042). RA+ exhibit less BOP than RA- and C (21.1% ± 3.0%, 45.9% ± 6.2% and 39.1% ± 7.2%; respectively, P = 0.0146) The mean PD in RA+ was shallower than RA- and C (3.22 ± 0.13, 3.85 ± 0.22, 3.77 ± 0.20; P = 0.055). CAL in RA+ was lower than RA- and C (3.68 ± 0.11, 4.52 ± 0.26, 4.35 ± 0.24; P = 0.0273). TNF-a levels in the GCF of RA+ were the lowest (0.663 pg/ml, 1.23 pg/ml and 0.949 pg/ml; P = 0.0401). A significant positive correlation was found between TNF-a levels in the GCF and CAL (r = 0.448, P = 0.0283). Conclusion: Rheumatoid arthritis patients receiving anti TNF-a medications have lower periodontal indices and GCF TNF-a levels. Thus, suppression of pro-inflammatory cytokines might prove beneficial in suppressing periodontal diseases.

  • 237.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Lingström, Peter
    Erovic, Seida
    Kristianstad University, School of Health and Society.
    Dålig andedräkt2009In: Tandläkartidningen, ISSN 0039-6982, Vol. 101, no 7, p. 58-60Article in journal (Other academic)
    Abstract [sv]

    Vid Högskolan i Kristianstad pågår studier för att kartlägga förekomsten av halitosis, dålig andedräkt, samt utvärdering av olika behandlingsmetoder för patienter med genuin oral halitosis.

  • 238.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Ohlsson, Ola
    Kristianstad University, School of Health and Society.
    Persson, Rutger
    Hjärt-kärlsjukdom och parodontit studeras2009In: Tandläkartidningen, ISSN 0039-6982, Vol. 101, no 7, p. 56-57Article in journal (Other academic)
    Abstract [sv]

    tudier visar att patienter med omfattande kardiovaskulär sjukdom ofta också har parodontit. För att reducera risken för hjärt-kärlkomplikationer krävs troligen en väsentlig reduktion av den orala bakteriebelastningen. Patienter med omfattande parodontit bör remitteras till medicinsk undersökning av hjärta och kärl.

  • 239.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Ohlsson, Ola
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Persson, Susanna
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Lang, Niklaus P
    School of Dental Medicine, University of Berne, Switzerland.
    Persson, G. Rutger
    School of Dental Medicine, University of Berne, Switzerland.
    Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction2004In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, no 1, p. 19-24Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An association between periodontitis and cardiovascular diseases has been suggested.

    AIMS: To study whether a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AMI).

    MATERIAL AND METHODS: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created. The surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI.

    RESULTS: Age, gender, number of remaining teeth (mean value: 21.1 versus 21.6 teeth), smoking status, and pocket probing depth (PPD) distribution did not differ by group. Gingival recession was greater in control subjects (mean difference: 5.7, SD: +/- 1.9, p<0.01, 95% CI: 1.8-9.6). Bone loss > or = 4.0 mm was at all levels studied was significantly greater in subjects with AMI and bone loss > or = 50% (> or = 4 mm) was the best individual predictor of AMI (beta = 2.99, p < 0.000, 95% CI: 7.5-53.4). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (beta = 22.1, SE: 5.9, p < 0.0001, 95% CI: 10.3-33.7). The best association between AMI status and study variables was the combination of > or = 4 mm of bone loss > or = 50%, proportion of bleeding on probing (%BOP), %PPDs > or = 6 mm, and tooth loss (Nagelkirke r2 = 0.46).

    CONCLUSIONS: The combination of five periodontal parameters in a PPRD added predictive value, suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Radiographic evidence of bone loss was the best individual parameter.

  • 240.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Ohlsson, Ola
    Kristianstad University, School of Health and Society.
    Pettersson, Thomas
    Department of Medicine, Kristianstad Central Hospital.
    Persson, G. Rutger
    Department of Periodontology, University of Bern.
    Periodontitis: a future risk of acute coronary syndrome?: A follow-up study over 3 years2010In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 81, no 7, p. 992-1000Article in journal (Refereed)
    Abstract [en]

    Background: Periodontitis has been associated with cardiovascular disease. We assess if the recurrence of acute coronary syndrome (ACS) could be predicted by preceding medical and periodontal conditions. Methods: A total of 165 consecutive subjects with ACS and 159 medically healthy, matched control subjects were examined and followed for 3 years. Periodontitis was defined by alveolar bone loss. Subgingival microbial samples were studied by the checkerboard DNA-DNA hybridization method. Results: The recurrence of ACS was found in 66 of 165 (40.0%) subjects, and a first ACS event was found in seven of 159 (4.4%) subjects among baseline control subjects. Subjects who later had a second ACS event were older (P<0.001). Significantly higher serum levels of high-density lipoprotein (P <0.05), creatinine (P <0.01), and white blood cell (WBC) counts (P <0.001) were found in subjects with future ACS. Periodontitis was associated with a first event of ACS (crude odds ratio [OR]: 10.3:1; 95% confidence interval [CI]: 6.1 to 17.4; P <0.001) and the recurrence of ACS (crude OR: 3.6:1; 95% CI: 2.0 to 6.6; P <0.001). General linear modeling multivariate analysis, controlling for age and the prediction of a future ACS event, identified that WBC counts (F = 20.6; P <0.001), periodontitis (F = 17.6; P <0.001), and serum creatinine counts (F = 4.5; P<0.05) were explanatory of a future ACS event. Conclusions: The results of this study indicate that recurrent ACS events are predicted by serum WBC counts, serum creatinine levels, and a diagnosis of periodontitis. Significantly higher counts of putative pathogens are found in subjects with ACS, but these counts do not predict future ACS events.

  • 241.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Washington, Seattle, USA.
    Parodontit hos äldre2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, no 1, p. 52-56Article in journal (Other academic)
    Abstract [sv]

    I framtiden kommer den äldre befolkningen att ha fler egna tänder. Ökad ålder är ofta förknippad med försämrad medvetenhet, reducerad motorik och ökad användning av läkemedel. Dessa faktorer kan påverka möjligheterna att upprätthålla en adekvat munhygien, vilket ökar risken för parodontit och karies. Förekomsten av P gingivalis och B forsythus, rökning och ett försämrat immunförsvar ökar också risken för parodontit. Flera allmänsjukdomar, t ex diabetes och kardiovaskulära sjukdomar, är vanligare bland äldre. Ett samband mellan parodontit och kardiovaskulära sjukdomar har redovisats. Även om det är för tidigt att dra långtgående slutsatser om sambandet mellan parodontit och allmänsjukdomar kan det från allmän preventiv synpunkt vara indicerat att behandla parodontit ur allmänmedicinsk aspekt. Det finns ingen anledning tro att parodontal behandling av äldre inte är framgångsrik. Enbart ålder kan därför inte utgöra ett hinder för behandling. Klorhexidin kan vid behov användas som ett supplement till mekanisk tandrengöring under såväl kortare som längre tidsperioder.

  • 242.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Washington, USA & University of Berne, Switzerland.
    Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss2004In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, no 3, p. 208-213Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Limited subject-based information exists on the relationship between clinical and radiographic periodontal data.

    AIMS: To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). Material and Methods: Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic.

    RESULTS: The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001).

    CONCLUSIONS: The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.

  • 243.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Persson, G. Rutger
    Department of Periodontology, University of Berne.
    Periodontitis as a potential risk factor for peri-implantitis.2009In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, no Suppl 10, p. 9-14Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVES: To review the literature regarding the possible association between a previous history of periodontitis and peri-implantitis. MATERIAL AND METHODS: A search of MEDLINE as well as a manual search of articles were conducted. Publications and articles accepted for publication up to January 2008 were included. RESULTS: Out of 951 papers retrieved, a total of three papers were selected for the review. Thus, the available evidence for an association between periodontitis and peri-implantitis is scarce. CONCLUSIONS: Based on three studies with a limited number of patients and considerable variations in study design, different definitions of periodontitis, and confounding variables like smoking that not been accounted for, this systematic review indicates that subjects with a history of periodontitis may be at greater risk for peri-implant infections. It should, however, be stressed that the data to support this conclusion are not very robust.

  • 244.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Supportive periodontal therapy2004In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 36, p. 179-195Article, review/survey (Refereed)
  • 245.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, G. Rutger
    USA.
    Treatment of periodontal disease in older adults2016In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 72, no 1, p. 108-119Article in journal (Refereed)
    Abstract [en]

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

  • 246.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Persson, Rigmor E.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    A history of frequent dental care reduces the risk of tooth loss but not periodontitis in older subjects2011In: Swedish Dental Journal, ISSN 0347-9994, Vol. 35, no 2, p. 69-76Article in journal (Refereed)
    Abstract [en]

    Objectives: Information on the significance of dental care in older adults is limited. We hypothesized that regular dental visits has an effect on the number of remaining teeth and periodontal conditions in older subjects. Materials and Methods: 1020 randomly selected individuals age 60 - 96 from the Swedish National Study on Aging and Care Blekinge received a comprehensive oral health examination. Results: Dentate women and men had, on average 18.4 teeth (SD +7.6,) and 18.9 teeth (SD + 7.5) respectively (NS). In the youngest group (60 and 66 years old) with less than one dental visit per year, 37 % had >20 teeth, compared with 73 % among those with at least annual visits. Among the old-old, comparable figures were 1.8 % and 37% respectively. Across age groups, bleeding on probing was 23 %. When adjusting for age, and number of teeth GLM univariate analysis failed to demonstrate an effect of dental visit frequency on alveolar bone loss (p = 0.18), the number of periapical lesions (p = 0.65), or the number of endodontically treated teeth ( p = 0.41). Frequent dental visitors had more teeth than infrequent visitors (p = 0.001). Conclusions:Tooth loss and alveolar bone loss severity increase with age. Individuals with regular dental visits retained more teeth but the frequency of dental visits had no impact on plaque deposits, gingival inflammation, or alveolar bone levels.

  • 247.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Persson, Rigmor E.
    University of Blekinge.
    Persson, G. Rutger
    University of Bern.
    Access to dental care reduces the risk of tooth loss in older subjects2009In: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, p. 149-Conference paper (Refereed)
    Abstract [en]

    Background: The significance of access to dental care on oral conditions in older subjects is limited. We hypothesized that dental care control for aging effects on oral and periodontal conditions. Materials and methods: 1020 randomly selected subjects between age 60 and 96 from the Swedish National Study on Aging and Care Blekinge study received comprehensive medical and dental examinations. Results: Dentate women and men had, on average,18.4 teeth (S.D. ± 7.6), and 18.9 teeth (S.D.±7.5) (P = 0.37) respectively. In the youngest age group with infrequent dental visits 37% had > 20 teeth, and 73% had > 20 teeth if they had annual visits. Among old-old infrequent dental visitors 1.8% had > 20 teeth and 37% had > 20 teeth with annual visits. Across age groups, the overall % bleeding on probing was 23%. When adjusting for age, GLM univariate analysis failed to demonstrate an effect of frequency of dental visits and ABL scores (P = 0.18) but frequent dental visitors had significantly more teeth than infrequent visitors (P = 0.001). Conclusions: Tooth loss and extent of alveolar bone loss increase with age. Frequent dental visits seem to preserve teeth but has no impact on the amounts of deposits, gingival inflammation, or alveolar bone levels.

  • 248.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, Rigmor E
    Departments of Oral Medicine and Periodontics, School of Dentistry, University of Washington, Seattle.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Tooth loss and periodontitis in older individuals: results from the Swedish national study on aging and care2013In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 84, no 8, p. 1134-1144Article in journal (Refereed)
    Abstract [en]

    Background: Due to the increasing number of older people, there is a need for studies focused on this population. The aims of the present study are to assess oral and systemic conditions in individuals aged 60 to 95 years with access to dental insurance. Methods: Probing depths (PDs), tooth loss, alveolar bone levels, and systemic health were studied among a representative cohort of older individuals. Results: A total of 1,147 individuals in young-old (aged 60 or 67 years), old (aged 72 or 78 years), and old-old (aged ≥81 years) age groups were enrolled, including 200 individuals who were edentulous, in this study. Annual dental care was received by 82% of dentate individuals. Systemic diseases were common (diabetes: 5.8%; cardiovascular diseases: 20.7%; obesity: 71.2%; elevated C-reactive protein [CRP]: 98.4%). Serum CRP values were unrelated to periodontal conditions. Rates of periodontitis, defined as ≥30% of sites with a distance from cemento-enamel junction to bone of ≥5 mm, were 11.2% in women in the young-old age group and 44.9% in men in the old-old age group. Individuals in older age groups had a higher likelihood of periodontitis defined by bone loss and cutoff levels of PD ≥5 mm (odds ratio: 1.8; 95% confidence interval: 1.2 to 2.5; P <0.01). A total of 7% of individuals in the old-old age group had ≥20 teeth and no periodontitis. Systemic diseases, dental use, or smoking were not explanatory, whereas age and sex were explanatory for periodontitis. Conclusions: The prevalence of periodontitis increased with age. Sex seems to be the dominant explanatory factor for periodontitis in older individuals. Despite frequent dental visits, overall oral health in the oldest age cohort was poor.

  • 249.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society.
    Persson, Rutger
    Berglund, Johan
    Resebo, Jan
    Fokus på sambandet munhälsa - allmänhälsa2009In: Tandläkartidningen, ISSN 0039-6982, Vol. 101, no 7, p. 52-54Article in journal (Other academic)
    Abstract [sv]

    Sedan 2001 har Blekinge deltagit i en nationell äldrestudie där även munhälsobedömning ingår. Studien gör det mäjligt att analysera eventuella samband mellan allmänhälsa och munhälsa. Analys av materialet pågår men det är redanpåvisat att man genom en enkel analys av den kortikala mandibulära benplattan kan uppskatta förekomsten av osteoporos.

  • 250.
    Renvert, Stefan
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. Blekinge Institute of Technology.
    Persson, Rutger G
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. USA.
    Pirih, Flavia Q
    USA.
    Camargo, Paulo M
    USA.
    Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45 Suppl 20, p. 278-285Article in journal (Refereed)
    Abstract [en]

    The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.

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