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Branco-de-Almeida L, Velsko I, de Oliveira I, de Oliveira R, Shaddox L. Impact of Treatment on Host Responses in Young Individuals with Periodontitis. J Dent Res 2023; 102:473-488. [PMID: 36803061 PMCID: PMC10150440 DOI: 10.1177/00220345221148161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Grade C periodontitis in young individuals is characterized by severe/rapid periodontal destruction, usually early onset, in systemically healthy individuals. An individual's host response, triggered by a dysbiotic subgingival biofilm, has been reported as a contributor to the tissue destruction, although mechanisms of this response and contributions to such disease remain poorly understood. Nonsurgical treatment has resulted in positive clinical responses for both localized (now molar-incisor pattern) and generalized forms of grade C periodontitis, especially when adjunctive systemic antibiotics are used. Nonsurgical treatment may also affect host responses, although mechanisms leading to significant changes in this response remain unclear. Significant effects on inflammatory response to antigens/bacteria have been described posttreatment, but evidence for long-term effects remains limited. Nonsurgical treatment in these individuals may also modulate a variety of host markers in serum/plasma and gingival crevicular fluid along with clinical parameter improvements. The impact of other adjuncts to nonsurgical treatment focusing on controlling exacerbated immunoinflammatory responses needs to be further explored in grade C periodontitis in young individuals. Recent evidence suggests that nonsurgical treatment with adjunctive laser therapy may modulate host and microbial responses in those subjects, at least in the short term. Available evidence, while very heterogeneous (including variations in disease definition and study designs), does not provide clear conclusions on this topic yet provides important insights for future studies. In this review, studies within the past decade evaluating the impact of nonsurgical treatment on systemic/local host responses in young individuals with grade C periodontitis, as well as long-term clinical responses posttreatment, will be critically appraised and discussed.
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Affiliation(s)
- L.S. Branco-de-Almeida
- Post Graduate Program in Dentistry,
School of Dentistry, Federal University of Maranhão, São Luís, Maranhão,
Brazil
| | - I.M. Velsko
- Department of Archaeogenetics, Max
Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - I.C.V. de Oliveira
- Post Graduate Program in Dentistry,
School of Dentistry, Federal University of Maranhão, São Luís, Maranhão,
Brazil
| | - R.C.G. de Oliveira
- Division of Periodontology, Center for
Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY,
USA
| | - L.M. Shaddox
- Division of Periodontology, Center for
Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY,
USA
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2
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Periodontal Diseases in Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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3
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Ck AA, Tholupunuri H, Reddy MR, Muralidhar M, Jayyarapu D, Nair S. Genetic Impact on Bone Modulation-A Review Bridging Bioscience to Genetic Engineering. Glob Med Genet 2021; 8:51-56. [PMID: 33987623 PMCID: PMC8110364 DOI: 10.1055/s-0041-1725069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Genes control approximately 60% to 75% of the variance of peak bone mass/density and a much smaller amount of variance in rate of loss. Bone mass increases during growth to a peak value and soon after begins to decline. Most of the genetic effect is exerted during growth and so influences peak bone mass; whether there is an additional genetic effect on the rate of bone loss is less clear. So, this article aims to place emphasis on various oral and systemic conditions that are manifested due to altered gene function. Genetic polymorphisms and mutations are simple, although the consequences of the mechanism are complex. The syndromic manifestation due to changes at genetic level will greatly affect the bone quality, which will ultimately affect any treatment prognosis. Hence, a better understanding of molecular mechanisms of bone remodeling helps to identify pathogenic causes of bone, skeletal diseases, and leads to the development of targeted therapies for these diseases. This review highlights notions on the connecting link between science and genetics as well as various oral scenarios where gene could bring about changes, resulting in deformities. There is an intense research awaited in the future which could intervene with the causes that bring about genetic modulations, so as to decrease the mortality rate of humans.
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Affiliation(s)
| | | | - M Ramu Reddy
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Mamatha Muralidhar
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Dilip Jayyarapu
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
| | - Sangeeta Nair
- Department of Prosthodontics Anoor Dental College, Muvattupuzha, Kerala, India
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4
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Rebeis ES, Albuquerque-Souza E, Paulino da Silva M, Giudicissi M, Mayer MPA, Saraiva L. Effect of periodontal treatment onAggregatibacter actinomycetemcomitanscolonization and serum IgG levels againstA. actinomycetemcomitansserotypes and Omp29 of aggressive periodontitis patients. Oral Dis 2018; 25:569-579. [DOI: 10.1111/odi.13010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/04/2018] [Accepted: 11/22/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Estela Sanches Rebeis
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Emmanuel Albuquerque-Souza
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Maike Paulino da Silva
- Department of Microbiology, Institute of Biomedical Sciences; University of São Paulo; Sao Paulo Brazil
| | - Marcela Giudicissi
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - Marcia P. A. Mayer
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
- Department of Microbiology, Institute of Biomedical Sciences; University of São Paulo; Sao Paulo Brazil
| | - Luciana Saraiva
- Division of Periodontics, Department of Stomatology, School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
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5
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Jiao J, Zhang L, Meng HX, Shi D, Lu RF, Xu L, Feng XH, Cao ZQ. Clinical performance of non-surgical periodontal therapy in a large Chinese population with generalized aggressive periodontitis. J Clin Periodontol 2018; 45:1184-1197. [PMID: 29974483 DOI: 10.1111/jcpe.12981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/18/2018] [Accepted: 07/01/2018] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate clinical performance of non-surgical periodontal treatment (NSPT) and its influential factors in a large Chinese population with generalized aggressive periodontitis (GAgP). MATERIAL AND METHODS Longitudinal periodontal examination data of 1,004 GAgP patients (numbers of patients with observation periods 6 weeks~, 3 months~, 6 months~, 1 year~, 3 years~ and >5 years were 203, 310, 193, 205, 70 and 23, respectively) were extracted from a hospital-based electronic periodontal charting record system and analysed by multilevel analysis. RESULTS Mean probing depth (PD) and attachment loss (AL) reductions at patient level were 1.17 mm and 1.07 mm, respectively. Multilevel analysis demonstrated PD reductions after maintenance were mainly influenced by frequency of supportive periodontal treatment (FSPT), gender, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD and bleeding index reductions were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline AL, baseline mobility, tooth type and baseline PD. CONCLUSION The clinical performance of NSPT on patients with GAgP was proved in the large Chinese population. Outcomes of NSPT were mainly influenced by FSPT, adjunctive systemic use of antibiotics, baseline mobility, tooth type and baseline PD.
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Affiliation(s)
- Jian Jiao
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Zhang
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huan-Xin Meng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dong Shi
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Rui-Fang Lu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiang-Hui Feng
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zhan-Qiang Cao
- Information Center, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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6
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Periodontol 2018; 89 Suppl 1:S120-S139. [DOI: 10.1002/jper.17-0062] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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7
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Needleman I, Garcia R, Gkranias N, Kirkwood KL, Kocher T, Iorio AD, Moreno F, Petrie A. Mean annual attachment, bone level, and tooth loss: A systematic review. J Clin Periodontol 2018; 45 Suppl 20:S112-S129. [DOI: 10.1111/jcpe.12943] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/29/2017] [Accepted: 05/28/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Ian Needleman
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Raul Garcia
- Department of Health Policy and Health Services Research; Boston University Henry M. Goldman School of Dental Medicine; Boston MA USA
| | - Nikos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry; Barts and The London School of Medicine and Dentistry, Queen Mary University of London; London UK
| | - Keith L. Kirkwood
- Department of Oral Biology; University at Buffalo, State University of New York; Buffalo NY USA
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry; Dental School of the University Medicine Greifswald; Greifswald Germany
| | - Anna Di Iorio
- UCL Library Services; University College London; London UK
| | - Federico Moreno
- Unit of Periodontology; University College London Eastman Dental Institute; London UK
| | - Aviva Petrie
- Biostatistics Unit; University College London Eastman Dental Institute; London UK
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8
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Goh V, Nihalani D, Yeung KWS, Corbet EF, Leung WK. Moderate- to long-term therapeutic outcomes of treated aggressive periodontitis patients without regular supportive care. J Periodontal Res 2017; 53:324-333. [DOI: 10.1111/jre.12517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/14/2022]
Affiliation(s)
- V. Goh
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
- Faculty of Dentistry; The National University of Malaysia; Kuala Lumpur Malaysia
| | - D. Nihalani
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - K. W. S. Yeung
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - E. F. Corbet
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
| | - W. K. Leung
- Faculty of Dentistry; The University of Hong Kong; Hong Kong China
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9
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Bajaj P, Agarwal E, Rao NS, Naik SB, Pradeep AR, Kalra N, Priyanka N, Kumari M. Autologous Platelet-Rich Fibrin in the Treatment of 3-Wall Intrabony Defects in Aggressive Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol 2017; 88:1186-1191. [PMID: 28820320 DOI: 10.1902/jop.2017.120661] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) has recently been applied in osseous regeneration. The aim of the present study is to explore the efficacy of PRF in treatment of intrabony defects (IBDs) in aggressive periodontitis. METHODS Fifty-four IBDs in 17 patients were treated either with autologous PRF with open flap debridement (OFD) or OFD alone. Clinical and radiologic parameters such as probing depth (PD), clinical attachment level (CAL), IBD depth, and percentage defect change were recorded at baseline and 9 months postoperatively. RESULTS Mean PD reduction and mean CAL gain were significantly greater in PRF compared with the control group. Furthermore, a significantly greater percentage of mean bone defect change was found in the PRF group. CONCLUSION Within the limits of the present study, there is greater bone fill at sites treated with PRF with conventional OFD than conventional OFD alone.
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Affiliation(s)
- Pavan Bajaj
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Esha Agarwal
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Nishanth S Rao
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Savitha B Naik
- Department of Endodontics and Conservative Dentistry, Government Dental College and Research Institute
| | - A R Pradeep
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Nitish Kalra
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - N Priyanka
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
| | - Minal Kumari
- Department of Periodontics, Government Dental College and Research Institute, Fort Bangalore, Karnataka, India
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10
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Thorbert-Mros S, Cassel B, Berglundh T. Age of onset of disease in subjects with severe periodontitis: A 9- to 34-year retrospective study. J Clin Periodontol 2017; 44:778-783. [DOI: 10.1111/jcpe.12757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sara Thorbert-Mros
- Department of Periodontology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Björn Cassel
- Clinic of Periodontics; Public Dental Health Services; Region Västra Götaland; Gothenburg Sweden
| | - Tord Berglundh
- Department of Periodontology; Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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11
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Lü D, Meng H, Xu L, Wang X, Zhang L, Tian Y. Root abnormalities and nonsurgical management of generalized aggressive periodontitis. J Oral Sci 2017; 59:103-110. [PMID: 28367890 DOI: 10.2334/josnusd.16-0258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
To investigate long-term nonsurgical treatment outcomes in patients with generalized aggressive periodontitis (GAgP) and the impact of root abnormalities (RAs) and other patient-level factors in relation to GAgP progression. Patients (n = 64) from a GAgP cohort who completed active nonsurgical periodontal treatment and consented to re-evaluation after 3 to 11 (mean 5.3) years, were enrolled. RAs were identified using radiographs. Periodontal parameters (e.g., probing depths [PDs], and tooth loss [TL]) were investigated. Multivariate analysis was performed to identify factors contributing to TL and bone level alteration (∆BL). After treatment, the mean number of sites with PDs > 5 mm decreased from 54.3 to 17.2. Annual TL was 0.11/patient. Twenty-one patients (32.8%) had >4 teeth with root abnormalities (RA-teeth) and exhibited a higher risk for TL (univariate odds ration [OR] = 3.52, multivariate logistic OR = 6.57). Factors correlated to ∆BL were sites with residual PD > 5 mm (β = -0.400) and observation time (β = -0.210). Nonsurgical treatment provides beneficial outcomes in GAgP patients. Higher incidence of RAs and high prevalence of residual deep pockets have a negative impact on long-term outcomes. PRACTICAL IMPLICATIONS in cases of GAgP with residual deep pockets and high incidence of RAs, clinicians must emphasize that long-term outcomes of nonsurgical treatment may be compromised.
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Affiliation(s)
- Da Lü
- Department of Periodontology, Peking University School and Hospital of Stomatology
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12
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Miller KAFS, Branco-de-Almeida LS, Wolf S, Hovencamp N, Treloar T, Harrison P, Aukhil I, Gong Y, Shaddox LM. Long-term clinical response to treatment and maintenance of localized aggressive periodontitis: a cohort study. J Clin Periodontol 2016; 44:158-168. [PMID: 27767222 DOI: 10.1111/jcpe.12640] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 11/27/2022]
Abstract
AIM To evaluate long-term clinical response to periodontal therapy and maintenance in localized aggressive periodontitis (LAP). MATERIALS AND METHODS One hundred forty-one African Americans diagnosed with LAP, aged 5-25 years, were enrolled. Patients underwent periodontal mechanical debridement plus 1 week of amoxicillin/metronidazole. Mechanical therapy was repeated as needed and clinical parameters were recorded at baseline, 3, 6, 12, 18 and 24 months, and two additional annual follow-up visits after treatment. Radiographs from primary dentition of patients with LAP in permanent dentition, and additional healthy siblings (HS) were analysed retrospectively. RESULTS Periodontal therapy significantly improved probing depth and clinical attachment level up to 4 years (mean reductions: 2.18 ± 1.03 and 2.80 ± 1.43 mm, respectively). Percentage of affected sites was reduced at all time points and maintained up to 4 years. Non-compliance with antibiotics/appointments negatively affected the treatment response. Ninety per cent of LAP patients in permanent dentition and 32% of HS presented radiographic bone loss in primary dentition. CONCLUSIONS Mechanical debridement with 1 week of systemic antibiotics along with proper periodontal maintenance was effective in the treatment and successful maintenance of LAP for up to 4 years. LAP in permanent dentition may be preceded in the primary dentition. Clinicaltrials.gov #NCT01330719.
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Affiliation(s)
- Karina A F S Miller
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Luciana S Branco-de-Almeida
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Department of Dentistry II, School of Dentistry, Federal University of Maranhão, São Luís, MA, Brazil
| | - Sandra Wolf
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Nicole Hovencamp
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Tina Treloar
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Peter Harrison
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA.,Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Ikramuddin Aukhil
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Luciana M Shaddox
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
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13
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Dopico J, Nibali L, Donos N. Disease progression in aggressive periodontitis patients. A Retrospective Study. J Clin Periodontol 2016; 43:531-7. [DOI: 10.1111/jcpe.12533] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 01/18/2023]
Affiliation(s)
- José Dopico
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Periodontology Unit; Universidad de Santiago de Compostela; Santiago de Compostela Spain
| | - Luigi Nibali
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
| | - Nikos Donos
- Periodontology Unit; Division of Clinical Research; UCL Eastman Dental Institute; London UK
- Clinical Oral Research Centre; Institute of Dentistry; Queen Mary University London (QMUL); London UK
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14
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Abstract
For decades, Aggregatibacter actinomycetemcomitans has been considered the most likely etiologic agent in aggressive periodontitis. Implementation of DNA-based microbiologic methodologies has considerably improved our understanding of the composition of subgingival biofilms, and advanced open-ended molecular techniques even allow for genome mapping of the whole bacterial spectrum in a sample and characterization of both the cultivable and not-yet-cultivable microbiota associated with periodontal health and disease. Currently, A. actinomycetemcomitans is regarded as a minor component of the resident oral microbiota and as an opportunistic pathogen in some individuals. Its specific JP2 clone, however, shows properties of a true exogenous pathogen and has an important role in the development of aggressive periodontitis in certain populations. Still, limited data exist on the impact of other microbes specifically in aggressive periodontitis. Despite a wide heterogeneity of bacteria, especially in subgingival samples collected from patients, bacteria of the red complex in particular, and those of the orange complex, are considered as potential pathogens in generalized aggressive periodontitis. These types of bacterial findings closely resemble those found for chronic periodontitis, representing a mixed polymicrobial infection without a clear association with any specific microorganism. In aggressive periodontitis, the role of novel and not-yet-cultivable bacteria has not yet been elucidated. There are geographic and ethnic differences in the carriage of periodontitis-associated microorganisms, and they need to be taken into account when comparing study reports on periodontal microbiology in different study populations. In the present review, we provide an overview on the colonization of potential periodontal pathogens in childhood and adolescence, and on specific microorganisms that have been suspected for their role in the initiation and progression of aggressive forms of periodontal disease.
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15
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Onabolu O, Donos N, Tu YK, Darbar U, Nibali L. Periodontal progression based on radiographic records: An observational study in chronic and aggressive periodontitis. J Dent 2015; 43:673-82. [PMID: 25769263 DOI: 10.1016/j.jdent.2015.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES The current classification assumes that aggressive periodontitis (AgP) has a faster rate of progression than chronic periodontitis (CP). However, this has not been clearly proven and difficulties exist in establishing progression. This study aimed to assess the feasibility of retrospectively utilising previous records for clinical diagnosis of periodontal diseases and to assess if two different patterns of disease progression exist between AgP and CP. MATERIALS AND METHODS Previous radiographic records of a cohort of 235 patients clinically diagnosed with AgP or CP were requested from the referring general dental practitioners (GDPs). Comparable radiographic records were analysed in order to assess progression patterns and associate these with clinical diagnosis, by multilevel analysis. RESULTS 43 patients out of the initial 235 had comparable radiographs retrieved from the GDPs. 858 sites were followed for an average 6.6 years. Radiographically, AgP showed a faster linear pattern of progression than CP (0.31mm/year vs. 0.20mm/year, p<0.001). CONCLUSION This study provides evidence for a faster disease progression in untreated AgP compared to CP as assessed by radiographic bone levels. Furthermore, it shows that retrievability of previous radiographs from GDPs is unpredictable and GDPs should be encouraged to send them along with their referral. CLINICAL SIGNIFICANCE The importance of differentially diagnosing AgP and CP might be useful in establishing a clinically relevant definition for periodontal disease progression and may have an impact on the clinical management of aggressive periodontitis, since our findings show that there is continuous destruction in patients with aggressive periodontitis if left untreated.
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Affiliation(s)
- Olanrewaju Onabolu
- Periodontology Unit and Division of Clinical Research, Eastman Dental Institute and Hospital, University College London (UCL), United Kingdom
| | - Nikos Donos
- Periodontology Unit and Division of Clinical Research, Eastman Dental Institute and Hospital, University College London (UCL), United Kingdom
| | - Yu-Kang Tu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ulpee Darbar
- Periodontology Unit and Division of Clinical Research, Eastman Dental Institute and Hospital, University College London (UCL), United Kingdom
| | - Luigi Nibali
- Periodontology Unit and Division of Clinical Research, Eastman Dental Institute and Hospital, University College London (UCL), United Kingdom.
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16
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Teughels W, Dhondt R, Dekeyser C, Quirynen M. Treatment of aggressive periodontitis. Periodontol 2000 2014; 65:107-33. [PMID: 24738589 DOI: 10.1111/prd.12020] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 12/12/2022]
Abstract
Despite etiological differences between aggressive and chronic periodontitis, the treatment concept for aggressive periodontitis is largely similar to that for chronic periodontitis. The goal of treatment is to create a clinical condition that is conducive to retaining as many teeth as possible for as long as possible. When a diagnosis has been made and risk factors have been identified, active treatment is commenced. The initial phase of active treatment consists of mechanical debridement, either alone or supplemented with antimicrobial drugs. Scaling and root planing has been shown to be effective in improving clinical indices, but does not always guarantee long-term stability. Antimicrobials can play a significant role in controlling aggressive periodontitis. Few studies have been published on this subject for localized aggressive periodontitis, but generalized aggressive periodontitis has been subject to more scrutiny. Studies have demonstrated that systemic antibiotics as an adjuvant to scaling and root planing are more effective in controlling disease compared with scaling and root planing alone or with supplemental application of local antibiotics or antiseptics. It has also become apparent that antibiotics ought to be administered with, or just after, mechanical debridement. Several studies have shown that regimens of amoxicillin combined with metronidazole or regimens of clindamycin are the most effective and are preferable to regimens containing doxycycline. Azithromycin has been shown to be a valid alternative to the regimen of amoxicillin plus metronidazole. A limited number of studies have been published on surgical treatment in patients with aggressive periodontitis, but the studies available show that the effect can be comparable with the effect on patients with chronic periodontitis, provided that proper oral hygiene is maintained, a strict maintenance program is followed and modifiable risk factors are controlled. Both access surgery and regenerative techniques have shown good results in patients with aggressive periodontitis. Once good periodontal health has been obtained, patients must be enrolled in a strict maintenance program that is directed toward controlling risk factors for disease recurrence and tooth loss. The most significant risk factors are noncompliance with regular maintenance care, smoking, high gingival bleeding index and poor plaque control. There is no evidence to suggest that daily use of antiseptic agents should be part of the supportive periodontal therapy for aggressive periodontitis.
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Meyer-Bäumer A, Eick S, Mertens C, Uhlmann L, Hagenfeld D, Eickholz P, Kim TS, Cosgarea R. Periodontal pathogens and associated factors in aggressive periodontitis: results 5-17 years after active periodontal therapy. J Clin Periodontol 2014; 41:662-72. [PMID: 24708362 DOI: 10.1111/jcpe.12255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To assess the association between presence of periodontal pathogens and recurrence of disease in patients with aggressive periodontitis (AgP) after active periodontal therapy (APT) and further influencing factors. MATERIAL & METHODS Microbiological samples were taken from 73 patients with AgP 5-17 years after APT at 292 sites (deepest site per quadrant). Real-time polymerase chain reactions were used to detect the periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Uni- and multivariate analyses evaluated the associations between pathogens and recurrence of disease, smoking and adjunctive antibiotic therapy. RESULTS At re-examination A. actinomycetemcomitans could be detected in six patients (8.2%), P. gingivalis in 24 (32.9%), T. forsythia in 31 (42.5%) and T. denticola in 35 (48.0%). Increased levels of T. forsythia and T. denticola at re-examination were significantly associated with recurrence of disease in multivariate analyses (OR: 12.72, p < 0.001; OR 5.55, p = 0.002 respectively). Furthermore, high counts of T. denticola were found in patients with increased percentage of sites with clinical attachment levels (CAL) ≥ 6 mm compared to those with low counts (13.8% versus 3.2%, p = 0.005). CONCLUSION In patients with recurrence of disease T. forsythia and T. denticola were detected more frequently and in higher counts. Furthermore, T. denticola was found more frequently in patients with increased CAL.
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Affiliation(s)
- Amelie Meyer-Bäumer
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
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Albandar JM. Aggressive periodontitis: case definition and diagnostic criteria. Periodontol 2000 2014; 65:13-26. [DOI: 10.1111/prd.12014] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nibali L, Farias BC, Vajgel A, Tu YK, Donos N. Tooth loss in aggressive periodontitis: a systematic review. J Dent Res 2013; 92:868-75. [PMID: 23955159 DOI: 10.1177/0022034513501878] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aggressive periodontitis (AgP) is thought to have a faster rate of progression than chronic periodontitis (CP). However, there is a lack of studies systematically investigating disease progression and tooth loss in AgP. A systematic search of the literature was conducted by two independent reviewers for longitudinal studies including patients with AgP (previously known as 'periodontosis', 'juvenile' or 'early-onset' periodontitis) indicating measures of disease progression. Ovid MEDLINE(®) and Embase databases were searched for at least 5-year longitudinal human studies in AgP patients. In total, 16 studies were included in the review, from an initial search of 1,601 titles. Heterogeneity was detected for disease definition and clinical data reporting; hence meta-analysis was feasible only for the objective measure 'tooth loss'. The average tooth loss for all AgP cases was 0.09 (95% C.I. = 0.06-0.16) per patient-year. The corresponding values by diagnosis were 0.05, 0.14, and 0.12 tooth loss per patient-year, respectively, for LAgP, GAgP, and un-specified AgP. For studies reporting tooth loss during the 'observational period' (excluding extractions at initial therapy), the average tooth loss for AgP was 0.09 per patient-year. High heterogeneity was detected for these analyses. In conclusion, most studies report good long-term stability of treated AgP cases.
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Affiliation(s)
- L Nibali
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK
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Lü D, Meng H, Xu L, Lu R, Zhang L, Chen Z, Feng X, Shi D, Tian Y, Wang X. New attempts to modify periodontal risk assessment for generalized aggressive periodontitis: a retrospective study. J Periodontol 2013; 84:1536-45. [PMID: 23305112 DOI: 10.1902/jop.2013.120427] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontal risk assessment (PRA) model was designed for risk evaluation of treated patients with periodontal disease. However, its use on generalized aggressive periodontitis (GAgP) had been scarcely reported. This study aims to investigate the association of original PRA/modified PRA (MPRA) and compliance of periodontal maintenance with long-term treatment outcomes of Chinese patients with GAgP. METHODS Eighty-eight patients from a GAgP cohort, who completed active periodontal treatment (APT) and accepted reevaluation 3 to 11 years (mean of 5.5 years) afterward, were enrolled. PRA was modified (three strategies involving replacement of bleeding on probing with bleeding index >2, counting sites with probing depth ≥6 mm and changing method of bone loss [BL] calculation) to classify patients into different risk groups based on data at the first recall after APT. PRA and three MPRA models were investigated regarding long-term association with tooth loss (TL) and alteration of bone level (∆BL). RESULTS Based on original PRA, 87 patients (98.8%) had a high-risk profile. According to three MPRA models, annual TL per patient values were greater in high-risk groups than in low-to-moderate risk groups (MPRA-1, 0.20 ± 0.33 versus 0.04 ± 0.14; MPRA-2, 0.18 ± 0.32 versus 0.05 ± 0.14; MPRA-3, 0.17 ± 0.32 versus 0.05 ± 0.15; P <0.05). By MPRA-1, irregular compliers with low-to-moderate risk profile had greater ∆BL (0.027 ± 0.031, indicating bone increment) than those with high risk (-0.012 ± 0.064, tendency for BL). For regular compliers, no significant differences of annual TL or ∆BL were found between risk groups. CONCLUSIONS MPRA models could be used for evaluating the long-term outcomes of Chinese patients with severe GAgP, especially irregular compliers. High-risk patients of MPRAs exhibited more TL and less bone fill than low-to-moderate risk ones.
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Affiliation(s)
- Da Lü
- Department of Periodontology, School and Hospital of Stomatology, Peking University, Beijing, China
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Silva-Senem MXE, Heller D, Varela VM, Torres MCB, Feres-Filho EJ, Colombo APV. Clinical and microbiological effects of systemic antimicrobials combined to an anti-infective mechanical debridement for the management of aggressive periodontitis: a 12-month randomized controlled trial. J Clin Periodontol 2013; 40:242-51. [DOI: 10.1111/jcpe.12052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/06/2012] [Accepted: 11/30/2012] [Indexed: 01/15/2023]
Affiliation(s)
- Mayra Xavier e Silva-Senem
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Débora Heller
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Periodontology and Oral Biology Department; Boston University; Boston MA USA
| | - Victor Macedo Varela
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Maria Cynesia Barros Torres
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Eduardo Jorge Feres-Filho
- Division of Graduate Periodontics; School of Dentistry, Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Ana Paula Vieira Colombo
- Department of Medical Microbiology, Institute of Microbiology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
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Kumar A, Masamatti SS, Virdi MS. Periodontal diseases in children and adolescents: a clinician's perspective part 2. ACTA ACUST UNITED AC 2012; 39:639-42, 645-6, 649-52. [DOI: 10.12968/denu.2012.39.9.639] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ashish Kumar
- Reader, Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh
| | - Sujata Surendra Masamatti
- Reader, Department of Periodontics, ITS – Centre for Dental Studies and Research, Murad Nagar, Ghaziabad, Uttar Pradesh
| | - Mandeep Singh Virdi
- Professor and Head, Department of Pedodontics and Preventive Dentistry, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
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Meyer-Bäumer A, Pritsch M, Cosgarea R, El Sayed N, Kim TS, Eickholz P, Pretzl B. Prognostic value of the periodontal risk assessment in patients with aggressive periodontitis. J Clin Periodontol 2012; 39:651-8. [DOI: 10.1111/j.1600-051x.2012.01895.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2012] [Indexed: 12/25/2022]
Affiliation(s)
- Amelie Meyer-Bäumer
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg; Germany
| | - Maria Pritsch
- Institute of Medical Biometry and Informatics; University of Heidelberg; Heidelberg; Germany
| | - Raluca Cosgarea
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg; Germany
| | - Nihad El Sayed
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg; Germany
| | - Ti-Sun Kim
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg; Germany
| | - Peter Eickholz
- Department of Periodontology; Center of Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt; Germany
| | - Bernadette Pretzl
- Section of Periodontology; Department of Conservative Dentistry; Clinic for Oral; Dental and Maxillofacial Diseases; University Hospital Heidelberg; Heidelberg; Germany
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Varela VM, Heller D, Silva-Senem MX, Torres MCMB, Colombo APV, Feres-Filho EJ. Systemic Antimicrobials Adjunctive to a Repeated Mechanical and Antiseptic Therapy for Aggressive Periodontitis: A 6-Month Randomized Controlled Trial. J Periodontol 2011; 82:1121-30. [DOI: 10.1902/jop.2011.100656] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Graetz C, Dörfer CE, Kahl M, Kocher T, Fawzy El-Sayed K, Wiebe JF, Gomer K, Rühling A. Retention of questionable and hopeless teeth in compliant patients treated for aggressive periodontitis. J Clin Periodontol 2011; 38:707-14. [PMID: 21627675 DOI: 10.1111/j.1600-051x.2011.01743.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM The aim of this study was to determine the survival rates of questionable and hopeless teeth in patients with aggressive periodontitis (AgP) and chronic periodontitis (CP) during 15 years of supportive periodontal therapy (SPT). MATERIALS AND METHODS Thirty-four AgP and 34 CP patients (SPT≥10 years) with bone loss of ≥50% at ≥2 teeth were consecutively recruited. Bone loss was measured on digitized radiographs and teeth were categorized as "questionable" (≥50 to <70% bone loss) or as "hopeless" (≥70%). Progression in pocket probing depths (PPD) during SPT, tooth loss and reasons for extraction were analysed. RESULTS In AgP patients, 262 teeth were considered as questionable and 63 as hopeless (CP: 149/51). During active periodontal therapy, 25 questionable and 26 hopeless teeth were extracted (CP: 12/16). During 15.3 ± 4.1 years of SPT of AgP 28 questionable and 15 hopeless teeth were removed (CP: 28/12). The mean tooth loss per patient during SPT in total was 0.14 (AgP) and 0.16 (CP) teeth/year. There were no significant differences in tooth loss or longitudinal progression of PPD between AgP and CP patients. CONCLUSIONS In patients with AgP, 88.2% (209 of 237) of questionable and 59.5% (22 of 37) of hopeless teeth survived 15 years during regular SPT in a dental school department.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
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Bäumer A, Pretzl B, Cosgarea R, Kim TS, Reitmeir P, Eickholz P, Dannewitz B. Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors. J Clin Periodontol 2011; 38:644-51. [PMID: 21564157 DOI: 10.1111/j.1600-051x.2011.01733.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess prognostic factors for tooth loss after active periodontal therapy (APT) in patients with aggressive periodontitis (AgP) at tooth level. MATERIAL AND METHODS Eighty-four patients with AgP were re-evaluated after a mean period of 10.5 years of supportive periodontal therapy (SPT). Two thousand and fifty-four teeth were entered into the model. The tooth-related factors including baseline bone loss, tooth location and type, furcation involvement (FI), regenerative therapy, and abutment status, as well as time of follow-up and other patient-related factors were tested for their prognostic value at tooth level. Multilevel regression analysis was performed for statistical analysis to identify factors contributing to tooth loss. RESULTS During SPT, 113 teeth (1.34 teeth per patient) were lost. Baseline bone loss, use as abutment tooth, tooth type, and maxillary location contributed significantly to tooth loss during SPT. Molars showed the highest risk for tooth loss after APT. Moreover, time of follow-up and the patient-related factor "educational status" significantly accounted for tooth loss at tooth level. CONCLUSION Baseline bone loss, abutment status, tooth location, and type as well as time of follow-up and educational status were detected as prognostic factors for tooth loss during SPT in patients with AgP at tooth level.
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Affiliation(s)
- Amelie Bäumer
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
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Bäumer A, El Sayed N, Kim TS, Reitmeir P, Eickholz P, Pretzl B. Patient-related risk factors for tooth loss in aggressive periodontitis after active periodontal therapy. J Clin Periodontol 2011; 38:347-54. [PMID: 21284688 DOI: 10.1111/j.1600-051x.2011.01698.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Evaluation of patient-related risk factors contributing to tooth loss and recurrence of periodontitis 10.5 years after initial therapy in patients with aggressive periodontitis (AgP). MATERIAL AND METHODS Eighty-four of 174 patients were included. Re-examination consisted of patient's history, clinical examination and test for interleukin (IL)-1 composite genotype. Patients' charts were searched for regularity of maintenance and initial diagnosis. Statistical analysis was performed using Poisson and logistical regression analysis. RESULTS The responder rate was 48%. Thirteen of 84 patients presented a localized AgP, 68 were females and 29 smoked. One hundred and thirteen teeth out of 2154 were lost after therapy (1.34 teeth/patient). Age (p=0.0018), absence of IL-1 composite genotype (p=0.0091) and educational status (p=0.0085) were identified as statistically significant risk factors for tooth loss. Twenty patients exhibited recurrence of periodontitis at re-examination. Smoking (p=0.0034) and mean Gingival Bleeding Index (GBI) (p=0.0239) contributed significantly to recurrence of disease. No patient participating regularly in supportive periodontal therapy (SPT) showed disease recurrence. CONCLUSION Age, absence of IL-1 composite genotype and low social status are detected as risk factors for tooth loss. Smoking and high mean GBI are associated with an increased risk for recurrence of periodontitis, whereas regular SPT acts as a protective factor.
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Affiliation(s)
- Amelie Bäumer
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
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Armitage GC, Cullinan MP. Comparison of the clinical features of chronic and aggressive periodontitis. Periodontol 2000 2010; 53:12-27. [DOI: 10.1111/j.1600-0757.2010.00353.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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König J, Schwahn C, Fanghänel J, Plötz J, Hoffmann T, Kocher T. Repeated scaling versus surgery in young adults with generalized advanced periodontitis. J Periodontol 2008; 79:1006-13. [PMID: 18533777 DOI: 10.1902/jop.2008.070380] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Residual probing depth (PD) after subgingival scaling can be treated with repeated scaling or periodontal surgery. Ambiguous results about the additional clinical benefit of a second scaling procedure exist. Therefore, we performed a prospective study comparing the clinical results of repeated subgingival scaling versus periodontal surgery in 30- to 40-year-old subjects with generalized advanced periodontitis. METHODS Twenty-six subjects (mean age, 37 +/- 3 years) were treated after an initial examination (t(1)), initial subgingival scaling, and baseline examination (t(2)) with a randomly assigned second subgingival scaling (test) and periodontal surgery (control) in a split-mouth design. The final examination (t(3)) took place 6 months postoperatively. Intraindividual comparisons of mean PD and clinical attachment level (CAL) were analyzed. RESULTS PD was reduced from 4.1 +/- 0.2 mm initially (t(1)) to 3.1 +/- 0.1 mm at baseline (t(2)), and to 2.9 +/- 0.1 mm at the end of the study (t(3)) for the test sites; and from 4.5 +/- 0.2 mm (t(1)) to 3.5 +/- 0.1 mm (t(2)), and 3.1 +/- 0.1 mm (t(3)) for the control sites. The total PD decrease from t(1) to t(3) was significant (P <0.001) for both therapies. PD reduction from t(2) to t(3) was only significant (P <0.001) for control sites, resulting in a significant (P = 0.010) difference between test and control at the final examination. CAL increased 0.2 +/- 0.1 mm (t(2)) plus 0.3 +/- 0.1 mm (t(3)) for the test sites and 0.2 +/- 0.1 mm (t(2)) plus 0.2 +/- 0.1 mm (t(3)) for the control sites. Total CAL gain was statistically significant for the test and control sites. CAL gain from t(2) to t(3) was only significant (P = 0.022) for the test sites. CONCLUSIONS Both treatments reduced PD and increased CAL. A second subgingival scaling resulted in significant additional CAL gain and reduced the need for surgery.
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Affiliation(s)
- Jörgen König
- Unit of Periodontology, School of Dentistry, University of Greifswald, Greifswald, Germany.
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Shin CR, Moores J, Best AM, Tew JG, Schenkein HA, Barbour SE. Differential platelet-activating factor synthesis by monocytes and polymorphonuclear leukocytes from subjects with localized aggressive periodontitis. J Periodontal Res 2007; 42:202-11. [PMID: 17451539 DOI: 10.1111/j.1600-0765.2006.00933.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Platelet-activating factor is elevated in localized aggressive periodontitis. We previously demonstrated that the elevated level of platelet-activating factor in localized aggressive periodontitis is at least partially attributable to low levels of platelet-activating factor acetylhydrolase, the enzyme that catabolizes platelet-activating factor. The objective of this study was to determine if platelet-activating factor synthesis was also elevated in localized aggressive periodontitis. To test this, platelet-activating factor synthesis was quantified in the monocytes and polymorphonuclear neutrophils of periodontally healthy patients and of subjects with localized aggressive periodontitis. MATERIAL AND METHODS Cells were labeled with [(3)H]acetate and treated with vehicle or stimulated with calcium ionophore A23187. Platelet-activating factor was extracted and quantified by scintillation counting. RESULTS For both subject groups, resting monocytes and polymorphonuclear neutrophils produced platelet-activating factor, and calcium ionophore A23187 stimulated platelet-activating factor production in both cell types. However, calcium ionophore A23187-activated monocytes from subjects with localized aggressive periodontitis produced less platelet-activating factor than did activated periodontally healthy monocytes (p < 0.0001), suggesting an aberrant calcium ionophore A23187 response in monocytes from subjects with localized aggressive periodontitis. Indeed, when the data were expressed as fold induction of platelet-activating factor synthesis in response to calcium ionophore A23187, monocytes from subjects with localized aggressive periodontitis exhibited only a fourfold increase in platelet-activating factor synthesis, whereas calcium ionophore A23187-stimulated monocytes from periodontally healthy, chronic periodontitis and generalized aggressive periodontitis subjects produced approximately 12 times more platelet-activating factor than did resting monocytes. In contrast, both resting and activated localized aggressive periodontitis polymorphonuclear neutrophils synthesized more platelet-activating factor than did periodontally healthy polymorphonuclear neutrophils. CONCLUSION These data suggest that high levels of platelet-activating factor in subjects with localized aggressive periodontitis result from both increased synthesis and reduced catabolism. While localized aggressive periodontitis polymorphonuclear neutrophils contribute to increased platelet-activating factor mass through synthesis, the contribution of monocytes is probably the result of reduced catabolism by platelet-activating factor acetylhydrolase.
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Affiliation(s)
- C R Shin
- Department of Biochemistry, Virginia Commonwealth University, Richmond, VA 23298-0614, USA
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Salzberg TN, Overstreet BT, Rogers JD, Califano JV, Best AM, Schenkein HA. C-reactive protein levels in patients with aggressive periodontitis. J Periodontol 2006; 77:933-9. [PMID: 16734565 DOI: 10.1902/jop.2006.050165] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Sera from patients with periodontal infections contain elevated levels of C-reactive protein (CRP) compared to periodontally healthy individuals. Most studies to date have included patients with chronic periodontitis, and few investigators have studied CRP levels in subjects with aggressive periodontitis (AgP). The purpose of this study was to determine the relative levels of serum CRP in AgP patients and periodontally healthy subjects and to examine patients' characteristics that might account for intergroup differences. METHODS Serum samples were collected from 93 patients with generalized AgP (GAgP), from 97 patients with localized AgP (LAgP), and from 91 healthy controls (non-periodontitis [NP]). Periodontal examination consisted of plaque index, gingival index, probing depth, bleeding index, and attachment loss measurements. Current smoking was assessed by determination of serum cotinine levels by enzyme-linked immunosorbent assay (ELISA), and serum CRP levels were determined using a high-sensitivity ELISA assay. RESULTS The three groups were significantly different from one another (P <0.0001). The 95% confidence interval for serum CRP concentrations were as follows: NP, 0.65919 (0.4901 to 0.8869); LAgP, 1.10138 (0.8265 to 1.468); and GAgP, 2.05318 (1.5313 to 2.7538) mg/l. CRP levels in both LAgP and GAgP subjects were significantly greater than those in NP subjects, and levels in GAgP were significantly greater than those in LAgP. Following adjustment of the data for periodontal and demographic variables and current smoking, both mean probing depth and periodontal diagnosis remained correlated with CRP levels. CONCLUSIONS Patients with AgP have statistically significant elevations in serum CRP levels compared to subjects without periodontitis. Elevated CRP in these subjects might represent a contribution of periodontal infections to systemic inflammation in relatively young individuals.
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Affiliation(s)
- Trang N Salzberg
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, 23298-0566, USA
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Abstract
van Winkelhoff AJ. Antibiotics in periodontics: are we getting somewhere? J Clin Periodontol 2005; 32: 1094-1095. doi: 10.1111/j.1600-051X.2005.00830.x. (c) Blackwell Munksgaard 2005.
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Kawamura M, Sadamori S, Okada M, Sasahara H, Hamada T. Non-surgical approach to advanced chronic periodontitis: a 17.5-year case report. Aust Dent J 2004; 49:40-4. [PMID: 15104133 DOI: 10.1111/j.1834-7819.2004.tb00048.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This 17.5-year longitudinal case report details the treatment of advanced chronic periodontitis in a female patient commencing at 34 years of age. The woman was provided with periodontal care comprising of temporary fixation, scaling and root planing, intra-pocket irrigation using a root canal syringe and regular supervised maintenance. The patient presented with a 10-year history of bleeding gums. Therapy conducted in general practice had included simple curettage and irrigation. However, these treatments proved unsuccessful and the patient often changed dentists seeking better treatment. She presented to the University Dental Hospital, for diagnosis and treatment of her periodontal conditions after her mandibular lateral incisor had exfoliated. On presentation a purulent exudate could be expressed from all of the pockets. All anterior teeth, excluding the maxillary canines, demonstrated +2 to +3 mobility. The patient did not want any surgical treatment or her teeth extracted. It was decided to treat the patient conservatively without surgery. By postponing extraction, the authors were in a better position to determine the prognosis of the remaining teeth after the infection was under control. Although six teeth were extracted during the 17.5 years, this case report suggests that a non-surgical approach is a viable option while maintaining regular visits for periodontal care.
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Affiliation(s)
- M Kawamura
- Preventive Dentistry, Hiroshima University Hospital, Japan.
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Abstract
Children and adolescents are subject to several periodontal diseases. Although there is a much lower prevalence of destructive periodontal diseases in children than in adults, children can develop severe forms of periodontitis. In some cases, this destructive disease is a manifestation of a known underlying systemic disease. In other young patients, the underlying cause for increased susceptibility and early onset of disease is unknown. These diseases are often familial, suggesting a genetic predisposition for aggressive disease. Current modalities for managing periodontal diseases of children and adolescents may include antibiotic therapy in combination with non-surgical and/or surgical therapy. Since early diagnosis ensures the greatest chance for successful treatment, it is important that children receive a periodontal examination as part of their routine dental visits.
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Affiliation(s)
- Mauricio Ronderos
- Periodontics Department, School of Dentistry, University of the Pacific, San Francisco, California, USA
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Loesche WJ. The antimicrobial treatment of periodontal disease: changing the treatment paradigm. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2000; 10:245-75. [PMID: 10759408 DOI: 10.1177/10454411990100030101] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the last 100 years, methods of surgical periodontal treatment have enjoyed a history of success in improving oral health. The paradigm of care is based on the "non-specific plaque hypothesis"--that is, the overgrowth of bacterial plaques cause periodontal disease, and the suppression of this overgrowth reduces disease risk. The central feature of this approach to care is the removal of inflamed gingival tissue around the teeth to reduce periodontal pocket depth, thereby facilitating plaque removal by the dentist and by the patient at home. Over the last 30 years, with the recognition that periodontal disease(s) is caused by specific bacteria and that specific antimicrobial agents can reduce or eliminate the infection, a second paradigm has developed. This new paradigm, the "specific plaque hypothesis", focuses on reducing the specific bacteria that cause periodontal attachment loss. The contrast between the two paradigms can be succinctly stated as follows: The antimicrobial therapy reduces the cause, while the surgical therapy reduces the result of the periodontal infection. The specific plaque hypothesis has two important implications. First, with the increasing attention to evidence-based models for prevention, treatment, outcome assessment, and reimbursement of care, increasing attention and financial effort will be channeled into effective preventive and treatment methods. Second, the recent observations that periodontal infections increase the risk of specific systemic health problems, such as cardiovascular disease, argue for the prevention and elimination of these periodontal infections. This review highlights some of the evidence for the specific plaque hypothesis, and the questions that should be addressed if antimicrobial agents are to be used responsively and effectively.
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Affiliation(s)
- W J Loesche
- University of Michigan School of Dentistry, Ann Arbor 48109, USA
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Mullally BH, Breen B, Linden GJ. Smoking and patterns of bone loss in early-onset periodontitis. J Periodontol 1999; 70:394-401. [PMID: 10328651 DOI: 10.1902/jop.1999.70.4.394] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aims of this study were to investigate the extent and distribution of bone loss in subjects with early-onset periodontitis (EOP) referred for periodontal care and to study the relationship between smoking and EOP. METHODS A total of 71 consecutive referrals (21 male, 50 female) under 35 years old, who were otherwise healthy, with a clinical diagnosis of severe periodontitis were recruited for the study. Bone loss was measured from available radiographs using a Schei ruler to identify 2 patterns of destruction: localized (LEOP) in 41 (58%) and generalized early-onset periodontitis (GEOP) in 30 (42%) subjects. RESULTS The study population had a mean of 25.0 (SD 2.4) teeth, excluding third molars, and mean bone loss of 28.7% (SD 13.0). Bone loss was more severe in the maxilla, 30.9% (SD 13.8) compared with 26.6% (SD 14.0) in the lower arch. More than one-third (36%) of the teeth examined had at least 30% bone loss. Mean smoking experience was 9.2 pack years (SD 5.6), and 39 (55%) of the EOP subjects smoked. Smokers had significantly more maxillary bone loss than non-smokers. A much higher proportion of GEOP (70%) currently smoked compared with 44% of LEOP, P = 0.029. CONCLUSIONS It is concluded that young adults with early-onset forms of periodontitis often have advanced periodontal destruction before they are referred for specialist care. In addition, there was a relationship between smoking and severe bone destruction in subjects with EOP, particularly those with generalized disease.
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Affiliation(s)
- B H Mullally
- Division of Restorative Dentistry (Periodontics), School of Clinical Dentistry, Queen's University of Belfast, Northern Ireland.
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Novo E, Garcia-MacGregor E, Viera N, Chaparro N, Crozzoli Y. Periodontitis and anti-neutrophil cytoplasmic antibodies in systemic lupus erythematosus and rheumatoid arthritis: a comparative study. J Periodontol 1999; 70:185-8. [PMID: 10102556 DOI: 10.1902/jop.1999.70.2.185] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This investigation was designed to determine and compare the distribution pattern of anti-neutrophil cytoplasmic antibodies (ANCA) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in the presence or absence of periodontal disease. METHODS Sera of 30 patients with SLE and 30 with RA were tested for ANCA utilizing an indirect enzyme immunosorbent assay (ELISA) directed to a neutrophil granular extract and 6 neutrophil granule proteins. A control group of 20 healthy individuals showing neither evidence of periodontal disease nor systemic compromise was also included in this study. RESULTS For RA, the number of ANCA-positive sera was very low but was evenly distributed among patients with and without periodontitis. Conversely, a high number of ANCA-positive sera in SLE was found mostly in individuals presenting periodontal compromise. A statistically significant association between ANCA and periodontitis in SLE patients was found (P <0.005, chi square test). CONCLUSIONS A marked difference in the number and distribution of ANCA with respect to periodontitis between RA and SLE was found. Hyperresponsiveness of B cells and polyclonal B activation to periodontopathic bacteria in SLE might be accountable for the high numbers of ANCA and the close association observed between those autoantibodies and periodontitis in SLE.
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Affiliation(s)
- E Novo
- Immunobiology Laboratory, Dental Research Institute, School of Dentistry, Universidad del Zulia, Maracaibo, Venezuela.
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Abstract
Numerous epidemiological studies have shown that caries is the main reason for tooth loss. More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries. In considering the issue of periodontal disease and tooth loss the following observations were made. The presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. There is a strong correlation between smoking, the severity of periodontal disease and tooth mortality. Cross-sectional population surveys of tooth loss reported lower anterior teeth to be the most frequently extracted due to periodontal reasons, followed by upper anteriors and upper second molars. However, in long term maintenance studies, molars were lost most frequently. Periodontal reasons for tooth loss were mainly mobility followed by furcation involvement. Periodontal surgery did not significantly enhance tooth retention in high risk groups. Ethnic differences observed were not significant and would need further investigations to address variables such as cultural differences, health habits, diet and socio-economic status. In conclusion, periodontal tooth mortality was found to be associated with the loss of periodontal attachment and risk groups with advanced periodontitis contributing to major tooth loss in a minority of the population.
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Affiliation(s)
- G Ong
- Department of Preventive Dentistry, National University of Singapore, Singapore
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Abstract
The authors estimate the prevalence of early-onset periodontitis, or EOP, in U.S. adolescents and describe the clinical features that occur at an early stage in those who have EOP. In 1986 and 1987, about 10.0 percent of African-American, 5.0 percent of Hispanic and 1.3 percent of white U.S. adolescents had EOP. Clinical features that may be useful in the early detection of EOP include overt gingival inflammation, dental calculus and a high rate of caries, restorations and tooth loss.
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Kobayashi T, Westerdaal NA, Miyazaki A, van der Pol WL, Suzuki T, Yoshie H, van de Winkel JG, Hara K. Relevance of immunoglobulin G Fc receptor polymorphism to recurrence of adult periodontitis in Japanese patients. Infect Immun 1997; 65:3556-60. [PMID: 9284119 PMCID: PMC175506 DOI: 10.1128/iai.65.9.3556-3560.1997] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Polymorphonuclear neutrophil (PMN) phagocytic function has been shown to be impaired in some patients with periodontitis. PMN constitutively express members of two immunoglobulin G receptor (Fc gammaR) classes: Fc gammaRIIa (CD32) and Fc gammaRIIIb (CD16). Both receptors exhibit genetically determined structural and functional biallelic polymorphisms, which have been shown to influence PMN phagocytic function. In this study, we assessed the relevance of these Fc gammaR polymorphisms to susceptibility to adult periodontitis and recurrence rate. The distribution of Fc gammaRIIa and Fc gammaRIIIb genotypes of 100 Japanese patients with adult periodontitis during follow-up was compared to the distribution of genotypes in 105 race-matched healthy controls. No significant skewing of distributions of Fc gammaRIIa and Fc gammaRIIIb genotypes was observed between patients and controls. Notably, however, a significant overrepresentation of the Fc gammaRIIIb-NA2 allotype was found in patients with disease recurrence (P < 0.05; odds ratio, 4.29; 95% confidence interval, 1.19 to 16.24). Moreover, the annual rate of recurrence was significantly higher in patients with the Fc gammaRIIIb-NA2/NA2 and Fc gammaRIIIb-NA1/NA2 genotypes than in Fc gammaRIIIb-NA1/NA1 individuals (P < 0.05). Fc gammaRIIa-R/R131 individuals also exhibited higher recurrence rates, though the difference was not statistically significant (P = 0.06). These results suggest that the Fc gammaRIIIb-NA2 allotype represents a risk factor for recurrence of adult periodontitis.
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Affiliation(s)
- T Kobayashi
- Department of Periodontology, Niigata University School of Dentistry, Japan
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Albandar JM, Brown LJ, Genco RJ, Löe H. Clinical classification of periodontitis in adolescents and young adults. J Periodontol 1997; 68:545-55. [PMID: 9203098 DOI: 10.1902/jop.1997.68.6.545] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
THE AIM OF THIS STUDY was to determine the degree to which clinical classifications based on cross-sectional assessments endure in the course of development of early-onset periodontitis (EOP), and to introduce new criteria which might improve the clinical classification of these diseases. Subjects with EOP and a matched group without EOP were identified within a national probability sample examined during the 1986/87 survey of US schoolchildren. Of these, 265 subjects (mean age 16 years) were re-examined during the 1992/93 school year. The clinical attachment level of teeth was assessed, and the individuals were classified into localized juvenile periodontitis (LJP), generalized juvenile periodontitis (GJP), incidental attachment loss (IAL), and no-periodontitis groups using three classification methods previously described. A fourth method that considered the extent and severity of attachment loss and the number of missing teeth was introduced to classify the individuals at baseline and at follow-up as having localized, generalized, or incidental EOP, and no-periodontitis groups. Furthermore, the individuals were classified using criteria based on the rate and pattern of change in attachment loss during 6 years. The results showed low correlations between the baseline classifications and the classifications at the 6-year follow-up examination, irrespective of the method used. In addition, the cross-sectional classifications were not predictive of the rate of progression of periodontal disease in these subjects. In the generalized disease group, two-thirds of the individuals exhibited moderate/rapid disease progression, while one-third had slow or no progression. In the localized disease group, one-half of the individuals had moderate/rapid disease progression and one-half had slow or no progression. In the incidental disease group one-fourth of the individuals had moderate/rapid disease progression and three-fourths had slow or no progression. We propose that the term early-onset periodontitis be used as a generic term to describe periodontal disease before its normal onset. In addition, we suggest that incidental, localized, and generalized EOP are heterogenous groups comprising rapidly and slowly progressing forms within each classification. The findings suggest that a classification system in which subsets of the disease that are defined according to a combination of cross-sectional criteria and the disease progression may be useful in studies of EOP. Furthermore, the findings suggest that clinical classifications of EOP be used as generic descriptors until a full understanding of the pathogenesis of this disease is accomplished.
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Affiliation(s)
- J M Albandar
- National Institute of Dental Research, Bethesda, MD, USA
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Abstract
OBJECTIVES This manuscript attempts to critically review current literature regarding the natural history, aetiology and pathogenesis of the common periodontal diseases to affect children and adolescents. The logic behind the emergence of a new classification in the early 1990s is explained and potential problems with the interpretation of such systems outlined. DATA SOURCES The manuscript focuses upon recent developments, reported in the international periodontal literature, aimed at unraveling the molecular basis for this group of diseases. The concept of one disease type progressing with time to another disease within the same individual is discussed, and early data presented that indicate the possibility of microbial transmission from deciduous to permanent dentition's within a subject. CONCLUSIONS It is concluded that differing classification systems for adolescent and childhood periodontal diseases may lead to confusion within the dental profession, unless the clinical and molecular basis for such diseases is fully understood. Further advances in basic research using molecular biology tools should assist in our understanding of the aetiopathology at a molecular level and hopefully lead to the development of new treatment strategies.
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Affiliation(s)
- S Dibart
- Department of Periodontology, Goldman School of Graduate Dentistry, Boston, MA 02118, USA
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Albandar JM, Brown LJ, Löe H. Dental caries and tooth loss in adolescents with early-onset periodontitis. J Periodontol 1996; 67:960-7. [PMID: 8910834 DOI: 10.1902/jop.1996.67.10.960] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of this study was to assess the caries experience and tooth loss over 6 years in subjects with early-onset periodontitis as compared to their matched controls, and to describe the characteristics of teeth lost during this period. A multi-stage probability sample representing 8th to 12th grade U.S. schoolchildren were screened during the 1986/1987 school year to identify subjects with early-onset periodontitis (cases). The examination included measuring the clinical attachment level, presence of caries and dental restorations, and tooth loss. A random sample of controls without early-onset periodontitis were selected for a follow-up examination and were matched to cases on gender, race, age, and geographic location. A total of 266 subjects, with a mean age of 16 years at baseline, were examined during the 1992/1993 school year and were classified into localized (LJP) and generalized juvenile periodontitis (GJP), incidental attachment loss (IAL), and control groups. Whites had more caries experience than Blacks and Hispanics, but there were no significant differences in tooth loss between the ethnic groups. The LJP and the IAL groups, respectively, had higher and lower overall caries experience than the control group. The LJP group had a significantly higher number of missing teeth at follow-up, and exhibited more extensive tooth mortality during 6 years than the control group. The GJP group also showed more tooth loss than the control group, but the difference was not statistically significant. In the LJP, GJP, IAL, and control groups, respectively, 43%, 32%, 26%, and 18% of the subjects lost teeth over 6 years due to disease. The findings showed differences in caries activity between the early-onset periodontitis groups and a variation by race. The findings suggest that loss of periodontal support was the principal cause for tooth loss in the LJP and GJP groups, and that dental caries was the principal cause for tooth extraction in the IAL and the control groups.
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Affiliation(s)
- J M Albandar
- Division of Epidemiology and Oral Disease Prevention, National Institute of Dental Research, Bethesda, MD, USA
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Schenkein HA, Gunsolley JC, Koertge TE, Schenkein JG, Tew JG. Smoking and its effects on early-onset periodontitis. J Am Dent Assoc 1995; 126:1107-13. [PMID: 7560567 DOI: 10.14219/jada.archive.1995.0327] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The findings of a recent study show that smoking was more prevalent in a group of patients with generalized early-onset periodontitis and adult periodontitis than in patients with localized juvenile periodontitis or healthy periodontium. In patients with generalized early-onset periodontitis, smoking had a significant effect on periodontal attachment loss; these patients had significantly more teeth with affected sites and a greater mean loss of attachment than patients who did not smoke. Thus, the risk of smoking could greatly accelerate tooth loss in this relatively young group of individuals who are already at high risk for progressive periodontal attachment loss.
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Affiliation(s)
- H A Schenkein
- Clinical Research Center for Periodontal Diseases, School of Dentistry, Virginia Commonwealth University, Richmond 23298-0566, USA
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