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  • 51.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och Folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Halitosis (Dålig andedräkt)2016Other (Other academic)
  • 52.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Aghazadeh, Ahmad
    Uppsala Käkkirurgiska Centrum.
    Hallström, Hadar
    Hospital of Halland, Halmstad.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Factors related to peri-implantitis: a retrospective study2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 4, p. 522-529Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 53.
    Renvert, Stefan
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. Irland, Blekinge Institute of Technology, Hong Kong.
    Hirooka, Hideaki
    Japan.
    Polyzois, Ioannis
    Irland.
    Kelekis-Cholakis, Anastasia
    Canada.
    Wang, Hom-Lay
    USA.
    Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants: consensus report of working group 32019In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 69 Suppl 2, p. 12-17Article in journal (Refereed)
    Abstract [en]

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

  • 54.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Lessem, Jan
    Lindahl, Christel
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Svensson, Mari
    Treatment of incipient peri-implant infections using topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement2004In: Journal of the International Academy of Periodontology, ISSN 1466-2094, Vol. 6, no 4 Suppl, p. 154-159Article in journal (Refereed)
    Abstract [en]

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

  • 55.
    Renvert, Stefan
    et al.
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Lindahl, Christel
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Persson, Rutger G
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Occurrence of cases with peri-implant mucositis or peri-implantitis in a 21-26 years follow-up study2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 2, p. 233-240Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 56.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, G. Rutger
    USA.
    Treatment of periodontal disease in older adults2016In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 72, no 1, p. 108-119Article in journal (Refereed)
    Abstract [en]

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

  • 57.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, Rigmor E
    Departments of Oral Medicine and Periodontics, School of Dentistry, University of Washington, Seattle.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Tooth loss and periodontitis in older individuals: results from the Swedish national study on aging and care2013In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 84, no 8, p. 1134-1144Article in journal (Refereed)
    Abstract [en]

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

  • 58.
    Renvert, Stefan
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. Blekinge Institute of Technology.
    Persson, Rutger G
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. USA.
    Pirih, Flavia Q
    USA.
    Camargo, Paulo M
    USA.
    Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45 Suppl 20, p. 278-285Article in journal (Refereed)
    Abstract [en]

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

  • 59.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Polyzois, Ioannis
    Dublin Dental University Hospital.
    Risk indicators for peri-implant mucositis: a systematic literature review2015In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, no 16, p. 172-186Article, review/survey (Refereed)
    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.

  • 60.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Polyzois, Ioannis
    Irland.
    Treatment of pathologic peri-implant pockets2018In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 76, no 1, p. 180-190Article in journal (Refereed)
    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.

  • 61.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, 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-implantitis2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no Suppl. 1, p. 84-94Article, review/survey (Refereed)
    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.

  • 62.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Polyzois, Ioannis N
    Clinical approaches to treat peri-implant mucositis and peri-implantitis.2015In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 68, no 1, p. 369-404Article in journal (Refereed)
    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.

  • 63.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Polyzois, Ioannis
    Trinity College Dublin.
    Persson, G. Rutger
    University of Washington.
    Treatment modalities for peri-implant mucositis and peri-implantitis2013In: American Journal of Dentistry, ISSN 0894-8275, Vol. 26, no 6, p. 313-318Article in journal (Refereed)
    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.

  • 64.
    Renvert, Stefan
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Roos-Jansåker, Ann-Marie
    Kristianstad Public Dental Services.
    Persson, Rutger G
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute: a randomized clinical trial2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 10, p. 1266-1274Article in journal (Refereed)
    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.

  • 65.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Wallin-Bengtsson, Viveca
    Public Dental Health Services, Kristianstad.
    Berglund, Johan
    Blekinge Institute of Technology.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Periodontitis in older Swedish individuals fails to predict mortality2015In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, no 2, p. 193-200Article in journal (Refereed)
    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.

  • 66.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life. Blekinge Institute of Technology, Karlskrona.
    Widén, Cecilia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life. Department of Periodontics, University of Washington, Seattle.
    Cytokine expression in peri-implant crevicular fluid in relation to bacterial presence2015In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, no 7, p. 697-702Article in journal (Refereed)
    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.

  • 67.
    Renvert, Stefan
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Blekinge Institute of Techology, Dublin Dental University Hospital, Dublin.
    Widén, Cecilia
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, Rutger G.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Cytokine and microbial profiles in relation to the clinical outcome following treatment of peri-implantitis2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 9, p. 1127-1132Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 68. Riben-Grundstrom, C
    et al.
    Norderyd, O
    André, U
    Renvert, Stefan
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Blekinge tekniska högskolan .
    Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial2015In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, no 5, p. 462-469Article in journal (Refereed)
    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.

  • 69.
    Roos-Jansåker, Ann-Marie
    et al.
    Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Lindahl, Christel
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a 5-year follow up2014In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, no 11, p. 1108-1114Article in journal (Refereed)
    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.

  • 70. 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
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, 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 4.2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no Suppl 12, p. 202-6Article in journal (Refereed)
    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.

  • 71.
    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
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis2016In: Quintessence International, ISSN 0033-6572, Vol. 47, no 4, p. 293-296Article in journal (Refereed)
    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.

  • 72.
    Svard, Anna
    et al.
    Uppsala University.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Berglund, Johan
    Blekinge Inst Technology.
    Soderlin, Maria
    Lund University.
    Peridontitis and saliva antibodies to citrullinated peptides in rheumatoid arthtritis2019In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, p. 1530-1530Article in journal (Other academic)
  • 73.
    Särner, Barbro
    et al.
    University of Gothenburg.
    Birkhed, Dowen
    University of Gothenburg.
    Andersson, Pia
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Lingström, Peter
    University of Gothenburg.
    Recommendations by dental staff and use of toothpicks, dental floss and interdental brushes for approximal cleaning in an adult Swedish population2010In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 8, no 2, p. 185-194Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the present study was to evaluate the recommendations relating to the use of approximal cleaning aids given by dental hygienists and dentists, the self-care practices in a Swedish population and the ability to remove dental plaque. Materials and Methods: A structured questionnaire was randomly distributed to 500 dental hygienists and 500 dentists and a similar questionnaire was distributed to 1000 randomly selected individuals, divided equally into the following age groups: 15 to 20, 21 to 40, 41 to 60 and > 60 years. A clinical examination evaluating the ability to remove approximal dental plaque was also carried out in a total of 60 regular users of approximal cleaning aids. Plaque was scored before and after cleaning with a toothpick, dental floss or an interdental brush. Results: The response rate was 82%, 79% and 68% for the three groups. The results reveal that dental hygienists give more detailed information about a majority of the aspects that are related to the use of approximal cleaning aids compared with dentists (P < 0.01 or P < 0.001). The majority of the dental staff give recommendations to children and adolescents firstly to prevent dental caries and to older individuals to improve periodontal health. The use of different approximal cleaning aids on a daily basis varied with respect to age group (2% to 42%); dental floss dominated in the younger age groups and interdental brushes in the two oldest groups. In the clinical study, the largest plaque reduction was produced by the interdental brush (83%), followed by toothpicks (74%) and dental floss (73%). Conclusions: The present study indicated the importance of individual recommendations related to the use of approximal cleaning aids

  • 74.
    Tonetti, Maurizio S
    et al.
    Kina.
    Bottenberg, Peter
    Belgien.
    Conrads, Georg
    Tyskland.
    Eickholz, Peter
    Tyskland.
    Heasman, Peter
    Storbritannien.
    Huysmans, Marie-Charlotte
    Nederländerna.
    López, Rodrigo
    Danmark.
    Madianos, Phoebus
    Grekland.
    Müller, Frauke
    Schweiz.
    Needleman, Ian
    Storbritannien.
    Nyvad, Bente
    Danmark.
    Preshaw, Philip M.
    Storbritannien.
    Pretty, Iain
    Storbritannien.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Schwendicke, Falk
    Tyskland.
    Trombelli, Leonardo
    Italien.
    van der Putten, Gert-Jan
    Nederländerna.
    Vanobbergen, Jacques
    Belgien.
    West, Nicola
    Storbritannien.
    Young, Alix
    Norge.
    Paris, Sebastian
    Tyskland.
    Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no Suppl. 18, p. S135-S144Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 75. Tonetti, Maurizio S
    et al.
    Jepsen, Søren
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology2014In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41 Suppl 15, p. S36-43Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 76. Tonetti, Maurizio S
    et al.
    Van Dyke, Thomas E
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases.2013In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 40 Suppl 14, p. S24-9Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 77.
    Wallin Bengtsson, Viveca
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Berglund, Johan
    Institute of Technology, Karlskrona.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    A cross-sectional study of the associations between periodontitis and carotid arterial calcifications in an elderly population2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, p. 115-120Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 78.
    Wallin Bengtsson, Viveca
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Assessment of carotid calcifications on panoramic radiographs in relation to other used methods and relationship to periodontitis and stroke: a literature review2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 6, p. 401-412Article, review/survey (Refereed)
    Abstract [en]

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

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

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

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

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

  • 79.
    Wallin Bengtsson, Viveca
    et al.
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Persson, Rutger G
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. USA.
    Berglund, Johan
    Institute of Technology.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a long-term follow-up study2019In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 23, no 3, p. 1171-1179Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years.

    MATERIALS AND METHODS: Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014.

    RESULTS: Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001).

    CONCLUSIONS: Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals.

    CLINICAL RELEVANCE: Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination.

  • 80.
    Wallin Bengtsson, Viveka
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Periodontitis, carotid calcifications and future cardiovascular diseases in older individuals2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background. Periodontitis is a chronic inflammatory disease with a microbiological etiology affecting the supporting tissues of the tooth. The disease affects approximately 50% of the adult population. The prevalence of periodontitis increases with age. The complex bacterial infection, as well as an exaggerated host inflammatory reaction, may trigger subclinical atherosclerosis. Aims. The overall aim of the present thesis was to study the associations between periodontitis, cardiovascular diseases and mortality. The specific aims were: I) to evaluate the use and value of panoramic radiographs in assessing carotid calcifications in relation to other used methods (gold standards) and to assess the literature on carotid calcifications defined from panoramic radiographs and concurrent diagnosis of stroke and periodontitis, II) to evaluate if periodontitis is associated with the presence of carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population, III) to assess if carotid calcifications detected on panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10–13 years in individuals between 60 and 96 years, IV) to assess if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases or are at higher risk of death over a period of 17 years. Methods: A literature review based on peer-reviewed studies was performed evaluating the use of panoramic radiographs in assessing carotid calcifications compared to other methods. In study II, III, IV older individuals, 60 years and older participating in the Swedish National Study of Aging and Care (SNAC) were included in the studies. A dental hygienist performed a dental clinical and radiographic examination. Probing depths (PD) and bleeding on probing (BOP) was registered. From radiographic panoramic images, the distances between the alveolar bone level and the cement enamel junction (CEJ) were measured. In study II, a diagnosis of periodontitis was declared, using a composite definition; if a distance between the alveolar bone level and the CEJ ≥5 mm on panoramic radiographs at >10% of sites and PD ≥5 mm at one or more teeth and with BOP >20% of teeth. In study IV, an indicator of a history of periodontal disease was declared if a distance between the alveolar bone level and the CEJ ≥5 mm on panoramic radiographs at ≥30% of sites. Evidence of a radiopaque nodular mass in the intervertebral space at or below the vertebrae C3-C4 was identified as carotid calcification. In addition, a medical research team performed the medical examinations, and a medical doctor (JB) reviewed all medical records for information about events of stroke and ischemic heart diseases. Stroke and ischemic heart diseases were registered according to the ICD 10 codes: ICD 60-69 for stroke and ICD: 20-25 for ischemic heart diseases. Study I was a review of the literature, in study II, a cross-sectional study design was employed. In studies III and IV, a longitudinal prospective study design was used. Results: On the use of panoramic radiographs in assessing carotid calcifications in relation to other used methods, the sensitivity and specificity varied between studies published. Furthermore, only a small number of studies were found concerning carotid calcifications and stroke. These studies were primarily retrospective. Four studies were found on the association between periodontitis and carotid calcification. Study II identified that older individuals with periodontitis had a significantly higher prevalence of carotid calcifications than individuals who did not have a diagnosis of periodontitis. In study III, a significant association was found between carotid calcifications on panoramic radiographs and 13- year incidence of stroke using a logistic regression analysis adjusted for confounders (BMI, diabetes type 2, hypertension) in the 60-72 years. A statistically significant crude association between radiographic evidence of carotid calcifications and incidence of ischemic heart diseases was found in individuals between 60-72 years. Such an association was, however, not identified among individuals older than 72 years. In study IV, Cox regression analysis was used, adjusted for confounders (age group, BMI >30, diabetes type 2, gender, hypertension, history of AMI, history of stroke, periodontitis, smoking) and with a definition of periodontitis as having a distance between the alveolar bone level and the CEJ ≥5 mm in panoramic radiographs at ≥ 30% of sites. Periodontitis increased the risk for ischemic heart diseases in all individuals, in women and in the 78-96 years age group (OO). Associations between periodontitis, and mortality were found in all individuals, in men and in the 60-72 years age group (YO) in the long term follow-up. Conclusions: 1. 1. Study I identified that there are studies which have assessed the value of panoramic radiographs in relation to other used methods (gold standards). The sensitivity and the specificity varied, with the specificity being more often higher. Few studies have considered the relationship between radiographic evidence of carotid calcifications and stroke. Four studies identified a relationship between a diagnosis of periodontitis and carotid calcifications on panoramic radiographs. 2. Study II identified a significant association between periodontitis and carotid calcification in individuals 60-96 years. 3. Study III identified that signs of carotid calcifications assessed from panoramic radiographs from the 60-96-year-old individuals were consistent with an incident of stroke and/or ischemic heart diseases over 13 years follow-up. 4. Study IV identified that periodontitis was associated with future ischemic heart diseases in all individuals, in women and in the 78- 96 years age group. Periodontitis was associated with mortality in all indviduals, in men and in the 60-72 years age group.

  • 81.
    Wang, Chin-Wei
    et al.
    USA.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Wang, Hom-Lay,
    USA.
    Nonsurgical treatment of periimplantitis2019In: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 28, no 2, p. 155-160Article in journal (Refereed)
    Abstract [en]

    Purpose: Periimplantitis has become an emerging challenge faced by practicing dentists worldwide. When treating periimplantitis, we should attempt to manage this problem via nonsurgical therapies that include addressing all modifiable systemic risk factors and local contributing factors. Hence, the aim of this narrative review was to examine published studies on nonsurgical treatment of periimplantitis and evaluate their effectiveness and limitations.

    Materials and Methods: A literature search was performed in MEDLINE via PubMed database up to December 31, 2017. Current published clinical approaches focused on mechanical debridement, adjunctive antiseptictherapy, adjunctive antibiotic therapy, laser-assisted therapy, and combination approaches were included in this analysis.

    Results: Nonsurgical therapy of periimplantitis may result in complete healing of the disease and the patient is then placed on a supportive maintenance program. If the disease is not resolved and surgical intervention is not an option, active nonsurgical retreatment may be considered. In many cases where disease is not resolved, surgical therapy or implant removal could be considered.

    Conclusions: Nonsurgical treatment of periimplantitis usually provides clinical improvements in reducing bleeding tendency and in some cases pocket reduction. Early diagnosis, detection, and intervention remain the key for managing periimplantitis.

  • 82.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Research Platform for Collaboration for Health.
    Att äta och dricka2017In: Omvårdnad & äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, p. 253-271Chapter in book (Other academic)
  • 83.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Coleman, M.D.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Rumpunen, K.
    Protection of human erythrocytes against oxidative stress by berries2012In: Journal of Berry Research, ISSN 1878-5093, E-ISSN 1878-5123, Vol. 2, no 3Article in journal (Refereed)
    Abstract [en]

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

  • 84.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Critén, Sladjana
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, Rutger G
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Measuring inflammatory markers in saliva in polyphenols research2016In: 29th International Horticultural Congress on Horticulture: Sustaining Lives, Livelihoods and Landscapes (IHC) / [ed] Finn, CE & Mezzetti, B, 2016, p. 201-206Conference paper (Refereed)
    Abstract [en]

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

  • 85.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Critén, Sladjana
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Persson, Rutger G
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Measuring inflammatory markers in saliva inpolyphenols research2016Conference paper (Refereed)
    Abstract [en]

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

  • 86.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Ekholm, A.
    Department of Plant Breeding and Biotechnology Balsgård, Swedish University of Agricultural Sciences, Kristianstad.
    Coleman, M.D.
    School of Life and Health Sciences, Aston University, Birmingham.
    Renvert, Stefan
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Rumpunen, K.
    Department of Plant Breeding and Biotechnology Balsgård, Swedish University of Agricultural Sciences, Kristianstad.
    Erythrocyte antioxidant protection of rose hips (Rosa spp.)2012In: Oxidative Medicine and Cellular Longevity, ISSN 1942-0900, p. 621579-Article in journal (Refereed)
    Abstract [en]

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

  • 87.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Erovic Ademovski, Seida
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Karlgren-Andersson, Pernilla
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Sättlin, Susanna
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Wallin Bengtsson, Viveka
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Hälsoklinik på Tandhygienistprogrammet2017In: Högskolepedagogisk debatt, ISSN 2000-9216, no 2, p. 29-34Article in journal (Other (popular science, discussion, etc.))
  • 88.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Holmer, Helene
    Kristianstad Central Hospital, Kristianstad.
    Coleman, Michael
    England.
    Tudor, Marian
    Kristianstad Central Hospital, Kristianstad.
    Ohlsson, Ola
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Sättlin, Susanna
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Persson, G Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Systemic inflammatory impact of periodontitis on acute coronary syndrome2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 9, p. 713-719Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 89.
    Widén, Cecilia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen Oral hälsa.
    Antibacterial activity of berry juices, an in vitro study2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 7, p. 539-543Article in journal (Refereed)
    Abstract [en]

    Objective

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

    Materials and methods

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

    Results

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

    Conclusions

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

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