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  • 51.
    Persson, G. Rutger
    et al.
    University of Washington, Seattle, WA, USA.
    Persson, R E
    University of Washington, Seattle, WA, USA.
    MacEntee, C I
    University of British Columbia, Vancouver, BC, Canada.
    Wyatt, C C I I
    University of British Columbia, Vancouver, BC, Canada.
    Hollender, L G
    University of Washington, Seattle, WA, USA.
    Kiyak, H A
    University of Washington, Seattle, WA, USA.
    Periodontitis and perceived risk for periodontitis in elders with evidence of depression.2003Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 8, s. 691-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 52.
    Persson, G. Rutger
    et al.
    Department of Periodontics, University of Washington, Seattle, WA.
    Persson, Rigmor E
    Department of Oral Medicine, University of Washington.
    Hollender, Lars G
    Department of Oral Medicine, University of Washington.
    Kiyak, H Asuman
    Department of Oral and Maxillofacial Surgery, University of Washington.
    The impact of ethnicity, gender, and marital status on periodontal and systemic health of older subjects in the Trials to Enhance Elders' Teeth and Oral Health (TEETH).2004Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 75, nr 6, s. 817-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 53.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Persson, Rigmor Elisabeth
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Cardiovascular disease and periodontitis: an update on the associations and risk2008Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, nr 8 Suppl, s. 362-379Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 54.
    Persson, G. Rutger
    et al.
    University of Bern.
    Pettersson, T.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Periodontitis a future risk for acute coronary syndrome?: a follow up study over 3 years2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 33-33Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 55.
    Persson, G. Rutger
    et al.
    Departments of Periodontics and Oral Medicine, University of Washington, Seattle, WA, USA & Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Pettersson, Thomas
    Department of Medicine, Kristianstad Central Hospital, Kristianstad, Sweden.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Department of Medicine, Kristianstad Central Hospital, Kristianstad, Sweden.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    High-sensitivity serum C-reactive protein levels in subjects with or without myocardial infarction or periodontitis.2005Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, nr 3, s. 219-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 56.
    Persson, G. Rutger
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Cluster of bacteria associated with peri-implantitis2014Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 16, nr 6, s. 783-793Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 57.
    Persson, G. Rutger
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Roos-Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Microbiologic results after non-surgical erbium-doped yttrium, aluminum, and garnet laser or air-abrasive treatment of peri-implantitis2011Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 82, nr 9, s. 1267-1278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 58.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Salvi, Giovanni E
    University of Berne, Berne, Switzerland.
    Heitz-Mayfield, Lisa J A
    University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    University of Berne, Berne, Switzerland.
    Antimicrobial therapy using a local drug delivery system (Arestin) in the treatment of peri-implantitis. I: Microbiological outcomes2006Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 17, nr 4, s. 386-393Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 59.
    Persson, G. Rutger
    et al.
    Department of Periodontology, Clinical Dental Research Center, School of Dental Medicine, University of Bern.
    Samuelsson, Emelie
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Mechanical non-surgical treatment of peri-implantitis: a single-blinded randomized longitudinal clinical study. II. Microbiological results2010Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, nr 6, s. 563-573Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 60.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA & University of Washington.
    Weibel, Marianne
    University of Bern, Bern, Switzerland.
    Hirschi, Regula
    University of Bern, Bern, Switzerland.
    Katsoulis, Joannis
    University of Bern.
    Similarities in the subgingival microbiota assessed by a curet sampling method at sites with chronic periodontitis.2008Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, nr 12, s. 2290-2296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 61.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Yeates, Justin
    Persson, Rigmor E
    Hirschi-Imfeld, Regula
    Weibel, Marianne
    Kiyak, H Asuman
    The impact of a low-frequency chlorhexidine rinsing schedule on the subgingival microbiota (the TEETH clinical trial).2007Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 78, nr 9, s. 1751-1758Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 62.
    Persson, G.Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    The significance of periodontal inflammation on systemic health in old age2012Ingår i: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 29, nr 3, s. 169-170Artikel i tidskrift (Övrigt vetenskapligt)
  • 63.
    Persson, Rigmor E
    et al.
    University of Washington, Seattle, WA, USA.
    Hollender, L G
    University of Washington, Seattle, WA, USA.
    MacEntee, M I
    University of British Columbia. Vancouver B.C., Canada.
    Wyatt, C C L
    University of British Columbia. Vancouver B.C., Canada.
    Kiyak, H A
    University of Washington, Seattle, WA, USA.
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA.
    Assessment of periodontal conditions and systemic disease in older subjects.: Focus on diabetes mellitus2003Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 3, s. 207-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 64. Persson, Rigmor E
    et al.
    Hollender, L G
    Powell, L V
    MacEntee, M I
    Wyatt, C C L
    Kiyak, H A
    Persson, G. Rutger
    University of Washington.
    Assessment of periodontal conditions and systemic disease in older subjects. I. Focus on osteoporosis.2002Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, nr 9, s. 796-802Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 65.
    Persson, Rigmor E
    et al.
    University of Washington, Seattle, WA, USA,.
    Hollender, L G
    University of Washington, Seattle, WA, USA,.
    Powell, V L
    Private practice Ukia, CA, USA.
    MacEntee, M
    University of British Columbia, Vancouver B.C., Canada.
    Wyatt, C C L
    University of British Columbia, Vancouver B.C., Canada.
    Kiyak, H A
    University of Washington, Seattle, WA, USA,.
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA,.
    Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases.2002Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, nr 9, s. 803-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 66. Persson, Rigmor E
    et al.
    Kiyak, Asuman H
    Wyatt, Chris C I
    Macentee, Michael
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA & University of Berne, Berne, Switzerland.
    Smoking, a weak predictor of periodontitis in older adults.2005Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, nr 5, s. 512-517Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 67. Pradhan-Palikhe, Pratikshya
    et al.
    Mäntylä, Päivi
    Paju, Susanna
    Buhlin, Kåre
    Persson, G. Rutger
    University of Washington, Seattle, WA & University of Bern, Bern, Switzerland.
    Nieminen, Markku S
    Sinisalo, Juha
    Pussinen, Pirkko J
    Subgingival bacterial burden in relation to clinical and radiographic periodontal parameters.2013Ingår i: Journal of periodontology, ISSN 1943-3670, Vol. 84, nr 12, s. 1809-1817Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 68.
    Ravon, Nicolas A
    et al.
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Hollender, Lars G
    School of Dentistry, University of Washington, Seattle, WA, USA.
    McDonald, Vanessa
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Persson, G. Rutger
    School of Dentistry, University of Washington, Seattle, WA, USA.
    Signs of carotid calcification from dental panoramic radiographs are in agreement with Doppler sonography results.2003Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, nr 12, s. 1084-1090Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 69.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Aghazadeh, Ahmad
    Uppsala Käkkirurgiska Centrum.
    Hallström, Hadar
    Hospital of Halland, Halmstad.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap III. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Factors related to peri-implantitis: a retrospective study2014Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, nr 4, s. 522-529Artikel i tidskrift (Refereegranskat)
    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.

  • 70.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Berglund, J.
    University of Blekinge.
    Opalinska, T.
    University of Blekinge.
    Persson, R. E.
    University of Bern.
    Persson, G. Rutger
    University of Bern.
    Heel DXA T-scores and panoramic radiographs in the prediction of hip and hand fractures2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 9-Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 71.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona.
    Persson, Rigmor E.
    Department of Periodontology, University of Bern.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Osteoporosis and periodontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge)2011Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, nr 4, s. 201-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 72.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    The incidence of peri-implantitis for two different implant systems over a period of thirteen years2012Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, nr 12, s. 1191-1197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 73.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindahl, Christel
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Renvert, Helena
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics, Division of Oral Microbiology, University of Bern.
    Clinical and microbiological analysis of subjects treated with Brånemark or AstraTech implants: a 7-year follow-up study2008Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 19, nr 4, s. 342-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 74.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindahl, Christel
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Roos Jansåker, Ann-Marie
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Treatment of peri-implantitis using an Er:YAG laser or an air-abrasive device2011Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, nr 1, s. 65-73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

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

    Materials and methods

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

    Results

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

    Conclusions

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

  • 75.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Rutger
    Hjärt-kärlsjukdom och parodontit studeras2009Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 101, nr 7, s. 56-57Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

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  • 76.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, Susanna
    Lang, Niklaus P
    School of Dental Medicine, University of Berne, Switzerland.
    Persson, G. Rutger
    School of Dental Medicine, University of Berne, Switzerland.
    Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction2004Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, nr 1, s. 19-24Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 77.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Ohlsson, Ola
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Pettersson, Thomas
    Department of Medicine, Kristianstad Central Hospital.
    Persson, G. Rutger
    Department of Periodontology, University of Bern.
    Periodontitis: a future risk of acute coronary syndrome?: A follow-up study over 3 years2010Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 81, nr 7, s. 992-1000Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 78.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Washington, Seattle, USA.
    Parodontit hos äldre2001Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, nr 1, s. 52-56Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

  • 79.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Washington, USA & University of Berne, Switzerland.
    Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss2004Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, nr 3, s. 208-213Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 80.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, G. Rutger
    Department of Periodontology, University of Berne.
    Periodontitis as a potential risk factor for peri-implantitis.2009Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr Suppl 10, s. 9-14Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

  • 81.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Supportive periodontal therapy2004Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 36, s. 179-195Artikel, forskningsöversikt (Refereegranskat)
  • 82.
    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).
    Persson, G. Rutger
    USA.
    Treatment of periodontal disease in older adults2016Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 72, nr 1, s. 108-119Artikel i tidskrift (Refereegranskat)
    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.

  • 83.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Rigmor E.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    A history of frequent dental care reduces the risk of tooth loss but not periodontitis in older subjects2011Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 35, nr 2, s. 69-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 84.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Rigmor E.
    University of Blekinge.
    Persson, G. Rutger
    University of Bern.
    Access to dental care reduces the risk of tooth loss in older subjects2009Ingår i: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, s. 149-Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 85.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, Rigmor E
    Departments of Oral Medicine and Periodontics, School of Dentistry, University of Washington, Seattle.
    Persson, G. Rutger
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Tooth loss and periodontitis in older individuals: results from the Swedish national study on aging and care2013Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 84, nr 8, s. 1134-1144Artikel i tidskrift (Refereegranskat)
    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.

  • 86.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Persson, Rutger
    Berglund, Johan
    Resebo, Jan
    Fokus på sambandet munhälsa - allmänhälsa2009Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 101, nr 7, s. 52-54Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

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  • 87.
    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.

  • 88.
    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.

  • 89.
    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.

  • 90.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, E.
    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.

  • 91.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    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.

  • 92.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Samuelsson, Emelie
    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)
  • 93.
    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.

  • 94.
    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.

  • 95.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Blekinge Institute of Techology, Dublin Dental University Hospital, Dublin.
    Widén, Cecilia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, Rutger G.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Cytokine and microbial profiles in relation to the clinical outcome following treatment of peri-implantitis2017Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, nr 9, s. 1127-1132Artikel i tidskrift (Refereegranskat)
    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.

  • 96. 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.

  • 97.
    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.

  • 98.
    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.

  • 99.
    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.

  • 100.
    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.

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