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Henricsson S, Wallin Bengtsson V, Renvert S, Sanmartin Berglund J, Lundegren N, Andersson P. Self-perceived oral health and orofacial appearance in older adults - an 18-year follow-up study in Karlskrona, Sweden. Acta Odontol Scand 2024; 83:255-263. [PMID: 38700368 DOI: 10.2340/aos.v83.40574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 03/31/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES To analyze whether self-perceived oral health and orofacial appearance change with increasing age. METHODS This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001-2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran's Q test was conducted. Statistical significance was considered at p ≤ 0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests. RESULTS Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09). CONCLUSIONS Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.
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Affiliation(s)
- Sara Henricsson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden.
| | | | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden; Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | | | | | - Pia Andersson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Harrison P, Madeley E, Nolan M, Renvert S, Polyzois I. A longitudinal analysis of the impact of nonsurgical and surgical treatment of peri-implantitis upon clinical parameters and implant stability quotient values. A 2-3-year follow-up. Clin Exp Dent Res 2024; 10:e833. [PMID: 38345521 PMCID: PMC10838112 DOI: 10.1002/cre2.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/03/2023] [Accepted: 11/22/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES In this study, the aim was to investigate the medium- to long-term impact of peri-implantitis treatment upon clinical parameters and implant stability quotient values and to ascertain if magnetic resonance frequency analysis can be used as a diagnostic tool to demonstrate postoperative healing following treatment of peri-implantitis. MATERIALS AND METHODS A total of n = 26 patients (n = 86 implants) diagnosed with peri-implantitis were recruited for this prospective cohort study and four different treatment modalities were used. Baseline measurements of a number of clinical parameters as well as implant stability measurements in the form of ISQ were recorded. These measurements were repeated at 6, 12, and 24-36 months following treatment. Analysis of variance was performed for all implants treated as well as separately for each treatment modality. A regression model was also used to determine factors affecting ISQ measurements over time. RESULTS Treatment of peri-implantitis resulted in significant improvements of both average PPDs and BOP (p < .0001 and p < .01). ISQ values marginally improved initially for all treatment modalities, but improvement was only maintained for 2-3 years in treatment modalities I (+1.28), III (+1.49), and IV (+2.92). There was a statistically significant negative linear correlation between average PPD and the ISQ values recorded both at baseline (r = -.618, p < 0.0001) and at 2/3 years (r = -.604, p < 0.0001). CONCLUSION Over the 2-3-year follow-up period, all four treatment modalities led to improved clinical and radiographic peri-implant parameters but implant stability posttreatment, as indicated by the fact that the recorded ISQ scores remained stable. As a result, use of MRFA as an adjunct to the traditionally used periodontal and radiographic tools for the evaluation of postoperative implant stability following the treatment of peri-implant disease cannot be recommended.
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Affiliation(s)
- Peter Harrison
- Division of Restorative Dentistry & Periodontology, Dublin Dental University HospitalTrinity College DublinDublinIreland
| | - Edward Madeley
- Division of Restorative Dentistry & Periodontology, Dublin Dental University HospitalTrinity College DublinDublinIreland
| | - Michael Nolan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University HospitalTrinity College DublinDublinIreland
| | - Stefan Renvert
- Division of Restorative Dentistry & Periodontology, Dublin Dental University HospitalTrinity College DublinDublinIreland
- Department of Health SciencesKristianstad UniversityKristianstadSweden
- Blekinge Institute of TechnologyKarlskronaSweden
| | - Ioannis Polyzois
- Division of Restorative Dentistry & Periodontology, Dublin Dental University HospitalTrinity College DublinDublinIreland
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Flyborg J, Renvert S, Anderberg P, Larsson T, Sanmartin-Berglund J. Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health. Clin Oral Investig 2023; 28:8. [PMID: 38123762 PMCID: PMC10733217 DOI: 10.1007/s00784-023-05407-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants' self-estimated brush use. MATERIALS AND METHODS Objective brush usage data was extracted from the participants' powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants' self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination. RESULTS Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC. CONCLUSIONS Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use. CLINICAL RELEVANCE Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023.
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Affiliation(s)
- Johan Flyborg
- Department of Health, Blekinge Institute of Technology, 37179, Karlskrona, Sweden.
| | - Stefan Renvert
- Department of Health, Blekinge Institute of Technology, 37179, Karlskrona, Sweden
- Faculty of Health Sciences, Kristianstad University, 29188, Kristianstad, Sweden
| | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, 37179, Karlskrona, Sweden
- School of Health Sciences, University of Skövde, 54128, Skövde, Sweden
| | - Tobias Larsson
- Department of Health, Blekinge Institute of Technology, 37179, Karlskrona, Sweden
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Henricsson S, Bengtsson VW, Renvert S, Berglund JS, Lundegren N, Andersson P. Self-perceived oral health and orofacial appearance in an adult population, 60 years of age. Int J Dent Hyg 2023. [PMID: 37369990 DOI: 10.1111/idh.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 01/16/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE The study aimed to compare self-perceived oral health and orofacial appearance in three different cohorts of 60-year-old individuals. METHOD A cross-sectional design, based on data obtained from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprised 478 individuals, from baseline, 2001-2003 (n = 191), 2007-2009 (n = 218) and 2014-2015 (n = 69). Comparisons were made within and between the cohorts, with bivariate analysis and Fisher's exact test. Statistical significance was considered at p < 0.05. RESULTS The result showed that a low number of the participants reported self-perceived problems with oral health. Of the problems reported, a higher proportion in cohort 2014-2015 (39.3%) experienced problems with bleeding gums. The experience of bleeding gums increased between the cohorts 2001-2003 and 2014-2015 (p = 0.040) and between 2007-2009 and 2014-2015 (p = 0.017). The prevalence of discomfort with sensitive teeth was experienced in 7%-32%. Twice as many women compared to men experienced discomfort in all cohorts (no significant differences between the cohorts). Satisfaction with dental appearance was experienced in 75%-84%. Twice as many women compared to men were dissatisfied with their dental appearance in 2001-2003 (p = 0.011) and with discoloured teeth (p = 0.020). No significant differences could be seen between the cohorts regarding discomfort with dental appearance or discoloured teeth. CONCLUSION The 60-year-olds irrespective of birth cohort, perceived their oral health and orofacial appearance as satisfactory.
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Affiliation(s)
- Sara Henricsson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | | | | | - Pia Andersson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Svärd A, Kastbom A, Ljungberg KR, Potempa B, Potempa J, Persson GR, Renvert S, Berglund JS, Söderlin MK. Antibodies against Porphyromonas gingivalis in serum and saliva and their association with rheumatoid arthritis and periodontitis. Data from two rheumatoid arthritis cohorts in Sweden. Front Immunol 2023; 14:1183194. [PMID: 37325636 PMCID: PMC10265683 DOI: 10.3389/fimmu.2023.1183194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Background Periodontitis and oral pathogenic bacteria can contribute to the development of rheumatoid arthritis (RA). A connection between serum antibodies to Porphyromonas gingivalis (P. gingivalis) and RA has been established, but data on saliva antibodies to P. gingivalis in RA are lacking. We evaluated antibodies to P. gingivalis in serum and saliva in two Swedish RA studies as well as their association with RA, periodontitis, antibodies to citrullinated proteins (ACPA), and RA disease activity. Methods The SARA (secretory antibodies in RA) study includes 196 patients with RA and 101 healthy controls. The Karlskrona RA study includes 132 patients with RA ≥ 61 years of age, who underwent dental examination. Serum Immunoglobulin G (IgG) and Immunoglobulin A (IgA) antibodies and saliva IgA antibodies to the P. gingivalis-specific Arg-specific gingipain B (RgpB) were measured in patients with RA and controls. Results The level of saliva IgA anti-RgpB antibodies was significantly higher among patients with RA than among healthy controls in multivariate analysis adjusted for age, gender, smoking, and IgG ACPA (p = 0.022). Saliva IgA anti-RgpB antibodies were associated with RA disease activity in multivariate analysis (p = 0.036). Anti-RgpB antibodies were not associated with periodontitis or serum IgG ACPA. Conclusion Patients with RA had higher levels of saliva IgA anti-RgpB antibodies than healthy controls. Saliva IgA anti-RgpB antibodies may be associated with RA disease activity but were not associated with periodontitis or serum IgG ACPA. Our results indicate a local production of IgA anti-RgpB in the salivary glands that is not accompanied by systemic antibody production.
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Affiliation(s)
- Anna Svärd
- Center for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Alf Kastbom
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Karin Roos Ljungberg
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Barbara Potempa
- Department of Oral Immunity and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Jan Potempa
- Department of Oral Immunity and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - G. Rutger Persson
- Department of Periodontics, University of Washington, Seattle, WA, United States
- Department of Oral Medicine, University of Washington, Seattle, WA, United States
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
- School of Dental Science, Trinity College, Dublin, Ireland
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Maria K. Söderlin
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Flyborg J, Renvert S, Sanmartin Berglund J, Anderberg P. Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment. Gerodontology 2023; 40:74-82. [PMID: 35064682 DOI: 10.1111/ger.12619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/11/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study is to investigate whether the use of a powered toothbrush could maintain oral health by reducing the dental plaque (PI), bleeding on probing (BOP), and periodontal pocket depth (PPD) ≥4 mm in a group of individuals with MCI and also if changes in oral health affect various aspects of quality of life. BACKGROUND People with cognitive impairment tend to have poor oral hygiene and poorer Quality of life. In the present study, the participants were asked to use a powered toothbrush for at least 2 min morning and evening and no restrictions were given against the use of other oral care products. The participant survey conducted at each examination demonstrated that 61.2% of participants at baseline claimed to have experience of using a powered toothbrush, 95.4% at 6 months and 95% after 12 months. At the same time, the use of manual toothbrushes dropped from 73.3% to 44.7% from baseline to the 12-month check-up. This shows that several participants continue to use the manual toothbrush in parallel with the powered toothbrush, but that there is a shift towards increased use of the powered toothbrush. Removal of dental biofilm is essential for maintaining good oral health. We investigated whether using a powered toothbrush reduces the presence of dental plaque, bleeding on probing and periodontal pockets ≥4 mm in a group of older individuals with mild cognitive impairment. MATERIALS AND METHODS Two hundred and thirteen individuals with the mean age of 75.3 years living without official home care and with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous six months were recruited from the Swedish site of a multicenter project, Support Monitoring And Reminder Technology for Mild Dementia (SMART4MD) and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations and MMSE tests were conducted at baseline, 6 and 12 months. RESULTS One hundred seventy participants, 36.5% women and 63.5% men, completed a 12-month follow-up. The use of a powered toothbrush resulted, for the entire group, in a significant decrease in plaque index from 41% at baseline to 31.5% after 12 months (P < .000). Within the same time frame, the values for bleeding on probing changed from 15.1% to 9.9% (P < .000) and the percentage of probing pocket depths ≥4 mm from 11.5% to 8.2% (P < .004). The observed improvements in the Oral Health Impact Profile 14 correlate with the clinical improvements of oral health. CONCLUSION The use of a powered toothbrush was associated with a reduction of PI, BOP and PPD over 12 months even among individuals with low or declining MMSE score. An adequately used powered toothbrush maintain factors that affect oral health and oral health-related Quality of Life in people with mild cognitive impairment.
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Affiliation(s)
- Johan Flyborg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Stefan Renvert
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Oral Health Sciences, University of Kristianstad, Sweden
| | | | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.,School of Health Sciences, University of Skövde, Skövde, Sweden
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Aghazadeh A, Persson GR, Stavropoulos A, Renvert S. Reconstructive treatment of peri-implant defects-Results after three and five years. Clin Oral Implants Res 2022; 33:1114-1124. [PMID: 36062917 PMCID: PMC9826427 DOI: 10.1111/clr.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 07/06/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to assess the long-term efficacy of reconstructive treatment of peri-implantitis intraosseous defects. MATERIAL AND METHODS Peri-implant intraosseous defects were augmented using either an autogenous bone graft (AB) or a bovine-derived xenograft (BDX) in combination with a collagen membrane. Maintenance was provided every third month. RESULTS In the AB group, 16 patients with 25 implants remained at year five. In the BDX group, 23 patients with 38 implants remained. Between baseline and year 5, bleeding on probing (BOP) and probing pocket depth (PPD) scores were reduced in both groups (p < .001). In the AB and BDX groups, mean PPD between baseline and year five was reduced by 1.7 and 2.8 mm, respectively. The difference between groups was significant (p < .001). In the AB group, the mean bone level change at implant level between baseline and years three and five was-0,2 and -0.7 mm, respectively. In the BDX group, the mean bone level change at implant level between baseline and years three and five was 1.6 and 1.6 mm, respectively. The difference between the groups was significant (p < .001). Successful treatment (no bone loss, no probing pocket depth (PPD) > 5 mm, no suppuration, maximum one implant surface with bleeding on probing (BOP) at year five) was obtained in 9/25 implants (36%) in the AB group and in 29/37 implants (78.3%) in the BDX group. CONCLUSIONS Reconstructive surgical treatment of peri-implant defects using BDX resulted in more predictable outcomes than using autogenous bone over 5 years.
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Affiliation(s)
| | - G. Rutger Persson
- Department of Oral SciencesKristianstad UniversityKristianstadSweden,Department of Periodontics and Oral MedicineUniversity of WashingtonSeattleWAUSA
| | - Andreas Stavropoulos
- Department of PeriodontologyMalmö UniversityMalmöSweden,Division of Regenerative Dental Medicine and Periodontology, CUMDUniversity of GenevaGenevaSwitzerland
| | - Stefan Renvert
- Department of Oral SciencesKristianstad UniversityKristianstadSweden,Blekinge Institute of TechnologyKarlskronaSweden,Faculty of DentistryThe University of Hong KongHong KongSARChina
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Monje A, Amerio E, Cha JK, Kotsakis G, Pons R, Renvert S, Sanz-Martin I, Schwarz F, Sculean A, Stavropoulos A, Tarnow D, Wang HL. Strategies for implant surface decontamination in peri-implantitis therapy. Int J Oral Implantol (Berl) 2022; 15:213-248. [PMID: 36082658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Peri-implantitis is an infectious disease that leads to progressive bone loss. Surgical therapy has been advocated as a way of halting its progression and re-establishing peri-implant health. One of the most challenging but crucial tasks in the management of peri-implantitis is biofilm removal to achieve reosseointegration and promote the reduction of peri-implant pockets. A wide variety of strategies have been used for implant surface decontamination. Mechanical means have been demonstrated to be effective in eliminating calculus deposits and residual debris; however, the presence of undercuts and the grooves and porosities along the roughened implant surface make it difficult to achieve an aseptic surface. In conjunction with mechanical measures, use of chemical adjuncts has been advocated to dilute bacterial concentrations, destroy the bacteria's organic components and eliminate endotoxins. Pharmacological adjuncts have also been recommended to diminish the bacterial load. Other strategies, such as use of lasers, implantoplasty and electrolysis, have been suggested for implant surface decontamination to promote predictable clinical and radiographic outcomes.
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Critén S, Andersson P, Renvert S, Götrick B, Berglund JS, Bengtsson VW. Oral health status among 60-year-old individuals born in 1941-1943 and 1954-1955 and 81-year-old individuals born in 1922-1924 and 1933-1934, respectively: a cross-sectional study. Clin Oral Investig 2022; 26:6733-6742. [PMID: 35906339 DOI: 10.1007/s00784-022-04632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to analyze the oral health status of four different birth cohorts: two cohorts of 60-year-olds born in 1941-1943 and 1954-1955 and 2 cohorts of 81-year-olds born in 1920-1922 and 1933-1934. MATERIAL AND METHODS The study was based on data from an ongoing longitudinal population project, The Swedish National Study on Aging and Care (SNAC). Oral health status was repeatedly examined clinically and radiographically in 2001-2003 and 2014-2015, including 60- and 81-year-olds, in total 412 individuals. Statistical analyses were performed using independent-samples t test and Pearson's χ2 test. RESULTS More individuals were dentate in 2014-2015 compared to 2001-2003 in the two age groups: 60 and 81 years (p < 0.001 for both). The mean number of teeth increased in the 60-year-olds from 24.2 to 27.0 and in the 81-year-olds from 14.3 to 20.2. The numbers of at least one intact tooth increased for both age groups (p < 0.001 and p < 0.004, respectively). In the age groups 81 years, there was an increase in having at least one PPD ≥ 6 mm (p < 0.016) and bone loss ≥ 5 mm (p < 0.029) between the two examinations. No such differences were found in the age groups of 60 years. CONCLUSION Over 13 years, oral health improved for both 60- and 81-year-old age groups. The most significant changes were in the 81-year-olds where oral health had improved except for periodontal status. CLINICAL RELEVANCE More natural teeth and impaired periodontal status potentially impact oral health and should increase focus on preventive and supportive dental care in older individuals.
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Affiliation(s)
- Sladjana Critén
- Faculty of Health Sciences, Kristianstad University, 291 88, Kristianstad, Sweden.
| | - Pia Andersson
- Faculty of Health Sciences, Kristianstad University, 291 88, Kristianstad, Sweden
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, 291 88, Kristianstad, Sweden.,Department of Health, Blekinge Institute of Technology, 371 79, Karlskrona, Sweden
| | - Bengt Götrick
- Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
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Monje A, Amerio E, Farina R, Nart J, Ramanauskaite A, Renvert S, Roccuzzo A, Salvi GE, Schwarz F, Trombelli L, Wang HL. Significance of probing for monitoring peri-implant diseases. Int J Oral Implantol (Berl) 2021; 14:385-399. [PMID: 34726848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Peri-implant diseases at implant sites represent the most considerable concern for many dental clinicians nowadays due to their detrimental effect on implant longevity. Preventive measures include patient education and motivation, supportive peri-implant therapy and routine assessment of the hard and soft tissues. Nevertheless, the reliability of clinical parameters to monitor peri-implant conditions is subject to debate. As such, the primary purpose of the present review was to gain further insight into the diagnostic accuracy of probing as a clinical tool to monitor dental implants and assist clinicians in preventing peri-implant diseases. Studies have recommended periodic probing to monitor the condition of the peri-implant tissues. Increased probing pocket depth, profuse bleeding on probing and suppuration at implants are clinical signs that have been associated with peri-implantitis; thus, if these clinical parameters are present, radiographic assessment is encouraged to make a definitive diagnosis considering potential inaccuracies related to local and/or systemic factors identified in the present review.
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Hussain B, Haugen HJ, Aass AM, Sanz M, Antonoglou GN, Bouchard P, Bozic D, Eickholz P, Jepsen K, Jepsen S, Karaca EO, Kuru BE, Nemcovsky CE, Papapanou PN, Pilloni A, Renvert S, Roccuzzo M, Sanz-Esporrin J, Spahr A, Stavropoulos A, Verket A, Vražić D, Lyngstadaas SP. Peri-Implant Health and the Knowing-Doing Gap—A Digital Survey on Procedures and Therapies. Front Dent Med 2021. [DOI: 10.3389/fdmed.2021.726607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed.Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey.Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3–6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health.Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.
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Renvert S, Giovannoli JL, Roos-Jansåker AM, Rinke S. Surgical treatment of peri-implantitis with or without a deproteinized bovine bone mineral and a native bilayer collagen membrane: A randomized clinical trial. J Clin Periodontol 2021; 48:1312-1321. [PMID: 34169551 DOI: 10.1111/jcpe.13513] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 12/11/2022]
Abstract
AIM To assess whether the use of deproteinized bovine bone mineral (DBBM) and native bilayer collagen membrane (NBCM) improved healing of peri-implantitis-related bone defects at 12 months. MATERIALS AND METHODS In a multi-centre, randomized clinical trial, 32 individuals received surgical debridement (control group [CG]), and 34 received adjunct use of DBBM and NBCM (test group [TG]). Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUP), recession (REC), cytokines (IL-1β, IL-1RA, IL-6, IL-8, IL-12, IP10, PDGF-BB, TNF-α, VEGF), and patient-reported outcomes (PROs) were evaluated at 3, 6, 9, and 12 months. RESULTS RDF at the deepest site amounted 2.7 ± 1.3 mm in TG and 1.4 ± 1.2 mm in CG (p <.0001). PPD was reduced by 1.9 mm in TG and 2.3 mm in CG (p = .5783). There were no significant differences between groups regarding reductions of BOP, SUP, REC, cytokines levels, or oral health impact profile (OHIP)-14 scores at 12 months. Successful treatment (RDF ≥ 1.0 mm, PPD ≤5 mm, ≤1/4 site with BOP grade 1, no SUP) was identified in 32% in TG and 21% in CG. CONCLUSIONS DBBM and NBCM resulted in significantly more RDF than debridement alone. No difference was found in any clinical parameters or PROs between the groups. ClinicalTrials.gov Identifier: NCT02375750.
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Affiliation(s)
- Stefan Renvert
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden.,Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Jean-Louis Giovannoli
- Private Practice, Paris, France.,Institute of Health, University of Corsica, Corte, France
| | | | - Sven Rinke
- Private Practice, Hanau, Germany.,Department of Prosthodontics, University Medical Center, Goettingen, Germany
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Bengtsson VW, Persson GR, Berglund JS, Renvert S. Periodontitis related to cardiovascular events and mortality: a long-time longitudinal study. Clin Oral Investig 2021; 25:4085-4095. [PMID: 33506429 PMCID: PMC8137476 DOI: 10.1007/s00784-020-03739-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The present study assessed if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases, or at a higher risk of death for 17 years. MATERIAL AND METHODS At baseline individuals ≥ 60 received a dental examination including a panoramic radiograph. Periodontitis was defined as having ≥ 30% sites with ≥ 5-mm distance from the cementoenamel junction to the marginal bone level. Medical records were annually reviewed from 2001 to 2018. Findings from the medical records identifying an ICD-10 code of stroke and ischemic heart diseases or death were registered. RESULTS Associations between periodontitis and incidence of ischemic heart disease were found in this 17-year follow-up study in all individuals 60-93 years (HR: 1.5, CI: 1.1-2.1, p = 0.017), in women (HR: 2.1, CI: 1.3-3.4, p = 0.002), and in individuals 78-96 years (HR: 1.7, CI: 1.0-2.6, p = 0.033). Periodontitis was associated with mortality in all individuals (HR: 1.4, CI: 1.2-1.8, p = 0.002), specifically in men (HR: 1.5, CI: 1.1-1.9, p = 0.006) or in ages 60-72 years (HR: 2.2, CI: 1.5-3.2, p = 0.000). Periodontitis was more prevalent among men (OR: 1.8, CI: 1.3-2.4, p = 0.000). CONCLUSIONS Individuals with periodontitis have an increased risk for future events of ischemic heart diseases and death. CLINICAL RELEVANCE Improving periodontal health in older individuals may reduce overall mortality and ischemic heart diseases. Both dental and medical professionals should be aware of the associations and ultimately cooperate.
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Affiliation(s)
| | - Gösta Rutger Persson
- University of Kristianstad, Elmetorpsvägen 15, 29188 Kristianstad, Sweden
- Department of Periodontics, University of Washington, Seattle, WA USA
- Departments of Periodontics and Oral Medicine, University of Washington, Seattle, WA USA
| | - Johan Sanmartin Berglund
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Renvert
- University of Kristianstad, Elmetorpsvägen 15, 29188 Kristianstad, Sweden
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
- Dublin Dental Hospital Trinity College, Dublin, Ireland
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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14
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Söderlin MK, Persson GR, Renvert S, Sanmartin Berglund J. Cytokines in gingival crevicular fluid in elderly rheumatoid arthritis patients in a population-based cross-sectional study: RANTES was associated with periodontitis. J Periodontal Res 2021; 56:907-916. [PMID: 33954982 PMCID: PMC8518573 DOI: 10.1111/jre.12887] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/09/2021] [Accepted: 04/10/2021] [Indexed: 12/13/2022]
Abstract
Objective We studied cytokines in gingival crevicular fluid (GCF) in a cross‐sectional population‐based cohort of rheumatoid arthritis (RA) patients ≥61 years of age with and without a diagnosis of periodontitis. Background data Earlier studies on cytokines in GCF in RA patients have not given clear results. Methods In a population‐based cross‐sectional study of patients ≥61 years of age, 233 RA patients were identified. 132 (57%) dentate RA patients participated. All participants received rheumatological and dental examinations, and had a panoramic radiograph taken. GCF was sampled on each patient. Interleukins 1‐β (IL‐1β), IL‐4, IL‐6, IL‐10, IL‐17A, tumor necrosis factor alpha (TNF‐α), interferon gamma (IFN‐γ), and chemokines RANTES/CCL5, eotaxin and monocyte chemoattractant protein (MCP‐1) were analyzed in GCF. These cytokines were stratified for periodontitis, age, gender, body mass index (BMI), smoking, and anti‐cyclic citrullinated protein (anti‐CCP) status. Binary logistic regression analyses with periodontitis as outcome were performed adjusting for the above mentioned confounding factors including anti‐rheumatic medication, disease duration and the cytokine in question. Results Periodontitis was diagnosed in 80/132 (61%) of study participants. The 110 RA patients not participating were older, had a higher mean erythrocyte sedimentation rate (ESR), had a higher mean DAS28ESR (Disease Activity Score 28 using ESR) and were less often on biologic treatment. Only RANTES was associated with periodontitis (p = .049, OR 1.001, 95% CI 1.000–1.002) in the binary logistic regression analyses. Conclusion In this population‐based elderly RA cohort, neither pro‐inflammatory nor anti‐inflammatory cytokines in GCF were clearly associated with a diagnosis of periodontitis.
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Affiliation(s)
- Maria K Söderlin
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Gösta Rutger Persson
- Department of Periodontics, and the Department of Oral Medicine, University of Washington, Seattle, WA, USA
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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15
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Serino G, Wada M, Mameno T, Renvert S. Two- and ten-year follow-up of patients responding and non-responding to the surgical treatment of peri-implantitis: A retrospective evaluation. Clin Oral Implants Res 2021; 32:410-421. [PMID: 33449388 DOI: 10.1111/clr.13711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/15/2020] [Accepted: 01/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To report a follow-up of patients following the surgical anti-infective treatment of peri-implantitis and to identify possible risk indicators for the progression of disease during supportive peri-implant therapy. MATERIAL AND METHODS Following peri-implant surgery, 41 patients (213 implants) were enrolled in a supportive peri-implant therapy. At the 2-year follow-up, two groups of patients were identified, with or without residual peri-implant pockets (responding and non-responding group). Eighteen patients (85 implants) of the non-responding group were followed for further 8 years. RESULTS At the 2-year examination, 73 of the 117 treated implants (62.4%) presented healthy peri-implant condition, while 44 (37.6%) presented persisting peri-implantitis associated with substantial bone loss before treatment. The 10-year examination of the non-responding group revealed that 1) 84% of the implants that regained health following surgery remained healthy during the entire observation period; 2) 66% of the implants with residual pockets following surgery maintained stable peri-implant condition; and 3) 29% of all treated implants showed disease progression, and 11 of those were extracted. Presence of pockets at 3-4 sites of the implants was identified as risk indicator for progression of peri-implantitis. CONCLUSION The peri-implant health achieved following therapy was maintained for most of the implants during the follow-up. Residual pockets were a frequent finding at implants with substantial bone loss before treatment. Presence of pockets around the entire circumference of the implants resulted as a risk indicator for further disease progression. The probability of progression of peri-implant disease increased with increased observation time.
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Affiliation(s)
- Giovanni Serino
- Clinic of Periodontology, Borås, Public Dental Service, Region Västra Götaland, Sweden.,Research and Development Unit, Borås, Sweden
| | - Masahiro Wada
- Clinic of Periodontology, Borås, Public Dental Service, Region Västra Götaland, Sweden.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Stefan Renvert
- Department of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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16
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Adel-Khattab D, Montero E, Herrera D, Zhao D, Jin L, Al-Shaikh Z, Renvert S, Meyle J. Evaluation of the FDI Chairside Guide for Assessment of Periodontal Conditions: A Multicentre Observational Study. Int Dent J 2021; 71:390-398. [PMID: 33531146 PMCID: PMC9275347 DOI: 10.1016/j.identj.2020.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective There is a need to develop easy-to-use tools to screen for periodontal conditions in daily practice. This study aimed to evaluate the FDI World Dental Federation “Chairside Guide” (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening. Methods Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis. Results Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001). Conclusion The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice.
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Affiliation(s)
- Doaa Adel-Khattab
- Faculty of Dentistry, Department of Oral Medicine, Periodontology and Diagnosis, Ain Shams University, Cairo, Egypt; Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
| | - Eduardo Montero
- Etiology and Research of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense of Madrid, Madrid, Spain.
| | - David Herrera
- Etiology and Research of Periodontal and Peri-implant Diseases (ETEP) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Dan Zhao
- Faculty of Dentistry, Division of Periodontology & Implant Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Faculty of Dentistry, Division of Periodontology & Implant Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Zahra Al-Shaikh
- Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden; Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Joerg Meyle
- Department of Periodontology, Zentrum fuer Zahn-, Mund- und Kieferheilkunde, University of Giessen, Geissen, Germany
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17
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Sordi MB, Perrotti V, Iaculli F, Pereira KCR, Magini RS, Renvert S, Gattone SA, Piattelli A, Bianchini MA. Multivariate analysis of the influence of peri-implant clinical parameters and local factors on radiographic bone loss in the posterior maxilla: a retrospective study on 277 dental implants. Clin Oral Investig 2020; 25:3441-3451. [PMID: 33155065 PMCID: PMC8137597 DOI: 10.1007/s00784-020-03666-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. MATERIALS AND METHODS Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. RESULTS Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) CONCLUSIONS: ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. CLINICAL RELEVANCE Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.
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Affiliation(s)
- Mariane B Sordi
- Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.
| | - Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Keila C R Pereira
- Public Health Sciences, University of South of Santa Catarina, Tubarao, Brazil
| | - Ricardo S Magini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University School of Dentistry, Kristianstad, Sweden.,Dublin Dental Hospital, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Stefano Antonio Gattone
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences (DiSFPEQ), University of Chieti-Pescara, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.,Biomaterials Engineering, Catholic University of Murcia (UCAM), Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (Pescara), Italy
| | - Marco A Bianchini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
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Gkikas G, McLaughlin M, Renvert S, Polyzois I. A Prospective Study Comparing the Effect of L-PRF and Porous Titanium Granules on the Preservation of the Buccal Bone Plate Following Immediate Implant Placement. INT J PERIODONT REST 2020; 40:767-774. [PMID: 32926007 DOI: 10.11607/prd.4299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to compare the effect of an autogenous blood concentrate (L-PRF) with the effect of white porous titanium granules (WPTG) on buccal bone remodeling. These materials were used to graft the void between the implant and the buccal bone following immediate implant placement. Clinical measurements were made at two time points, and the mean buccal bone horizontal dimension at placement was 2.94 ± 0.59 mm for L-PRF and 3.49 ± 0.99 mm for WPTG. At reentry, the values were 1.19 ± 0.90 mm and 2.12 ± 0.87 mm, respectively. Overall, there was no difference observed in the performance of the two materials regarding buccal bone resorption.
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19
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Renvert S, Berglund JS, Persson GR, Söderlin MK. The association between rheumatoid arthritis and periodontal disease in a population-based cross-sectional case-control study. BMC Rheumatol 2020; 4:31. [PMID: 32699831 PMCID: PMC7370413 DOI: 10.1186/s41927-020-00129-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background The association between rheumatoid arthritis (RA) and periodontitis remains unclear. Methods We studied oral health and periodontitis in a population-based case-control study of individuals with ≥10 remaining teeth ≥61 years of age and either with, or without a diagnosis of RA. 126 dentate individuals with RA were recruited together with age-matched control individuals without RA. The control individuals were recruited from the general population from the same city (n = 249). A dental examination including a panoramic radiograph was performed on all participants. All individuals with RA were examined and medical records were reviewed by a rheumatologist. In the control group, none of the participants presented with symptoms of RA and their medical records were also negative. Results The RA group included more women (66.7% vs. 55.8%) (p < 0.01). Individuals in the RA group had a higher body mass index (BMI) (p < 0.001). A diagnosis of periodontitis was more common in the RA group (61.1%) than in the control group (33.7%) (p = 0.001). Binary logistic regression analysis identified that a BMI > 25 (OR 6.2, 95% CI 3.6, 10.5, p = 0.000), periodontitis (OR 2.5 95% CI 1.5, 4.2 p = 0.000), and female gender (OR 2.3, 95% CI 1.3–4.0, p = 0.003) were associated with RA. Conclusion RA was associated a diagnosis of periodontitis.
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Affiliation(s)
- Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden.,Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | | | - G Rutger Persson
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden.,Departments of Periodontics, and the Department of Oral Medicine, University of Washington, Seattle, WA USA
| | - Maria K Söderlin
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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20
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Renvert S, Noack MJ, Lequart C, Roldán S, Laine ML. The Underestimated Problem of Intra-Oral Halitosis in Dental Practice: An Expert Consensus Review. Clin Cosmet Investig Dent 2020; 12:251-262. [PMID: 32753975 PMCID: PMC7342603 DOI: 10.2147/ccide.s253765] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022] Open
Abstract
Approximately 90% of halitosis cases originate within the oral cavity (intra-oral halitosis). With a focus on intra-oral halitosis, this narrative review article provides a current summary of the epidemiology, diagnosis and management of halitosis and discusses practical considerations for healthcare professionals (HCPs), including dentists, dental hygienists, general practitioners, community pharmacists, nurses and medical specialists. MEDLINE and PubMed were searched up to 31 December 2019. Additional information was sourced from reference lists of relevant published literature. Full-text articles which reported on the epidemiology, diagnosis and management of halitosis were considered for inclusion. Halitosis affects substantial numbers of individuals globally and is an underestimated problem in dental practice. Current estimates of the prevalence of halitosis, in addition to diagnostic methods and management considerations for halitosis, are discussed. Although not a life-threatening condition, halitosis has a significant impact on patients’ quality of life and can result in psychological consequences including social, professional and affective limitations. Using a simple step-wise approach for diagnosis and treatment, dentists and dental hygienists are ideally placed to respond to an initial consultation for halitosis.
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Affiliation(s)
- Stefan Renvert
- Department of Oral Health, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Michael J Noack
- Department of Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| | - Christophe Lequart
- Private practice, Sorigny, Union Française pour la Santé Bucco-Dentaire (UFSBD), Paris, France
| | - Silvia Roldán
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Marja L Laine
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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21
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Widén C, Holmer H, Sättlin S, Renvert S, Lernmark Å, Persson GR. Periodontal conditions, retinopathy, and serum markers in individuals with type 1 diabetes. J Periodontol 2020; 91:1436-1443. [PMID: 32484239 DOI: 10.1002/jper.19-0641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/18/2020] [Accepted: 04/19/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The prevalence of diabetes is high and increasing. Periodontitis has been identified as a risk factor in both type 1 and 2 diabetes. The study purpose was to assess periodontal conditions, retinopathy, and serum glutamic acid decarboxylase antibody (GADA) titers in relation to retinopathy in individuals with type 1 diabetes (T1D). METHODS The study is a case series. Adult individuals with a diagnosis of T1D (n = 85) monitored ≥5 years were recruited from an endocrinology clinic. Peripheral venous blood samples were analyzed including assessments of serum HbA1c levels and GADA titers. Medical and periodontal conditions were examined, and the data assessed. Independent t tests, binary and multivariate analyses, χ2 and odds ratios were employed. RESULTS Gingivitis was found in 68.2%, periodontitis in 21.2%, and retinopathy in 64.7%, GADA (≥35 U/mL) in 54.1%, and serum HbA1c > 48 mmol/mol in 94.3% of the individuals. The unadjusted odds ratio for periodontitis to differentiate a diagnosis of retinopathy was 7.3 (95%CI 1.6, 4.4, P <0.01). Multivariate analyses identified the following dependent factors to differentiate retinopathy; age, T1D duration, gingivitis, periodontitis at P < 0.001, sex, and serum GADA at P < 0.01, and by the number of remaining teeth at P < 0.05. CONCLUSION Retinopathy as a complication to T1D is linked to the duration of diabetes, age of the individual and with increasing severity to periodontitis. Periodontal intervention studies are warranted.
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Affiliation(s)
- Cecilia Widén
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | | | - Susanna Sättlin
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University/Clinical Research Centre, University Hospital, Malmö, Sweden
| | - G Rutger Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Oral Medicine, University of Washington, Seattle, WA, USA.,Department of Periodontics, University of Washington, Seattle, WA, USA
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22
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Svärd A, Renvert S, Sanmartin Berglund J, Persson RG, Söderlin M. Antibodies to citrullinated peptides in serum and saliva in patients with rheumatoid arthritis and their association to periodontitis. Clin Exp Rheumatol 2020; 38:699-704. [PMID: 31820729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES A connection between prevalence of rheumatoid arthritis (RA) and periodontitis has been reported. The hypothesis for this association involves increased citrullination in the oral mucosa in patients with periodontitis. Whether ongoing periodontitis has an effect on IgA antibodies to citrullinated peptides (ACPA) in saliva is unknown. We studied IgA ACPA in saliva and serum and their relation to periodontitis and smoking in a population-based elderly RA cohort. METHODS A population-based cohort of patients with RA ≥61 years of age (n=132) was examined by rheumatologists and a dental hygienist. Analyses of IgG ACPA in serum and IgA ACPA in serum and saliva were performed. The presence of ACPA was compared in patients with RA with and without periodontitis. RESULTS IgA ACPA in serum occurred in 35% of RA patients with periodontitis and in 43% of RA patients without periodontitis (p=0.740). IgG ACPA in serum was found in 66% of RA patients with periodontitis, and in 69% without periodontitis (p=0.740). IgA ACPA in saliva occurred in 20% with periodontitis and 55% without periodontitis (p=0.062). A logistic regression analysis adjusting for age, gender and smoking gave an odds ratio (OR) of 0.456 (95% CI=0.183-1.137, p=0.092) for saliva IgA ACPA positive individuals to have periodontitis. CONCLUSIONS IgA ACPA in serum or saliva was not more common in RA patients with periodontitis. This implies that local production of ACPA by the oral mucosa is not enhanced by periodontal inflammation, in patients with established RA.
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Affiliation(s)
- Anna Svärd
- Center for Clinical Research Dalarna/Uppsala University, Sweden.
| | | | | | - Rutger G Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Maria Söderlin
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Aghazadeh A, Persson RG, Renvert S. Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis. Int J Implant Dent 2020; 6:33. [PMID: 32548733 PMCID: PMC7297900 DOI: 10.1186/s40729-020-00219-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/24/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To assess if (I) the alveolar bone defect configuration at dental implants diagnosed with peri-implantitis is related to clinical parameters at the time of surgical intervention and if (II) the outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment. MATERIALS AND METHODS In a prospective study, 45 individuals and 74 dental implants with ≥ 2 bone wall defects were treated with either an autogenous bone transplant or an exogenous bone augmentation material. Defect fill was assessed at 1 year. RESULTS At baseline, no significant study group differences were identified. Most study implants (70.7%, n = 53) had been placed in the maxilla. Few implants were placed in molar regions. The mesial and distal crestal width at surgery was greater at 4-wall defects than at 2-wall defects (p = 0.001). Probing depths were also greater at 4-wall defects than at 2-wall defects (p = 0.01). Defect fill was correlated to initial defect depth (p < 0.001). Defect fill at 4-wall defects was significant (p < 0.05). CONCLUSIONS (I) The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration, (II) 4-wall defects demonstrated more defect fill, and (III) deeper defects resulted in more defect fill.
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Affiliation(s)
| | - Rutger G Persson
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden.,Department of Periodontics, University of Washington, Seattle, WA, USA.,Department of Oral Medicine, University of Washington, Seattle, WA, USA
| | - Stefan Renvert
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden. .,Blekinge Institute of Technology, SE-371 79, Karlskrona, Sweden. .,School of Dental Science, Trinity College, Dublin, Ireland. .,Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China.
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24
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Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci 2020; 50:183-196. [PMID: 32617183 PMCID: PMC7321710 DOI: 10.5051/jpis.2020.50.3.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.
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Affiliation(s)
- Sven Rinke
- Department of Prosthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Marc Nordlohne
- Private Practice, Weilburg, Germany.,Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Andreas Leha
- Department of Medical Statistics, Georg-August-University, Goettingen, Germany
| | - Stefan Renvert
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
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25
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Winning L, Polyzois I, Sanmartin Berglund J, Renvert S. Periodontitis and airflow limitation in older Swedish individuals. J Clin Periodontol 2020; 47:715-725. [PMID: 32246489 DOI: 10.1111/jcpe.13287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/05/2020] [Accepted: 03/24/2020] [Indexed: 12/21/2022]
Abstract
AIM To investigate whether there was an association between periodontitis and airflow limitation in older Swedish individuals. MATERIALS AND METHODS Study individuals were randomly selected from the Swedish civil registration database representing the ageing population in Karlskrona, Sweden. Clinical and radiographic examinations were performed, alongside which participants completed questionnaires gathering information on their medical history, social circumstances, demographic background and tobacco use. A physical examination assessed anthropometric measures. Standard spirometry was performed to identify subjects with airflow limitation. Periodontitis was defined based on radiographic periodontal bone loss. Analysis included multiple logistic regression with adjustment for various confounders. RESULTS A total of 826 Caucasian dentate subjects were included in the analysis. The median age of participants was 73.2 (IQR 66-81) years, and 443 (54.6%) subjects were female. Eighty-six (10.4%) individuals presented with airflow limitation. The proportion of participants presenting with periodontitis in the airflow limitation group was 65.1% compared to 41.5% with normal respiratory function (p < .001). Multiple logistic regression analysis showed that periodontitis was independently associated with airflow limitation with an odds ratio of 2.31 (95% CI 1.27-4.22) p < .01. CONCLUSION In this group of older dentate individuals, periodontitis was significantly associated with airflow limitation independent of other known risk factors.
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Affiliation(s)
- Lewis Winning
- Dublin Dental University Hospital, Trinty College Dublin, Dublin, Ireland
| | - Ioannis Polyzois
- Dublin Dental University Hospital, Trinty College Dublin, Dublin, Ireland
| | - Johan Sanmartin Berglund
- Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Renvert
- Dublin Dental University Hospital, Trinty College Dublin, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden.,School of Health and Society, Kristianstad University, Kristianstad, Sweden.,Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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26
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Jepsen S, Schwarz F, Cordaro L, Derks J, Hämmerle CHF, Heitz-Mayfield LJ, Hernández-Alfaro F, Meijer HJA, Naenni N, Ortiz-Vigón A, Pjetursson B, Raghoebar GM, Renvert S, Rocchietta I, Roccuzzo M, Sanz-Sánchez I, Simion M, Tomasi C, Trombelli L, Urban I. Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration. J Clin Periodontol 2019; 46 Suppl 21:277-286. [PMID: 31038223 DOI: 10.1111/jcpe.13121] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/19/2018] [Accepted: 04/22/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. MATERIAL AND METHODS The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures. RESULTS A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. CONCLUSIONS The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post-operative complications.
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Affiliation(s)
- Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Luca Cordaro
- Department of Periodontics and Prosthodontics, Policlinico Umberto I, Eastman Dental Hospital, Rome, Italy
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zürich, Zurich, Switzerland
| | - Lisa J Heitz-Mayfield
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, International University of Catalonia, Barcelona, Spain
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zürich, Zurich, Switzerland
| | - Alberto Ortiz-Vigón
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, University of Iceland, Reykjavik, Iceland
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden
| | | | - Mario Roccuzzo
- Division of Maxillofacial Surgery, University of Torino, Torino, Italy
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Massimo Simion
- Department of Periodontology, University of Milan, Milan, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases University of Ferrara, Ferrara, Italy
| | - Istvan Urban
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, California
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27
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Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2019; 89 Suppl 1:S313-S318. [PMID: 29926955 DOI: 10.1002/jper.17-0739] [Citation(s) in RCA: 410] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 11/09/2022]
Abstract
A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed. Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support. The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis. Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss. The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal. Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.
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Affiliation(s)
- Tord Berglundh
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gary Armitage
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - Juan Blanco
- Universidad Santiago de Compostela, Santiago, Spain
| | | | | | - David Cochran
- University of Texas Health Science Center, San Antonio, TX, USA
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | | | - Guy Huynh-Ba
- University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Ki-Tae Koo
- Seoul National University, Seoul, South Korea
| | - France Lambert
- Department of Periodontology and Oral Surgery, University of Liège, Liège, Belgium
| | - Laurie McCauley
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | | | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hom-Lay Wang
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nicola Zitzmann
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
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28
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S304-S312. [PMID: 29926953 DOI: 10.1002/jper.17-0588] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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29
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Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Clin Periodontol 2019; 45 Suppl 20:S278-S285. [PMID: 29926496 DOI: 10.1111/jcpe.12956] [Citation(s) in RCA: 165] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 12/26/2022]
Abstract
The objective of this review is to identify case definitions and clinical criteria of peri-implant healthy tissues, peri-implant mucositis, and peri-implantitis. The case definitions were constructed based on a review of the evidence applicable for diagnostic considerations. In summary, the diagnostic definition of peri-implant health is based on the following criteria: 1) absence of peri-implant signs of soft tissue inflammation (redness, swelling, profuse bleeding on probing), and 2) the absence of further additional bone loss following initial healing. The diagnostic definition of peri-implant mucositis is based on following criteria: 1) presence of peri-implant signs of inflammation (redness, swelling, line or drop of bleeding within 30 seconds following probing), combined with 2) no additional bone loss following initial healing. The clinical definition of peri-implantitis is based on following criteria: 1) presence of peri-implant signs of inflammation, 2) radiographic evidence of bone loss following initial healing, and 3) increasing probing depth as compared to probing depth values collected after placement of the prosthetic reconstruction. In the absence of previous radiographs, radiographic bone level ≥3 mm in combination with BOP and probing depths ≥6 mm is indicative of peri-implantitis.
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Affiliation(s)
- Stefan Renvert
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - G Rutger Persson
- School of Health and Society, Department of Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.,Departments of Periodontics and Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Flavia Q Pirih
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paulo M Camargo
- School of Dentistry, Section of Periodontics, University of California, Los Angeles, Los Angeles, CA, USA
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30
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Renvert S, Hirooka H, Polyzois I, Kelekis-Cholakis A, Wang HL. Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants - Consensus report of working group 3. Int Dent J 2019; 69:12-17. [PMID: 31478575 PMCID: PMC9379037 DOI: 10.1111/idj.12490] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The following consensus report is based on four background reviews. The frequency of maintenance visits is based on patient risk indicators, homecare compliance and prosthetic design. Generally, a 6-month visit interval or shorter is preferred. At these visits, peri-implant probing, assessment of bleeding on probing and, if warranted, a radiographic examination is performed. Diagnosis of peri-implant mucositis requires: (i) bleeding or suppuration on gentle probing with or without increased probing depth compared with previous examinations; and (ii) no bone loss beyond crestal bone level changes resulting from initial bone remodelling. Diagnosis of peri-implantitis requires: (i) bleeding and/or suppuration on gentle probing; (ii) an increased probing depth compared with previous examinations; and (iii) bone loss beyond crestal bone level changes resulting from initial bone remodelling. If diagnosis of disease is established, the inflammation should be resolved. Non-surgical therapy is always the first choice. Access and motivation for optimal oral hygiene are key. The patient should have a course of mechanical therapy and, if a smoker, be encouraged not to smoke. Non-surgical mechanical therapy and oral hygiene reinforcement are useful in treating peri-implant mucositis. Power-driven subgingival air-polishing devices, Er: YAG lasers, metal curettes or ultrasonic curettes with or without plastic sleeves can be used to treat peri-implantitis. Such treatment usually provides clinical improvements such as reduced bleeding tendency, and in some cases a pocket-depth reduction of ≤ 1 mm. In advanced cases, however, complete resolution of the disease is unlikely.
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Affiliation(s)
- Stefan Renvert
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden
- School of Dental Science, Trinity College, Dublin, Ireland
- Blekinge Institute of Technology, Karlskrona, Sweden
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Hideaki Hirooka
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Sweden Dental Center, Tokyo, Japan
| | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology, Trinity College, Dublin Dental University Hospital, Dublin, Ireland
| | - Anastasia Kelekis-Cholakis
- Division of Periodontics, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Working Group 3
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden
- School of Dental Science, Trinity College, Dublin, Ireland
- Blekinge Institute of Technology, Karlskrona, Sweden
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Sweden Dental Center, Tokyo, Japan
- Department of Restorative Dentistry and Periodontology, Trinity College, Dublin Dental University Hospital, Dublin, Ireland
- Division of Periodontics, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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31
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Nilsson H, Sanmartin Berglund J, Renvert S. Longitudinal evaluation of periodontitis and tooth loss among older adults. J Clin Periodontol 2019; 46:1041-1049. [PMID: 31294471 DOI: 10.1111/jcpe.13167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 12/21/2022]
Abstract
AIM To evaluate pattern of change in periodontal variables and tooth loss in a twelve-year follow-up study of older adults living in Sweden. METHODS In a prospective population study of older adults, a clinical examination and radiographic dental examination were performed at baseline (2001-2003) and after 12 years (2013-2015). In 375 individuals, the number and proportion of sites with a distance ≥4 mm and ≥5 mm from cemento-enamel junction to the bone level, the number and proportion of teeth with pockets ≥5 mm and number of teeth lost were calculated. Dental caries was registered. Periodontitis was defined as having ≥2 sites with ≥5 mm distance from cemento-enamel junction to the marginal bone level and ≥1 tooth with pockets ≥5 mm. RESULTS A diagnosis of periodontitis was evident in 39% of the individuals, and 23% of the individuals lost ≥3 teeth over the study period. The proportion of sites with ≥4 mm and ≥5 mm bone loss increased with age, while the proportion of teeth with pockets remained stable. Periodontitis was the strongest predictor for losing ≥3 teeth, OR 2.9 (p < .001) in the final model. CONCLUSIONS Periodontitis is a risk factor for future tooth loss among older adults.
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Affiliation(s)
| | - Johan Sanmartin Berglund
- Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Renvert
- Blekinge Institute of Technology, Karlskrona, Sweden.,Faculty of Health, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Alotaibi M, Moran G, Grufferty B, Renvert S, Polyzois I. The effect of a decontamination protocol on contaminated titanium dental implant surfaces with different surface topography in edentulous patients. Acta Odontol Scand 2019; 77:66-75. [PMID: 30264636 DOI: 10.1080/00016357.2018.1504986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objectives: To investigate if it is possible to achieve complete decontamination of dental implant surfaces with different surface characteristics.Materials and methods: Twelve implant pieces with an Osseotite® surface and 12 implant pieces with a Ti-Unite® surface were attached on to the complete lower dentures of six patients and were allowed to accumulate plaque for 30 days. When retrieved, the implant decontamination protocol used, involved both mechanical (PeriBrush™) and chemical (3% H2O2) decontamination. The number of colony forming units per millilitre was determined and the dominant micro-organisms in selected samples was identified by 16s rRNA gene amplicon sequencing. The effect of the titanium brush on the implant surface was examined by SEM.Results: Complete decontamination was achieved in five out of 24 implants (four Osseotite® and one Ti-Unite®). The mean CFU/ml detected after decontamination were 464.48 for Osseotite® and 729.09 for Ti-Unite® implants. On the surface of the implants in which complete decontamination was not achieved, all of the predominant bacteria identified were streptococci except for one which was identified as micrococcus. SEM images revealed that the surface features of the decontaminated implants were not significantly altered.Conclusions: Mechanical decontamination using a titanium brush supplemented with chemical treatment for one minute (3% H2O2) can achieve complete decontamination of implant surfaces in edentulous patients.
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Affiliation(s)
- Mohammad Alotaibi
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Gary Moran
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital Trinity College, Dublin, Ireland
| | - Brendan Grufferty
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Stefan Renvert
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
- Department of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Blekinge Institute of Technology, Karlskrona, Sweden
| | - Ioannis Polyzois
- Department of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
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Kröger A, Hülsmann C, Fickl S, Spinell T, Hüttig F, Kaufmann F, Heimbach A, Hoffmann P, Enkling N, Renvert S, Schwarz F, Demmer RT, Papapanou PN, Jepsen S, Kebschull M. The severity of human peri‐implantitis lesions correlates with the level of submucosal microbial dysbiosis. J Clin Periodontol 2018; 45:1498-1509. [DOI: 10.1111/jcpe.13023] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/01/2018] [Accepted: 10/15/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Annika Kröger
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
- Department of Oral SurgerySchool of DentistryUniversity of Birmingham Birmingham UK
| | - Claudia Hülsmann
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
| | - Stefan Fickl
- Department of PeriodontologyUniversity of Würzburg Würzburg Germany
| | - Thomas Spinell
- Department of Operative Dentistry and PeriodontologyLMU Munich Munich Germany
- Private Practice Bolzano Italy
| | - Fabian Hüttig
- Department of ProsthodonticsUniversity of Tübingen Tübingen Germany
| | | | - André Heimbach
- Department of Human GeneticsUniversity of Bonn Bonn Germany
| | - Per Hoffmann
- Department of Human GeneticsUniversity of Bonn Bonn Germany
- Department of BiomedicineUniversity of Basel Basel Switzerland
| | | | - Stefan Renvert
- Department of Health SciencesKristianstad University Kristianstad Sweden
| | - Frank Schwarz
- Department of Oral Surgery and ImplantologyCarolinumGoethe University Frankfurt Germany
- Department of Oral SurgeryUniversitätsklinikum Düsseldorf Düsseldorf Germany
| | - Ryan T. Demmer
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of Minnesota Minneapolis Minnesota
| | - Panos N. Papapanou
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesColumbia University College of Dental Medicine New York New York
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
| | - Moritz Kebschull
- Department of Periodontology, Operative and Preventive DentistryUniversity of Bonn Bonn Germany
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesColumbia University College of Dental Medicine New York New York
- The School of DentistryUniversity of Birmingham Birmingham UK
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Renvert S. Are implants for life? Peri-implant soft and hard tissue stability. Clin Oral Implants Res 2018. [DOI: 10.1111/clr.38_13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tonetti MS, Bottenberg P, Conrads G, Eickholz P, Heasman P, Huysmans MC, López R, Madianos P, Müller F, Needleman I, Nyvad B, Preshaw PM, Pretty I, Renvert S, Schwendicke F, Trombelli L, van der Putten GJ, Vanobbergen J, West N, Young A, Paris S. Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - Consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol 2018; 44 Suppl 18:S135-S144. [PMID: 28266112 DOI: 10.1111/jcpe.12681] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. AIMS The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. METHODS Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. RESULTS Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. CONCLUSIONS Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders.
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Affiliation(s)
- Maurizio S Tonetti
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China.,European Research Group on Periodontology, Genova, Italy
| | | | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH University Hospital Aachen, Aachen, Germany
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Peter Heasman
- Department of Restorative Dentistry, University of Newcastle, Newcastle, UK
| | - Marie-Charlotte Huysmans
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rodrigo López
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Phoebus Madianos
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Ian Needleman
- International Centre for Evidence-Based Oral Health, Unit of Periodontology, UCL Eastman Dental Institute, London, UK
| | - Bente Nyvad
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Philip M Preshaw
- Department of Restorative Dentistry, University of Newcastle, Newcastle, UK
| | - Iain Pretty
- Division of Dentistry, University of Manchester, Manchester, UK
| | - Stefan Renvert
- Department of Periodontology, Kristianstad University, Kristianstad, Sweden
| | - Falk Schwendicke
- Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Gert-Jan van der Putten
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jacques Vanobbergen
- Community Dentistry and Oral Public Health, Ghent University, Ghent, Belgium
| | - Nicola West
- Department of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Sebastian Paris
- Department of Operative Dentistry, Charitè - Universitätsmedizin Berlin, Berlin, Germany
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Nilsson H, Sanmartin Berglund J, Renvert S. Longitudinal evaluation of periodontitis and development of cognitive decline among older adults. J Clin Periodontol 2018; 45:1142-1149. [PMID: 30076762 DOI: 10.1111/jcpe.12992] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/19/2018] [Accepted: 08/01/2018] [Indexed: 12/28/2022]
Abstract
AIM To determine whether having periodontitis is associated with cognitive decline among older adults. MATERIAL AND METHODS A prospective population study of older adults, Swedish National Study on Ageing and Care, (SNAC) provided repeated registrations of cognitive functions. Cognitive decline was defined as ≥3-points deterioration from a predetermined level at baseline, using the Mini-Mental State Examination (MMSE). Between 2001 and 2003, 715 individuals had a medical as well as a clinical and radiographic dental examination. The individuals were re-examined after 6 years. Periodontitis was defined as ≥4 mm bone loss at ≥30% of tooth sites. Social variables were captured from questionnaires. RESULTS The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of periodontitis and cognitive decline after adjustments of confounding factors of importance. CONCLUSIONS A history of periodontitis may be of importance for cognitive functions among older adults.
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Affiliation(s)
| | - Johan Sanmartin Berglund
- Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Renvert
- Blekinge Institute of Technology, Karlskrona, Sweden.,School of Health and Society, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland
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Renvert S, Roos-Jansåker AM, Persson GR. Surgical treatment of peri-implantitis lesions with or without the use of a bone substitute-a randomized clinical trial. J Clin Periodontol 2018; 45:1266-1274. [DOI: 10.1111/jcpe.12986] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/13/2018] [Accepted: 07/09/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Stefan Renvert
- Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- School of Dental Science; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
| | | | - Gösta Rutger Persson
- Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- Department of Periodontics; School of Dentistry; University of Washington; Seattle Washington
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Zubair M, Widén C, Renvert S, Rumpunen K. Water and ethanol extracts of Plantago major leaves show anti-inflammatory activity on oral epithelial cells. J Tradit Complement Med 2018; 9:169-171. [PMID: 31193927 PMCID: PMC6544575 DOI: 10.1016/j.jtcme.2017.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/18/2017] [Accepted: 09/06/2017] [Indexed: 11/07/2022] Open
Abstract
Context The leaves of Plantago major have been used for the treatment of wounds and inflammation in folk medicine from prehistoric times. However there is no report on the use of P. major to treat inflammation in oral epithelial cell lines. Objective The present study was undertaken to reveal possible anti-inflammatory effects of Plantago major leaf extracts on oral epithelial cells in-vitro. Materials and methods Water- and ethanol-based extracts of P. major leaves were prepared from freeze-dried plant material, and tested in-vitro using the oral epithelial cell line H400. The anti-inflammatory activity of P. major was tested against E. coli lipopolysaccharide (LPS) using the nuclear factor kappa beta (NF-kB) assay. Results Both the water- and the ethanol-based extracts, as well as a combination of the two extracts, showed anti-inflammatory activity. A concentration of 0.1 mg/mL (on dry weight basis) yielded the best results for all extracts. Discussion and conclusion The results show that synergistic effects of both polyphenols and water-soluble compounds (possibly polysaccharides) are responsible for anti-inflammatory activities of P. major.
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Affiliation(s)
- Muhammad Zubair
- Swedish University of Agricultural Sciences, Department of Plant Breeding and Biotechnology Balsgård, Fjälkestadsvägen 459, SE-291 94 Kristianstad, Sweden.,Department of Bioinformatics and Biotechnology, Government College University (GCU), Faisalabad, Pakistan
| | - Cecilia Widén
- Swedish University of Agricultural Sciences, Department of Plant Breeding and Biotechnology Balsgård, Fjälkestadsvägen 459, SE-291 94 Kristianstad, Sweden.,Kristianstad University, School of Health and Society, SE-291 88 Kristianstad, Sweden
| | - Stefan Renvert
- Kristianstad University, School of Health and Society, SE-291 88 Kristianstad, Sweden
| | - Kimmo Rumpunen
- Swedish University of Agricultural Sciences, Department of Plant Breeding and Biotechnology Balsgård, Fjälkestadsvägen 459, SE-291 94 Kristianstad, Sweden
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Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018. [PMID: 29926955 DOI: 10.1002/jper.17‐0739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed. Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support. The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis. Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss. The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal. Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.
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Affiliation(s)
- Tord Berglundh
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gary Armitage
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - Juan Blanco
- Universidad Santiago de Compostela, Santiago, Spain
| | | | | | - David Cochran
- University of Texas Health Science Center, San Antonio, TX, USA
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | | | - Guy Huynh-Ba
- University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Ki-Tae Koo
- Seoul National University, Seoul, South Korea
| | - France Lambert
- Department of Periodontology and Oral Surgery, University of Liège, Liège, Belgium
| | - Laurie McCauley
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | | | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hom-Lay Wang
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nicola Zitzmann
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
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Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CH, Heitz-Mayfield LJ, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; 45 Suppl 20:S286-S291. [DOI: 10.1111/jcpe.12957] [Citation(s) in RCA: 408] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Tord Berglundh
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - Gary Armitage
- University of California San Francisco; San Francisco CA USA
| | | | | | - Juan Blanco
- Universidad Santiago de Compostela; Santiago Spain
| | | | | | - David Cochran
- University of Texas Health Science Center; San Antonio TX USA
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | | | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich; Zurich Switzerland
| | | | - Guy Huynh-Ba
- University of Texas Health Science Center; San Antonio TX USA
| | | | - Ki-Tae Koo
- Seoul National University; Seoul South Korea
| | - France Lambert
- Department of Periodontology and Oral Surgery, University of Liège; Liège Belgium
| | - Laurie McCauley
- School of Dentistry, University of Michigan; Ann Arbor MI USA
| | | | | | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University; Frankfurt Germany
| | | | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - Hom-Lay Wang
- School of Dentistry, University of Michigan; Ann Arbor MI USA
| | - Nicola Zitzmann
- Department of Reconstructive Dentistry, University of Basel; Basel Switzerland
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Nilsson H, Berglund JS, Renvert S. Periodontitis, tooth loss and cognitive functions among older adults. Clin Oral Investig 2017; 22:2103-2109. [PMID: 29270902 DOI: 10.1007/s00784-017-2307-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/11/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aims to evaluate the potential association between periodontitis, the number of teeth and cognitive functions in a cohort of older adults in Sweden. MATERIAL AND METHODS In total, 775 individuals from 60 to 99 years of age were selected for the study. A clinical and radiographic examination was performed. The number of teeth and prevalence of periodontal pockets and bone loss was calculated and categorised. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and clock test. The education level was obtained from a questionnaire. Data were analysed using chi-square tests and multivariate logistic regression. RESULTS Age and gender were associated with the prevalence of bone loss. Age and education were associated with lower number of teeth. Gender was also associated with the presence of pockets. The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of bone loss, the number of teeth and the outcome on MMSE test. This association remained even after adjustment for age, education and gender. Tooth loss was also associated with lower outcome on clock test. Presence of periodontal pockets ≥ 5 mm was not associated with cognitive test outcome. CONCLUSIONS A history of periodontitis and tooth loss may be of importance for cognitive functions among older adults. CLINICAL RELEVANCE Diseases with and inflammatory profile may have an impact on cognitive decline.
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Affiliation(s)
- Helena Nilsson
- Maxillofacial Unit, Halland Hospital, 30185, Halmstad, Sweden.
| | - Johan Sanmartin Berglund
- Blekinge Institute of Technology, Karlskrona, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Renvert
- Blekinge Institute of Technology, Karlskrona, Sweden
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
- School of Dental Science, Trinity College, Dublin, Ireland
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Hallström H, Persson GR, Lindgren S, Renvert S. Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics: A randomized clinical trial. J Clin Periodontol 2017; 44:1285-1293. [DOI: 10.1111/jcpe.12805] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Hadar Hallström
- Department of Periodontology; School of Dentistry; Malmö University; Malmö Sweden
| | - G. Rutger Persson
- Department of Oral Health Sciences; School of Health and Society; Kristianstad University; Kristianstad Sweden
- Departments of Periodontics, and Oral Medicine; School of Dentistry; University of Washington; Seattle WA USA
| | | | - Stefan Renvert
- Department of Oral Health Sciences; School of Health and Society; Kristianstad University; Kristianstad Sweden
- School of Dental Science; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
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Andersson P, Renvert S, Sjogren P, Zimmerman M. Dental status in nursing home residents with domiciliary dental care in Sweden. Community Dent Health 2017; 34:203-207. [PMID: 29136361 DOI: 10.1922/cdh_4100andersson05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To describe the dental health status of elderly people in nursing homes receiving domiciliary dental care. DESIGN Case note review. CLINICAL SETTING Nursing homes in 8 Swedish counties. PARTICIPANTS Care dependent elderly people (≥65 years). METHODS Clinical data, including the number of remaining natural teeth, missing and decayed teeth (manifest dental caries) and root remnants, recorded by dentists according to standard practices. Medical and dental risk assessments were performed. RESULTS Data were available for 20,664 patients. Most were women (69.1%), with a mean age of 87.1 years (SD 7.42, range 65-109). The mean age for men was 83.5 years (SD 8.12, range 65-105). Two or more medical conditions were present in most of the population. A total of 16,210 individuals had existing teeth of whom 10,974 (67.7%) had manifest caries. The mean number of teeth with caries was 5.0 (SD 5.93) corresponding to 22.8% of existing teeth. One in four individuals were considered to have a very high risk in at least one professional dental risk assessment category. CONCLUSIONS Care dependent elderly in nursing homes have very poor oral health. There is a need to focus on the oral health-related quality of life for this group of frail elderly during their final period of life.
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Affiliation(s)
- P Andersson
- School of Health and Society, Kristianstad University Kristianstad 291 88, Sweden
| | - S Renvert
- School of Health and Society, Kristianstad University Kristianstad 291 88, Sweden.,Blekinge Institute of Thechology, Karlskrona, Sweden.,School of Dental Sciences - Trinity College, Dublin
| | - P Sjogren
- Oral Care AB, Box 10047 , Stockholm 12126, Sweden
| | - M Zimmerman
- Department of Dental Medicine - Karolinska Institutet, Stockholm, Sweden
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Renvert S, Lindahl C, Persson GR. Occurrence of cases with peri-implant mucositis or peri-implantitis in a 21-26 years follow-up study. J Clin Periodontol 2017; 45:233-240. [DOI: 10.1111/jcpe.12822] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Stefan Renvert
- School of Health and Society; Department of Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- School of Dental Science; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
| | - Christel Lindahl
- School of Health and Society; Department of Oral Health Sciences; Kristianstad University; Kristianstad Sweden
| | - Gösta Rutger Persson
- School of Health and Society; Department of Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- Departments of Periodontics, and Oral Medicine; School of Dentistry; University of Washington; Seattle WA USA
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Erovic Ademovski S, Mårtensson C, Persson GR, Renvert S. The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis-A randomized clinical trial. J Clin Periodontol 2017; 44:1010-1019. [PMID: 28727160 DOI: 10.1111/jcpe.12779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. MATERIALS AND METHODS Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H2 S) and methyl mercaptan (MM) concentrations in exhaled air. RESULTS A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p < .01, respectively), H2 S (p < .001), and MM (p < .01) in subjects' exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H2 S < 112 ppb), compared to 43% in the placebo group. CONCLUSION Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months.
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Affiliation(s)
| | - Carina Mårtensson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gösta Rutger Persson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Stefan Renvert
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
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Schwarz F, Becker K, Bastendorf KD, Cardaropoli D, Chatfield C, Dunn I, Fletcher P, Einwag J, Louropoulou A, Mombelli A, Ower P, Pavlovic P, Sahrmann P, Salvi GE, Schmage P, Takeuchi Y, Van Der Weijden F, Renvert S. Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis. Quintessence Int 2017; 47:293-6. [PMID: 26574612 DOI: 10.3290/j.qi.a35132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Air polishing was introduced as an alternative approach for the supra- and submucosal biofilm management at dental implants. An international expert meeting involving competent clinicians and researchers took place during the EUROPERIO 8 conference in London, UK, on 4 June 2015. Prior to this meeting a comprehensive systematic review dealing with the efficacy of air polishing in the treatment of peri-implant mucositis and peri-implantitis was prepared and served as a basis for the group discussions. This paper summarizes the consensus statements and practical recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis.
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Klinge B, Flemming T, Cosyn J, De Bruyn H, Eisner BM, Hultin M, Isidor F, Lang NP, Lund B, Meyle J, Mombelli A, Navarro JM, Pjetursson B, Renvert S, Schliephake H. The patient undergoing implant therapy. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res 2017; 26 Suppl 11:64-7. [PMID: 26385621 DOI: 10.1111/clr.12675] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The assignment for this working group was to update the existing knowledge regarding factors considered being of special relevance for the patient undergoing implant therapy. This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis. Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review. MATERIALS AND METHODS The literature in the respective areas of interest (antibiotic prophylaxis, peri-implantitis, patient-reported outcome measurements and health-economic aspects) was searched using different strategies for the different papers. Search strategies ranged from a complex systematic review to systematic- and narrative reviews, depending on subject and available literature. All collected material was critically reviewed. Four manuscripts were subsequently presented for group analysis and discussion and plenum discussions and concensus approval. The selected areas were considered to be of key importance and relevance for the patient undergoing implant therapy. RESULTS The results and conclusions of the review process are presented in the respective papers. The group's conclusions, identified knowledge gaps, directions for future research and concensus statements are presented in this article. The following reviews were available for group discussions and the foundation for subsequent plenary sessions: Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. (2015) Perioperative antibiotics in conjunction with dental implant placement. A complex systematic review. Renvert S & Quirynen M. (2015) Risk indicators for peri-implantitis. A narrative review. De Bruyn H, Raes S, Matthys C, Cosyn J. (2015) The current use of patient centered/reported outcomes in implant dentistry. A systematic review. Beikler T & Flemmig T.F. (2015) Economic evaluation of implant-supported prostheses. A narrative review.
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Affiliation(s)
- Björn Klinge
- Faculty of Odontology, Malmo University, Malmo and Karolinska Institutet, Department of Dental Medicine, Periodontology, Stockholm, Sweden
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Abstract
Papillon-Lefèvre syndrome (PLS), palmoplantar hyperkeratosis with periodontitis, has been genetically characterized. However, suspected associated immune dysfunctions remain elusive. The purpose of this study was to evaluate peripheral blood lymphocyte levels and natural killer (NK) cell cytotoxicity in PLS. Twenty patients and 20 healthy controls were examined. Peripheral blood lymphocytes were analyzed by flow cytometry for surface markers. NK cell cytotoxicity against K562 cells was determined by means of a 51Cr release assay. White blood cell differential and proportions of B-, T-, T-helper, T-suppressor, and NK cells revealed only sporadic borderline variations from control values. In contrast, NK cell cytotoxicity was consistently and severely depressed (32–53% of control values) in all patients. To the best of our knowledge, this newly described impairment of NK cell cytotoxic function is the first consistent immune dysfunction reported in PLS. This suggests that the impaired NK cell cytotoxicity might contribute to the pathogenesis of PLS-associated periodontitis.
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Affiliation(s)
- T Lundgren
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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