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  • 251.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Pettersson, Thomas
    Department of Medicine, Central Hospital, Kristianstad, Sweden.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Bacterial profile and burden of periodontal infection in subjects with a diagnosis of acute coronary syndrome.2006Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 77, nr 7, s. 1110-1119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Periodontitis has been identified as a potential risk factor in cardiovascular diseases. It is possible that the stimulation of host responses to oral infections may result in vascular damage and the inducement of blood clotting. The aim of this study was to assess the role of periodontal infection and bacterial burden as an explanatory variable to the activation of the inflammatory process leading to acute coronary syndrome (ACS).

    METHODS: A total of 161 consecutive surviving cases admitted with a diagnosis of ACS and 161 control subjects, matched with cases according to their gender, socioeconomic level, and smoking status, were studied. Serum white blood cell (WBC) counts, high- and low-density lipoprotein (HDL/LDL) levels, high-sensitivity C-reactive protein (hsC-rp) levels, and clinical periodontal routine parameters were studied. The subgingival pathogens were assayed by the checkerboard DNA-DNA hybridization method.

    RESULTS: Total oral bacterial load was higher in the subjects with ACS (mean difference: 17.4x10(5); SD: 10.8; 95% confidence interval [CI]: 4.2 to 17.4; P<0.001), and significant for 26 of 40 species including Porphyromonas gingivalis, Tannerella forsythensis, and Treponema denticola. Serum WBC counts, hsC-rp levels, Streptococcus intermedius, and Streptococcus sanguis, were explanatory factors to acute coronary syndrome status (Nagelkerke r2=0.49).

    CONCLUSION: The oral bacterial load of S. intermedius, S. sanguis, Streptococcus anginosus, T. forsythensis, T. denticola, and P. gingivalis may be concomitant risk factors in the development of ACS.

  • 252.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Polyzois, Ioannis
    Dublin Dental University Hospital.
    Risk indicators for peri-implant mucositis: a systematic literature review2015Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 16, s. 172-186Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objectives

    To examine the existing evidence in identifying risk indicators in the aetiology of peri-implant mucositis.

    Material and methods

    A search was performed in PubMed, Web of Science (WOS) and The Cochrane Library databases for articles published until June 2014.

    Results

    This search gave 3135 results out of which 15 studies fulfilled the inclusion criteria. The current review revealed that only a few studies provided data on risk indicators for the development of peri-implant mucositis. Based on the data available, there is evidence that plaque is a risk indicator for peri-implant mucositis. Smoking has also been identified as an independent risk indicator whereas the overall evidence for surface roughness, residual cement, the dimension of the keratinized tissue and time of implant in function is weak. There are limited data available to support systemic conditions as risk indicators for peri-implant mucositis.

    Conclusions

    Plaque accumulation at implants will result in development of peri-implant mucositis. Smoking should also be considered as a risk indicator for the development of peri-implant mucositis. This article is protected by copyright. All rights reserved.

  • 253.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Polyzois, Ioannis
    Irland.
    Treatment of pathologic peri-implant pockets2018Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 76, nr 1, s. 180-190Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Peri-implant and periodontal pockets share a number of anatomical features but also have distinct differences. These differences make peri-implant pockets more susceptible to trauma and infection than periodontal pockets. Inadequate maintenance can lead to infections (defined as peri-implant mucositis and peri-implantitis) within peri-implant pockets. These infections are recognized as inflammatory diseases, which ultimately lead to the loss of supporting bone. Diagnostic and treatment methods conventionally used in periodontics have been adopted to assess and treat these diseases. Controlling infection includes elimination of the biofilm from the implant surface and efficient mechanical debridement. However, the prosthetic supra-structure and implant surface characteristics can complicate treatment. Evidence shows that when appropriately managed, peri-implant mucositis is reversible. Nonsurgical therapy, with or without the use of antimicrobials, will occasionally resolve peri-implantitis, but for the majority of advanced lesions this approach is insufficient and surgery is indicated. The major objective of the surgical approach is to provide access and visualize the clinical situation. Hence, a more informed decision can be made regarding whether to use a resective or a regenerative surgical technique. Evidence shows that following successful decontamination, surgical treatment to regenerate the bone can be performed, and a number of regenerative techniques have been proposed. After treatment, regular maintenance and good oral hygiene are essential for a predictable outcome and long-term stability.

  • 254.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Polyzois, Ioannis
    School of Dental Sciences, Trinity College, Dublin.
    Claffey, Noel
    School of Dental Sciences, Trinity College, Dublin.
    How do implant surface characteristics influence peri-implant disease?2011Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, s. 214-222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To review the literature on how implant surface characteristics influence peri-implant disease. Material and Methods A search of PubMed and The Cochrane Library of the Cochrane Collaboration (CENTRAL) as well as a hand search of articles were conducted. Publications and articles accepted for publication up to March 2010 were included. Results Thirteen studies were selected for the review. Human studies: To date, few studies have investigated if such differences occur. Limited data suggest that smooth surfaces may be less affected by peri-implantitis than rough surface implants. Animal studies: In ligature-induced peri-implantitis studies, no difference between surfaces has been reported. In a spontaneous progression model of peri-implantitis, there was a suggestion that the progression was more pronounced at implants with a porous anodized surface. Conclusion The current review revealed that only a few studies provided data on how implant surfaces influence peri-implant disease. Based on the limited data available, there is no evidence that implant surface characteristics can have a significant effect on the initiation of peri-implantitis.

  • 255.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Naturvetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Polyzois, Ioannis
    Dublin Dental University Hospital, Dublin.
    Claffey, Noel
    Dublin Dental University Hospital, Dublin.
    Surgical therapy for the control of peri-implantitis2012Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, nr Suppl. 1, s. 84-94Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Material and methods Articles on surgical treatment of peri-implantitis in humans published up to December 2011 were included. Results Twenty-six studies were selected, thus limiting the available evidence. There is marked heterogeneity between study designs and case definitions for peri-implantitis in the studies cited, limiting the generalization of the reported results. Adjunctive systemic antibiotics were used in most studies, but no study evaluated the adjunctive benefit of systemic antibiotics. Access flap surgery, removal of granulation tissue and implant surface decontamination has been demonstrated to decrease plaque index, BOP, suppuration, probing depths and to arrest bone loss for 58% of implant sites over 5 years. Laser treatment of the exposed implant surface during surgery was not shown to be beneficial. Available data indicate that it is possible to obtain defect fill of peri-implantitis defects following surgical-treatment modalities with concomitant placement of bone or bone substitutes in such defects. However, there is lack of evidence that placement of membranes in addition to grafting procedures provides any additional defect fill. Conclusions Surgical therapy for treating peri-implantitis is a predictable method for treating peri-implant disease and patients receiving this therapy have benefited from it in the short term.

  • 256.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Polyzois, Ioannis
    School of Dental Sciences, Trinity College, Dublin.
    Maguire, Rory
    Blekinge Institute of Technology, Karlskrona.
    Re-osseointegration on previously contaminated surfaces: a systematic review2009Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 20, nr Suppl. 4, s. 216-227Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objectives The aim of this review was to search the literature for the existing evidence of re-osseointegration after treatment of peri-implantitis at contaminated implant surfaces. Material and Methods A search of PubMed as well as additional hand search of articles were conducted. Publications and articles accepted for publication up to November 2008 were included. Results A total of 25 animal studies fulfilled the inclusion criteria for this review. Access surgery with closed healing has been observed to positively influence the rate of re-osseointegration when compared with non-surgical decontamination of the implant surface with open healing. Open debridement including surface decontamination may result in re-osseointegration and this integration was more pronounced on rougher than on smooth implant surfaces. The adjunctive use of regenerative procedures resulted in varying amounts of re-osseointegration. Conclusions Re-osseointegration is possible to obtain on a previously contaminated implant surface and can occur in experimentally induced peri-implantitis defects following therapy. The amount of re-osseointegration, varied considerably within and between studies. Implant surface characteristics may influence the degree of re-osseointegration. Surface decontamination alone can not achieve substantial re-osseointegration on a previously contaminated implant surface. No method predictably accomplished complete resolution of the peri-implant defect.

  • 257.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Polyzois, Ioannis N
    Clinical approaches to treat peri-implant mucositis and peri-implantitis.2015Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 68, nr 1, s. 369-404Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Therapies proposed for the treatment of peri-implant diseases are primarily based on the evidence available from treating periodontitis. The primary objective is elimination of the biofilm from the implant surface, and nonsurgical therapy is a commonly used treatment. A number of adjunctive therapies have been introduced to overcome accessibility problems or difficulties with decontamination of implant surfaces as a result of specific surface characteristics. It is now accepted that following successful decontamination, clinicians can attempt to regenerate the bone that was lost as a result of infection. The ultimate goal is re-osseointegration, and a number of regenerative techniques have been introduced. By reviewing the existing evidence, it seems that peri-implant mucositis is reversible when appropriately treated. Additionally, a combined therapy (mechanical therapy with local antimicrobials as adjuncts) can serve as an alternative to surgical intervention when treating peri-implantits in cases not suitable for surgery. Surgical therapy is an effective method for treating peri-implantitis, and various degrees of success of the use of regenerative procedures have been reported, regardless of whether or not radiographic evidence of defect fill has been achieved. Finally, no matter which therapy is employed, a prerequisite for the long-term stability of treatment results obtained is the ability of the patient to maintain good oral hygiene.

  • 258.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Polyzois, Ioannis
    Trinity College Dublin.
    Persson, G. Rutger
    University of Washington.
    Treatment modalities for peri-implant mucositis and peri-implantitis2013Ingår i: American Journal of Dentistry, ISSN 0894-8275, Vol. 26, nr 6, s. 313-318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 259.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Roos-Jansåker, Ann-Marie
    Behandlingar av infekterade implantat analyseras2009Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 101, nr 7, s. 48-50Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

  • 260.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Roos-Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Claffey, Noel
    School of Dental Science, Trinity College, Dublin.
    Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review2008Ingår i: Journal of Clinical Periodontology, vol. 35 (8 Suppl.), 2008, Vol. 35, nr 8 Suppl, s. 305-15Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 261.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Roos-Jansåker, Ann-Marie
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics Division of Oral Microbiology, University of Berne.
    Infection at titanium implants with or without a clinical diagnosis of inflammation2007Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 18, nr 4, s. 509-516Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 262.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Roos-Jansåker, Ann-Marie
    Kristianstad Public Dental Services.
    Persson, Rutger G
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute: a randomized clinical trial2018Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, nr 10, s. 1266-1274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 263.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, E.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    University of Bern.
    Mechanical treatment of peri-implant mucositis: a double-blind randomized longitudinal clinical study2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 24-Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 264.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Department of Periodontology and Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I: clinical results2009Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr 7, s. 604-609Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 265.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Gösta Rutger
    Department of Periodontology and Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Erratum. Mechanical non-surgical treatment of peri-implantitis: a double-blind randomized longitudinal clinical study. I2009Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr 12, s. 1076-1076Artikel i tidskrift (Övrigt vetenskapligt)
  • 266.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Tonetti, Maurizio
    Europerio 6: Stockholm, Sweden 4-6 20092009Proceedings (redaktörskap) (Övrigt vetenskapligt)
  • 267.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Wallin-Bengtsson, Viveca
    Public Dental Health Services, Kristianstad.
    Berglund, Johan
    Blekinge Institute of Technology.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Periodontitis in older Swedish individuals fails to predict mortality2015Ingår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, nr 2, s. 193-200Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 268.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Blekinge Institute of Technology, Karlskrona.
    Widén, Cecilia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Department of Periodontics, University of Washington, Seattle.
    Cytokine expression in peri-implant crevicular fluid in relation to bacterial presence2015Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 7, s. 697-702Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 269. Riben-Grundstrom, C
    et al.
    Norderyd, O
    André, U
    Renvert, Stefan
    Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Blekinge tekniska högskolan .
    Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial2015Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 5, s. 462-469Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 270. Roberts, Frank A
    et al.
    Houston, Laura S
    Lukehart, Sheila A
    Mancl, Lloyd A
    Persson, G. Rutger
    University of Washington, Seattle, Washington.
    Page, Roy C
    Periodontitis vaccine decreases local prostaglandin E2 levels in a primate model.2004Ingår i: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 72, nr 2, s. 1166-1168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Interleukin-1beta, tumor necrosis factor alpha, prostaglandin E2 (PGE2), and Porphyromonas gingivalis-specific immunoglobulin G levels in gingival crevicular fluid were measured in primates immunized with a P. gingivalis vaccine followed by ligature-induced periodontitis. Only PGE2 levels were dramatically suppressed (P < 0.0001) in immunized animals versus controls. A significant correlation (P < 0.027) was also found between PGE2 levels and decreased bone loss scores. This study presents the first evidence of a potential mechanism involved in periodontitis vaccine-induced suppression of bone loss in a nonhuman primate model and offers insight into the role of PGE2 in periodontal destruction.

  • 271.
    Roos-Jansåker, A.-M.
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Surgical treatment of peri-implantitis using a bonegraft substitute with or without a resorbable membrane: 3-year radiographic control2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 24-Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 272.
    Roos-Jansåker, Ann Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part I: implant loss and associations to various factors.2006Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 283-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 273.
    Roos-Jansåker, Ann-Marie
    et al.
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Long-term stability of surgical bone regenerative procedures of peri-implantitis lesions in a prospective case-control study over 3 years2011Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, nr 6, s. 590-597Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 274.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions2006Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 290-295Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 275.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a 5-year follow up2014Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, nr 11, s. 1108-1114Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 276.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Helena
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Nine- to fourteen-year follow-up of implant treatment. Part III: factors associated with peri-implant lesions2006Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 33, nr 4, s. 296-301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 277.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Submerged healing following surgical treatment of peri-implantitis: a case series2007Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, nr 8, s. 723-727Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 278.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Stefan
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort study2007Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, nr 7, s. 625-632Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 279.
    Roos-Jansåker, Ann-Marie
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Egelberg, J
    Treatment of peri-implant infections: a literature review2003Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 6, s. 467-485Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 280.
    Safari Zonoozi, Nazanin
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Gullberg, Olena
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Orala hälsoproblem och ätsvårigheter hos äldre2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med litteraturstudien var att undersöka den orala hälsans påverkan på ätandet hos äldre personer.

    Vetenskapliga artiklar söktes i databasen PubMed med begränsning till artiklar inom tidsperioden 2000-2010, åldersgruppen 60 år och äldre. Totalt 11 artiklar inkluderades i studien.

    Resultatet visade att försämrad munhälsa, nedsatt tuggförmåga, många saknade tänder, smärta och obehag i munnen, illasittande tandproteser och muntorrhet ger problem med ätandet. Detta leder till att äldre med försämrad oral hälsa ändrar på sina val av livsmedel och ofta avstår från livsmedel som är problematiska att äta på grund av svårigheter med att tugga och svälja eller rädsla för att orsaka ytterligare skada på bräckliga tänder.

     

    Studiens slutsats är att en genomgång av litteraturen visade att äldre människor med nedsatt oral status hade risk för ätsvårigheter. Att ersätta förlorade tänder tycks ha betydelse för att upprätthålla en optimal tuggfunktion.

  • 281.
    Said Yekta, Sareh
    et al.
    Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Aachen University.
    Lampert, Friedrich
    Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Aachen University.
    Kazemi, Saeid
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Design och datavetenskap.
    Kazemi, Reza
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Brand, Henk S.
    Department of Oral and Maxillofacial Surgery and Department of Periodontology and Oral Biochemistry, VU University Medical Centre and Academic Centre for Dentistry Amsterdam.
    Baart, Jacques A.
    Department of Oral and Maxillofacial Surgery, VU University Medical Centre and Academic Centre for Dentistry Amsterdam.
    Mazandarani, Mina
    Department of Conservative Dentistry, Periodontology, and Preventive Dentistry, Aachen University.
    Evaluation of new injection and cavity preparation model in local anesthesia teaching2013Ingår i: Journal of Dental Education, ISSN 0022-0337, Vol. 77, nr 1, s. 51-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate a recently developed preclinical injection and cavity preparation model in local anesthesia. Thirty-three dental students administered an inferior alveolar nerve block injection in the model, followed by preparation on a tooth. The injection was evaluated by three observers, and the feedback from the model was registered. After completion of the practical session, the opinion of the dental students was explored with a ten-item questionnaire. Thirty dental students (91 percent) performed the injection correctly according to the feedback of the model, and twenty-eight students (85 percent) did so according to the expert opinion. The agreement between feedback from the training model and the expert opinion was high. The students were very satisfied with the opportunity to practice with the training model, as indicated by the high scores on each item of the questionnaire. These results suggest that use of this preclinical training model in anesthesia teaching may have beneficial effects on the administration of local anesthetics by dental students.

  • 282.
    Salvi, Giovanni E
    et al.
    University of Bern, Bern, Switzerland.
    Franco, Lea M
    University of Michigan, Ann Arbor, MI, USA.
    Braun, Thomas M
    University of Michigan, Ann Arbor, MI, USA.
    Lee, Angie
    University of Michigan, Ann Arbor, MI, USA.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland.
    Lang, Niklaus P
    University of Bern, Bern, Switzerland & University of Hong Kong.
    Giannobile, William V
    University of Michigan, Ann Arbor, MI, USA.
    Pro-inflammatory biomarkers during experimental gingivitis in patients with type 1 diabetes mellitus: a proof-of-concept study.2010Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, nr 1, s. 9-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To compare gingival crevicular fluid (GCF) biomarker levels and microbial distribution in plaque biofilm (SP) samples for subjects with type 1 diabetes (T1DM) versus healthy subjects without diabetes during experimental gingivitis (EG).

    MATERIALS AND METHODS: A total of nine T1DM patients and nine healthy controls of age and gender similar to the T1DM patients were monitored for 35 days during EG. Hygiene practices were stopped for 3 weeks, and GCF, SP, plaque index (PI) and gingival index were determined. IL-1beta, IL-8, MMP-8 and MMP-9 were quantified by enzyme-linked immunosorbent assay, and SP samples were assessed by DNA-DNA hybridization for a panel of 40 subgingival microbial species.

    RESULTS: IL-1beta levels in T1DM patients were elevated compared with healthy individuals, and showed differences between groups at 7-21 days while healthy patients showed IL-1beta increases from baseline to 14-21 days (p<0.05). Differences were observed in MMP-9 levels between patients with and without T1DM at 7-14 days (p<0.05). Orange complex species and PI measurements displayed a superior correlation with biomarker levels when compared with other complexes or clinical measurements during EG.

    CONCLUSIONS: The mean GCF biomarker levels for IL-1beta and MMP-8 were most significantly elevated in T1DM subjects compared with healthy individuals during EG, not resulting from differences in the mean PI or microbial composition.

  • 283.
    Salvi, Giovanni E
    et al.
    University of Berne, Berne, Switzerland.
    Fürst, Mirjam M
    University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    University of Berne, Berne, Switzerland.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    One-year bacterial colonization patterns of Staphylococcus aureus and other bacteria at implants and adjacent teeth.2008Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 19, nr 3, s. 242-248Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: (i) To assess the pattern of early bacterial colonization on titanium oral implants after installation, at 12 weeks and at 12 months, (ii) to compare the microbiota at submucosal implant sites and adjacent subgingival tooth sites and (iii) to assess whether or not early colonization was predictive of 12-month colonization patterns.

    MATERIAL AND METHODS: Submucosal/subgingival plaque samples from 17 titanium oral implants and adjacent teeth were analyzed by checkerboard DNA-DNA hybridization 30 min, 12 weeks and 12 months after implant installation.

    RESULTS: At 12 months, none of the inserted implants had been lost or presented with signs of peri-implantitis. The distribution of sites at implants and teeth with bleeding on probing varied between 2% and 11%. Probing pocket depths < or =3 mm were found at 75% of implant sites. At 12 months, the sum of the bacterial counts of 40 species was statistically significantly higher at tooth compared with implant sites (mean difference: 34.4 x 10(5), 95% confidence interval -0.4 to 69.4, P<0.05). At 12 months, higher individual bacterial counts at tooth sites were found for 7/40 species compared with implant sites. Detection or lack of detection of Staphylococcus aureus at implant sites at 12 weeks resulted in the highest positive (e.g. 80%) and negative (e.g. 90%) predictive values, respectively. Between 12 weeks and 12 months, the prevalence of Tannerella forsythia increased statistically significantly at implant sites (P<0.05). Lack of detection of Porphyromonas gingivalis at 12 weeks yielded a negative predictive value of 93.1% of this microorganism being undetectable at implant sites at 12 months.

    CONCLUSIONS: Within the limits of this study, the findings showed (i) a few differences in the prevalence of bacterial species between implant and adjacent tooth sites at 12 months and (ii) high positive and negative predictive values for selected bacterial species.

  • 284. Salvi, Giovanni E
    et al.
    Kandylaki, Maria
    Troendle, Amineh
    Persson, G. Rutger
    School of Dental Medicine, University of Berne.
    Lang, Niklaus P
    Experimental gingivitis in type 1 diabetics: a controlled clinical and microbiological study.2005Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, nr 3, s. 310-316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To monitor clinical and microbiological changes during experimental gingivitis in type 1 diabetics and non-diabetics.

    MATERIALS AND METHODS: Nine type 1 diabetics with good/moderate metabolic control and nine age-gender matched non-diabetics were recruited. Probing pocket depths in all subjects did not exceed 4 mm and none were affected by attachment loss. According to the original model, an experimental 3-week plaque accumulation resulting in experimental gingivitis development and a subsequent 2-week period of optimal plaque control were staged. Subgingival plaque samples were collected at days 0, 21 and 35 from one site per quadrant, pooled and analysed using checkerboard DNA-DNA hybridization.

    RESULTS: Diabetics (mean age 25.6+/-5.8 standard deviation (SD), range 16-35 years) had a mean HbA1c level of 8.1+/-0.7% (SD), while non-diabetics (mean age 24.8+/-5.7 (SD), range 15-36 years) were metabolically controlled (HbA1c< or =6.5%). Between Days 0, 21 and 35, no statistically significant differences in mean plaque and gingival index scores were observed between diabetics and non-diabetics. At days 7 and 21, however, diabetics showed statistically significantly higher percentages of sites with gingival index scores > or =2 compared with non-diabetics. Mean DNA probe counts of the red and orange complex species increased significantly (p<0.05) between days 0 and 21 and decreased significantly (p<0.05) between days 21 and 35 in both groups.

    CONCLUSION: Both diabetics and non-diabetics react to experimental plaque accumulation with gingival inflammation. Type 1 diabetics, however, develop an earlier and higher inflammatory response to a comparable bacterial challenge.

  • 285.
    Salvi, Giovanni E
    et al.
    School of Dental Medicine, University of Berne, Berne, Switzerland.
    Persson, G. Rutger
    School of Dental Medicine, University of Berne, Berne, Switzerland.
    Heitz-Mayfield, Lisa J A
    University of Western Australia, Perth, Australia.
    Frei, Marc
    School of Dental Medicine, University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    School of Dental Medicine, University of Berne, Berne, Switzerland.
    Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: clinical and radiographic outcomes.2007Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 18, nr 3, s. 281-285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis.

    MATERIAL AND METHODS: In 25 partially edentulous subjects, 31 implants diagnosed with peri-implantitis were treated. Three weeks after oral hygiene instruction, mechanical debridement and local antiseptic cleansing using 0.2% chlorhexidine gel, baseline (Day 0) parameters were recorded. Minocycline microspheres (Arestin) were locally delivered to each implant site with bone loss and a probing pocket depth (PPD) >or=5 mm. Rescue therapy with Arestin was allowed at Days 180 and 270 at any site exhibiting an increase in PPD>or=2 mm from the previous visit. The following clinical parameters were recorded at four sites/implant at Day 0, 10, 30, 60, 90, 180, 270 and 360: PPD, clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PlI).

    RESULTS: Six implants in six subjects were either rescued or exited because of persisting active peri-implantitis. Successful implants showed a statistically significant reduction in both PPD and percentage of sites with BOP between baseline and Day 360 (P<0.05). At mesial implant sites, the mean PPD reduction amounted to 1.6 mm (95% CI: 0.9-2.2 mm, P<0.001) and was accompanied by a statistically significant reduction of the BOP value (P<0.001). Binary regression analysis showed that the clinical parameters and smoking history could not discriminate between successfully treated and rescued or exited implants at any observation time point.

    CONCLUSION: Non-surgical mechanical treatment of peri-implantitis lesions with adjunctive local delivery of microencapsulated minocycline led to positive effects on clinical parameters up to 12 months.

  • 286. Sanai, Yasaman
    et al.
    Persson, G. Rutger
    University of Washington, Seattle, Washington, USA.
    Starr, Jacqueline R
    Luis, Henrique S
    Bernardo, Mario
    Leitao, Jorge
    Roberts, Marilyn C
    Presence and antibiotic resistance of Porphyromonas gingivalis, Prevotella intermedia, and Prevotella nigrescens in children.2002Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, nr 10, s. 929-934Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/AIMS: Only limited information exists about the prevalence in children of pathogens associated with periodontitis. The aim of the present study was to determine by culture whether 8-11-year-old children carry Porphyromonas gingivalis, Prevotella intermedia, and/or P. nigrescens in samples from the gingiva and/or the buccal mucosa taken before, and after caries treatment and oral hygiene instruction. A second aim was to assess the proportion of subjects who had gram-negative anaerobes carrying the tet(Q) and erm(F) genes, suggesting antibiotic resistance to tetracycline or erythromycin.

    METHOD: A total of 150 children provided gingival and buccal swab bacterial samples that were cultured for P. gingivalis, P. intermedia, and P. nigrescens. The species was verified using DNA-DNA hybridization with species-specific probes made from the variable region of the 16S rRNA sequences. Antibiotic-resistant genes, tet(Q) and erm(F), were identified using specific DNA-DNA hybridization with specific DNA probes.

    RESULTS: A total of 116 isolates of black-pigmented bacteria were cultured from 47 (31%) of 150 children. Five isolates were identified as P. gingivalis, 29 as P. intermedia, 33 as P. nigrescens, and 49 as other species. In general, the bacteria were not culturable at more than one time period. We found that 55% of these 47 children harbored black pigmented bacteria that carried either one or both of the two antibiotic-resistant genes studied (tet(Q), and erm(F)).

    CONCLUSION: The present study demonstrated that children not exposed to regular dental treatment carry bacteria outside the gingival sulcus that have been associated with periodontitis, and that standard treatment procedures may not clear the presence of the putative pathogens. In addition, antibiotic-resistant genes are common in identifiable gram-negative anaerobes, including putative pathogens.

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

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

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

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

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

  • 288.
    Schwarz, Frank
    et al.
    Tyskland.
    Becker, Kathrin
    Tyskland.
    Bastendorf, Klaus-Dieter
    Cardaropoli, Daniele
    Italien.
    Chatfield, Christina
    Storbritannien.
    Dunn, Ian
    Storbritannien.
    Fletcher, Paul
    USA.
    Einwag, Johannes
    Tyskland.
    Louropoulou, Anna
    Nederländerna.
    Mombelli, Andrea
    Schweiz.
    Ower, Philip
    Schweiz.
    Pavlovic, Pedja
    Sahrmann, Philipp
    Salvi, Giovanni E.
    Schweiz.
    Schmage, Petra
    Tyskland.
    Takeuchi, Yasuko
    Van Der Weijden, Fridus
    Nederländerna.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis2016Ingår i: Quintessence International, ISSN 0033-6572, Vol. 47, nr 4, s. 293-296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 289.
    Schwarz, Frank
    et al.
    Tyskland.
    Becker, Kathrin
    Tyskland.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och Folkhälsovetenskap.
    Efficacy of air polishing for the non-surgical treatment of peri-implant diseases: a systematic review2015Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 10, s. 951-959Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

  • 290.
    Sehovic, Amela
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Saado, Mona
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Erosionsskador hos barn och ungdomar2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Aim: The aim of this study was to examine and explain the various methods available to rate the erosion damage, and on which teeth and tooth surfaces of erosion damage mostly occurs in children and adolescents.

    Method: A literature review was conducted, based on 15 scientific articles that have been reviewed, evaluated and analyzed. Articles were searched for in the database PubMed.

    Result: Six of the articles used the TWI (tooth wear index), which is an index to diagnose the tooth wear in the primary and permanent dentition. Eight articles used other indices as they considered that the TWI was not sufficiently developed to register the degree of tooth wear on some teeth. Tooth wear in the primary dentition occurs most often in the canines and incisors. Tooth wear in the permanent dentition was found in the literature to be mostly occurring on the occlusal / incisal surfaces of all teeth and tooth surfaces.Lyssna

    Conclusion: There is no common index in the articles but many of them use the TWI. It may therefore be beneficial for the future to development a common index that can be useful for all age groups and categories in order to diagnose the tooth wear.

  • 291.
    Sims, Tom J
    et al.
    University of Washington, Seattle WA.
    Lernmark, Ake
    University of Washington, Seattle WA.
    Mancl, Lloyd A
    University of Washington, Seattle WA.
    Schifferle, Robert E
    Department of Periodontics and EndodonticsSUNY at Buffalo, NY.
    Page, Roy C
    University of Washington, Seattle WA.
    Persson, G. Rutger
    University of Washington, Seattle WA.
    Serum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitis.2002Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, nr 6, s. 551-562Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species-specific antigens of Porphyromonas gingivalis or to cross-reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin-dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings: 1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients. We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis-specific antigens may be useful in assessing risk for refractory periodontitis in such patients.

    AIM: To determine whether PDC resulting from non-surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalis-specific antigens, human HSP, and GAD65.

    METHODS: PDC was assessed two months after non-surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme-linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent-onset IDDM patients and 46 non-diabetic controls.

    RESULTS: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non-diabetic controls for GAD65 Ab + (p degrees = 0.002) and GAD65 Ab- (p = 0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log-transformed titers to HSP90 (r = - 0.62, p = 0.008), HSP70 (r = + 0.62, p = 0.009), GAD65 (r = - 0.60, p = 0.01) and P. gingivalis LPS (r = - 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log-transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann-Whitney).

    CONCLUSION: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non-surgical periodontal therapy.

  • 292. Sjögren, P.
    et al.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Medline search validity for randomised controlled trials in different areas of dental research2002Ingår i: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 192, nr 2, s. 97-99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To determine the validity of Medline searches for randomised controlled trials in dental research (RCT-Ds), using the medical subject headings (MeSH-terms). DESIGN: The Medline database was searched for randomised controlled trials in dental research (RCT-Ds) published in 1999 and with MeSH-terms corresponding to different areas of dental research. All RCT-Ds were manually examined for relevance to the different areas of dental research and cross-tabulated against the Medline search results. The sensitivity, specificity, positive (precision) and negative predictive values, as well as the accuracy of the search results were calculated. RESULTS: The highest validity in the Medline searches for RCT-Ds was seen for endodontics, followed by orthodontics, whereas the lowest validity was seen for pediatric dentistry and public health dentistry. For pediatric dentistry the MeSH-term searches had too low a sensitivity for adequate location of RCT-Ds. CONCLUSIONS: MeSH-term searches on Medline are a useful tool for rapid location of RCT-Ds in most areas of dental research. However, there is a vast variation in the search validity. More refined search strategies are required to locate RCT-Ds in areas of dental research with low search validity.

  • 293. Sjögren, P.
    et al.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Quality of reporting randomised clinical trials in dental and medical research2002Ingår i: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 192, nr 2, s. 100-103Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess 1) the quality of reporting randomised clinical trials in dental (RCT-Ds) and medical research (RCT-Ms), 2) the quality of RCT reports in relation to the journal impact factor, 3) the source of funding, and 4) the quality of RCT-Ds in different areas of dental research. DESIGN RANDOM: samples of 100 RCT-Ds and 100 RCT-Ms published in 1999 were evaluated for quality of reporting under blinded conditions with the Jadad quality assessment scale. In addition, correlation between the quality scores and journal impact factor or source of funding, as well as area of dental research were analysed. RESULTS: The quality of RCT-Ds and RCT-Ms published in 1999 was generally inadequate. The quality was largely equivalent in RCT-Ds and RCT-Ms. There was no correlation between the quality scores and the journal impact factor or the source of funding. Some differences were found in the quality scores between different areas of dental research. CONCLUSIONS: The results from these RCT-Ds and RCT-Ms show that most of them were imperfect in the reporting of methodology and trial conduct. There is a clear need to improve the quality of trial reporting in dental and medical research.

  • 294.
    Sjögren, Petteri
    et al.
    Public Dental Services Varberg.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Reliability methodology in caries epidemiological studies conducted in the Nordic countries between 1990 and 20012007Ingår i: Community Dental Health, ISSN 0265-539X, Vol. 24, nr 2, s. 97-104Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To describe and analyse the reporting of methodology relating to reliability in caries epidemiological studies conducted in the Nordic countries between 1990 and 2001. Basic research design. Basic research design Literature searches were conducted in the Medline database, and reference lists of all obtained publications were scrutinised for additional studies. Publications fulfilling the inclusion criteria were assessed for study design, and methodological aspects relating to reliability were assessed according to recommendations for evidence-based medicine (EBM). The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence was evaluated. Main outcome measures Reporting of predetermined methodological items relating to reliability and the frequency of endorsement of the assessed items were of primary interest. Results Initially, 724 publications were located in the literature searches. Of 133 eligible publications obtained, 32 fulfilled the inclusion criteria and remained throughout the analyses. The majority of the studies reported the reliability methodology, which was generally inadequate. The frequencies of endorsement ranged from 0% to 69 %. All publications contributed to a low strength of evidence. In this context, it was proposed that prospective longitudinal studies with a random sample selection be classified as type-2 (2b) level of evidence. Conclusion There seems to be a need to improve the reporting and the methodology relating to reliability in caries epidemiological publications. Reporting of random sample selection and at least two of the items assessed seems to discriminate between high and low quality with respect to the reported methodology relating to reliability.

  • 295.
    Sofrata, Abier H.
    et al.
    Periodontology Department, Institute of Odontology, Karolinska Institute.
    Claesson, Rolf L.K.
    Division of Oral Microbiology, Department of Odontology, Umeå University.
    Lingström, Peter K.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Gustafsson, Anders K.
    Periodontology Department, Institute of Odontology, Karolinska Institute.
    Strong antibacterial effect of miswak against oral microorganisms associated with periodontitis and caries2008Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, nr 8, s. 1474-1479Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The chewing stick (miswak) is used for oral hygiene in many parts of the world. In addition to the mechanical removal of plaque, an antibacterial effect has been postulated; however, tests of miswak extract from Salvadora persica (Arak) disclosed only low to moderate antibacterial effects. This may be attributable to the extraction process. Our aim was to test in vitro the antibacterial effect of miswak pieces, without extraction, on bacteria implicated in the etiology of periodontitis and caries. METHODS: Miswak pieces were standardized by size and weight (0.07 and 0.14 g) and tested against Streptococcus mutans, Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and, as a reference, Haemophilus influenzae. The miswak pieces were tested in two ways: embedded in the agar plate or suspended above the agar plate. RESULTS: The inhibitory effect was most pronounced on P. gingivalis, A. actinomycetemcomitans, and H. influenzae, less on S. mutans, and least on L. acidophilus. Suspended miswak had comparable or stronger effects than miswak embedded in agar. The 0.14-g suspended miswak exhibited significantly greater inhibition on A. actinomycetemcomitans and H. influenzae than the 0.14-g miswak embedded in agar (P<0.01 and P<0.001, respectively). CONCLUSIONS: Miswak embedded in agar or suspended above the agar plate had strong antibacterial effects against all bacteria tested. The antibacterial effect of suspended miswak pieces suggests the presence of volatile active antibacterial compounds.

  • 296.
    Sofrata, Abier
    et al.
    Institute of Odontology, Karolinska Institutet.
    Lingström, Peter
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Baljoon, M.
    Institute of Odontology, Karolinska Institutet.
    Gustafsson, A.
    Institute of Odontology, Karolinska Institutet.
    The effect of miswak extract on plaque pH: an in vivo study2007Ingår i: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 41, nr 6, s. 451-454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to document changes in plaque pH when an acidic challenge was followed by rinsing with miswak extract (Salvadora persica), and to evaluate the effect of miswak rinse on parotid gland secretion rate. Plaque pH was measured in 3-day-old plaque using the microtouch electrode. Rinsing with miswak extract, compared with water rinsing, resulted in protracted elevation of plaque pH (> 6.0). The difference in plaque pH between miswak extract and water rinse was statistically significant at 30 min (p < 0.001). Rinsing with miswak extract stimulated parotid gland secretion (p < 0.01). In conclusion, miswak extract raised the plaque pH, suggesting a potential role in caries prevention.

  • 297. Stenport, Victoria Franke
    et al.
    Roos-Jansåker, Ann-Marie
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Kuboki, Yoshinori
    Irwin, Chris
    Albrektsson, Tomas
    Claffey, Noel
    Failure to induce supracrestal bone growth between and around partially inserted titanium implants using bone morphogenetic protein (BMP): an experimental study in dogs2003Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 14, nr 2, s. 219-225Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 298.
    Sturesson, Annika
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Håkansson, Sara
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Oral hygiene experience, knowledge of oral health and oral diseases and attitudes about oral health care: A questionnaire study among students of nursing in Zambia2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med studien var att undersöka sjuksköterskestudenters munhygienvanor, deras kunskaper om oral hälsa och orala sjukdomar samt attityder till munhälsovård. Ett frågeformulär med 29 frågor delades ut till 119 andra- och tredje års studenter på sjuksköterskeskolan i Livingstone, Zambia. Respondenterna var både kvinnor och män mellan 20 och 43 år. Resultatet visade att flertalet studenter borstade sina tänder dagligen. Däremot var det ovanligt med täta tandvårdsbesök och den vanligaste orsaken till besök var smärta. Majoriteten av studenterna hade goda kunskaper om HIV-relaterade orala lesioner och det vanligaste svaret de uppgav var oral candida. De generella kunskaperna om HIV/AIDS- relaterade orala lesioner var väldigt goda och majoriteten av respondenterna var intresserade av mer information i ämnet. Generellt hade respondenterna goda kunskaper om oral hälsa, orala sjukdomar och majoriteten hade en positiv attityd till munhälsovård. Flertalet ansåg att ett samarbete mellan tand- och sjukvård var betydelsefullt. Trots den höga kunskapsnivån om oral hälsa visar resultatet att respondenterna inte besöker tandvården regelbundet.

  • 299. Ståhlnacke, Katri
    et al.
    Söderfeldt, Björn
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Unell, Lennart
    Axtelius, Björn
    Tillfedsställelse angående tandvård och tandvårdsbesök i en svensk ålderskohort född 19422005Ingår i: Tandhygienisttidningen. 25(3), 2005, Vol. 25, s. 61-Konferensbidrag (Övrigt vetenskapligt)
  • 300.
    Ståhlnacke, Katri
    et al.
    Örebro County Council.
    Söderfeldt, Björn
    Department of Oral Public Healt, Malmö University.
    Unell, Lennart
    Örebro County Council.
    Halling, Arne
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Axtelius, Björn
    Department of Oral Public Healt, Malmö University.
    Patient satisfaction with dental care in one Swedish age cohort: part 1 - descriptions and dimensions2007Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 31, nr 2, s. 103-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study were to investigate the dimensionality of satisfaction with dental care, to control the reproducibility of the analysis over time, to investigate changes between the two studied years and to relate satisfaction with elapsed time since the most recent visit to dental care. All persons born in 1942 in two counties in Sweden, Orebro and Ostergotland, were surveyed by post in 1992 at the age of 50 and resurveyed at the age of 55. There were 5363 persons responding at both times, constituting the study group. In this study, opinions are analysed about general satisfaction with dental care and about the most recent dental visit. Factor analysis, one-way ANOVA and contingency tables were used. Overall satisfaction was high both as to general satisfaction and as to the most recent dental care visit. Those with their most recent dental visit more than a year ago felt more pain, anxiety and unpleasantness and were also more generally dissatisfied. Of those having experiences of pain, anxiety and unpleasantness at most recent visit, there was an overrepresentation of non regular attenders. Factor analysis showed that the questions used revealed a stable pattern. In conclusion, the overall satisfaction with dental care was high. Differences between the two studied years were small. Persons not visiting dental care within the last year were more dissatisfied both generally and with the most recent visit. A greater number of regular attenders had no feelings of anxiety, pain or unpleasantness at all.

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