Alcohol use and periodontal pocket development: findings from a 4‐yr longitudinal study

This study investigated whether alcohol use influences periodontal pocket development during a 4‐yr follow‐up period. The study included those participants who took part in both the Health 2000 Survey and the Follow‐up Study on Finnish Adults’ Oral Health. The participants at baseline were aged ≥30 yr, periodontally healthy, and did not have diabetes or rheumatoid arthritis. The development of periodontal pockets at follow‐up was measured as the number of teeth with periodontal pockets and the presence of periodontal pockets. Alcohol use at baseline was measured as g/wk, frequency, and use over the risk limit. Incidence rate ratios with 95% CI were estimated using negative binomial regression models and Poisson regression models with a robust variance estimator. No consistent association was found between any of the alcohol variables and periodontal pocket development in the total population or among non‐smokers. Among smokers, a positive association was found with the frequency of alcohol use. In general, risk estimates were slightly higher for women than for men. In summary, light‐to‐moderate alcohol use appears not to be consistently associated with the development of periodontal pockets. The adverse effects on the periodontium seem, to some extent, to be dependent on gender and smoking.     

成年人牙周附着状况十年纵向研究

目的 观察口腔卫生条件较差的我国农村地区成年人牙周病的自然发展过程,分析牙周病进展速率与发达国家地区人群的区别。方法 在1984年对587名受检者进行的口腔状况调查的基础上,1994年由相同的检查人员随访复查了440人,其中398人仍有牙列,对其所有存留牙的牙齿松动度及牙周附着丧失、牙周袋深度等情况作了复查,分析牙周病的进展特点。结果 各年龄组受检者在10年后复查时,均有平均2mm以上的牙周附着丧失。下颌切牙和上颌磨牙的牙周病进展速率较其他牙齿为重。成年人的平均牙周附着丧失率在各年龄组之间差异无显著性。受检人群与其他口腔卫生习惯和口腔保健条件均较好的发达国家人群相比,牙周附着丧失情况基本相似。结论 与发达国家人群相比,牙周附着状况未显著不同;各年龄组相互之间,牙周病发展速率亦未见显著不同。提示人类牙周病发展可能是人类自身内在因素起决定性作用。     

Effect of Alcohol Consumption on Clinical Attachment Loss Progression in an Urban Population From South Brazil: A 5‐Year Longitudinal Study

Background: The aim of this study is to investigate the impact of alcohol consumption on clinical attachment loss (AL) progression over a period of 5 years. Methods: A multistage probability sampling strategy was used to draw a representative sample of the metropolitan area of Porto Alegre, Brazil. Five hundred thirty‐two individuals (209 males and 293 females) aged 18 to 65 years at baseline with no medical history of diabetes and at least six teeth were included in this analysis. Full‐mouth periodontal examinations with six sites per tooth were conducted at baseline and after 5 years. Alcohol consumption was assessed at baseline by asking participants about the usual number of drinks consumed in a week. Four categories of alcohol consumption were defined: 1) non‐drinker; 2) ≤1 glass/week; 3) >1 glass/week and ≤1 glass/day; and 4) >1 glass/day. Individuals showing at least two teeth with proximal (clinical AL) progression ≥3 mm over 5 years were classified as having disease progression. Multiple Poisson regression models adjusted for age, sex, smoking, socioeconomic status, and body mass index were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). Results: Overall, individuals who consumed >1 glass/day had 30% higher risk for clinical AL progression (RR = 1.30; 95% CI: 1.07 to 1.58) than non‐drinkers. Among males, risk of clinical AL progression for individuals drinking >1 glass/day was 34% higher than non‐drinkers (RR = 1.34; 95% CI: 1.09 to 1.64). Never‐smoker males drinking ≤1 glass/week had significantly lower risk for clinical AL progression than non‐drinkers (RR = 0.52; 95% CI: 0.30 to 0.89), whereas those drinking >1 glass/day had significantly higher risk (RR = 1.50; 95% CI: 1.08 to 1.99). Among females, no association between alcohol consumption and clinical AL progression was observed. Conclusions: Alcohol consumption increased the risk of clinical AL progression, and this effect was more pronounced in males. Low dosages (≤1.37 g of alcohol/day) of alcohol consumption may be beneficial to prevent periodontal disease progression in males. The impact of alcohol cessation initiatives on periodontal health should be evaluated.     

Association between periodontal and peri-implant conditions: a 10-year prospective study

OBJECTIVES: The aims of this study were to (1) compare prospectively the clinical and radiographic changes in periodontal and peri-implant conditions, (2) investigate the association of changes in periodontal parameters and peri-implant conditions over a mean observation period of 10 years (8-12 years) after implant installation, and (3) evaluate patient risk factors known to aggravate the periodontal conditions for their potential influence on the peri-implant tissue status. MATERIALS AND METHODS: Eighty-nine partially edentulous patients with a mean age of 58.9 years (28-88 years) were examined at 1 and 10 years after implant placement. The patients contributed with 179 implants that were placed after comprehensive periodontal treatment and restored with crowns or fixed partial dentures. One hundred and seventy-nine matching control teeth were chosen as controls. Also, the remaining teeth (n=1770) in the dentitions were evaluated. Data on smoking habits and general health aspects were collected at 1 and 10 years as well. RESULTS: At 10 years, statistically significant differences existed between implants and matching control teeth with regard to most of the clinical and radiographic parameters (P<0.01) with the exception of plaque index (PII) and recession. Multiple regression analyses were performed to associate combinations of periodontal diagnostic parameters to the peri-implant conditions: probing attachment level (PAL) at implants at 10 years was associated with implant location, full-mouth probing pocket depth (PPD) and full-mouth PAL (P=0.0001, r2=0.36). PPD at implants at 10 years correlated to implant location, full-mouth PPD and full-mouth PAL (P<0.001, r2=0.47). Marginal bone level at implants at 10 years was significantly associated to smoking, general health condition, implant location, full-mouth PAL and change over time in full-mouth PPD (P<0.001, r2=0.39). CONCLUSIONS: These results present evidence for the association between periodontal and peri-implant conditions and the changes in these tissues over 10 years in partially edentulous patients.     

The use of sustained release delivery of chlorhexidine for the maintenance of periodontal pockets: 2-year clinical trial

The release of chlorhexidine from an ethyl cellulose-based dosage form (SRD) has been shown to be effective in the reduction of the flora associated with periodontal pockets as well as in reducing probing depths. In this study, treatment with this dosage form was compared to routine maintenance therapy (RMT) in a 2-year, split mouth clinical trial. Ten patients with 84 pockets greater than or equal to 5 mm who had not received any periodontal therapy or systemic antibiotics over the last 6 months were included. The patients all received a full mouth scaling and root planing together with through oral hygiene instruction. Two months later (baseline) plaque index (P1I), bleeding on probing (BOP), pocket probing depth (PD), and attachment levels (AL) were assessed at all selected sites. Pockets on the control side then received RMT while the experimental pockets were treated with the SRD only. Treatment was repeated every 3 months for 2 years. The SRD treatment resulted in an improvement of greater than or equal to 3 mm in PD of at least 1 pocket in 8 of 10 patients, while RMT resulted in a similar improvement in only 1 of 10 patients (P = 0.012). Similarly a gain of attachment of greater than or equal to 3 mm was found in at least 1 SRD pocket in 8 of 10 patients. The RMT resulted in a similar improvement in only 2 patients (P = 0.012).(ABSTRACT TRUNCATED AT 250 WORDS)     

Occurrence of periodontal bacteria in healthy children: a 2-year longitudinal study

OBJECTIVES: To examine the occurrence of specific periodontal bacteria in children and adolescents. METHODS: Ten putative periodontal bacteria were longitudinally examined in plaque and saliva samples from 119 periodontally healthy children (2-15 years old) using a polymerase chain reaction method. RESULTS: Capnocytophaga ochracea, C. sputigena, and Actinobacillus actinomycetemcomitans were frequently found in saliva, and tended to persist in saliva for the remainder of the study, whereas Porphyromonas gingivalis, Treponema denticola, and Prevotella intermedia were rarely detected. P. nigrescens was more frequently detected in plaque and its prevalence increased with age. Eikenella corrodens and Campylobacter rectus were sometimes detected in both plaque and saliva, while Tannerella forsythensis was occasionally detected in saliva. CONCLUSION: A. actinomycetemcomitans, C. ochracea, C. sputigena, P. nigrescens, C. rectus, and E. corrodens are common members of the oral microbial flora of healthy children, whereas P. gingivalis, P. intermedia, and T. denticola appear to be transient organisms.     

Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults

Background: Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population‐based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full‐mouth examination. Methods: Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full‐mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health–related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. Results: Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full‐mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. Conclusion: Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.     

A histologic comparative study of the midpalatal suture and periodontal ligament tissue in the beagle dog

Abstract — The present investigation describes the morphological difference between. the suture and the periodontal ligament in beagie dogs. Specimens from fivs beagle dogs, 2 yr old, containing the anterior portion of the maxilla were used. Following routine histologic preparations frontal sections were cut with the microtome. The sections were stained and studied in the light microscope. The fibers in the midpaiatal suture seemed coarser and less organized than the fibers in the periodontal ligament tissue. The vessels in the suture had thicker walls than the vessels in the periodontal ligament. A probable reason for the morphologica differences between the two tissues is discussed.     

计算机辅助设计与辅助制作全瓷冠的八年临床随访

目的 对Cerec2计算机辅助设计与辅助制作(CAD-CAM)系统制作的全瓷冠进行8年随访,评价其远期效果,以期为临床提供参考.方法 使用Cerec2 CAD-CAM系统对22例患者的24颗牙体缺损的患牙进行CAD-CAM全瓷冠修复,定期随访,末次随访时参照改良美国加州牙科协会评价标准对CAD-CAM全瓷冠进行评价,同时对患者进行满意度问卷调查,并进行Kaplan-Meier生存率分析.结果 除3件CAD-CAM全瓷冠失败外,其余21件CAD-CAM全瓷冠随访82个月～102个月.除费用外,患者对其余指标的满意度达100%.Kaplan-Meier生存率分析显示,CAD-CAM全瓷冠的8年留存率为88%.结论 Cerec2 CAD-CAM系统制作的全瓷冠可在口腔环境中长期保存并行使功能.     

Effects of smoking and drinking habits on the incidence of periodontal disease and tooth loss among Japanese males: a 4-yr longitudinal study

OBJECTIVE: We investigated the risk of periodontal disease and tooth loss, associated with habits of smoking and alcohol consumption, in a longitudinal study. SUBJECTS AND METHODS: The subjects were 1332 Japanese males, 30-59 yr of age, who were free from periodontal disease at the baseline check-up, and who underwent a second check-up 4 yr later. Periodontal disease was diagnosed using the community periodontal index score, based on the clinical probing of pocket depth (> or = 4 mm). Smoking and alcohol consumption patterns were evaluated using a self-administered questionnaire. RESULTS: A dose-response relationship was observed between the amount of smoking and the incidence of periodontal disease in each age group. The overall odds ratios (95% confidence intervals), adjusted for age and alcohol, were 1.51 (0.95-2.22), 1.58 (1.13-2.22) and 2.81 (1.96-4.03), among smokers consuming 1-19, 20 or 21 or more cigarettes per day, respectively, with a significant linear trend (p < 0.0001). A similar association was found between smoking and tooth loss, except for the 50-59-yr-old age group. The adjusted odds ratios were 1.26 (0.60-2.64), 2.01 (1.21-2.32) and 2.06 (1.23-3.48), respectively. A significant linear trend between smoking and tooth loss was also observed (p = 0.01). Ex-smokers showed no significant difference compared with nonsmokers. We also found a significant linear trend between alcohol consumption and tooth loss among 30-39-yr-old subjects, while no relationship was observed between alcohol consumption and periodontal disease. CONCLUSION: Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.     

Surgical guided tissue regeneration treatment of advanced periodontal defects: a 5-year follow-up study

OBJECTIVES: To study the 5-year outcome of combined use of guided tissue regeneration (GTR) barriers and bovine bone in advanced periodontal defects. MATERIAL AND METHODS: In each of 24 patients, one defect was surgically exposed, debrided, filled with bovine bone, and covered with a bioresorbable barrier. Re-examinations were made after 1, 3, and 5 years. RESULTS: Average full-mouth plaque scores (FMPS) were 14.5% at baseline and 10.7%, 9.8%, and 18.9% after 1, 3, and 5 years, respectively. Mean probing pocket depth (PPD) was 10.0 mm at baseline. Mean PPD reduction was 5.2 mm after 1 year, 5.6 mm after 3 years, and 5.3 mm after 5 years. Mean gingival recession was 1.0 mm after 1 year, 1.6 mm after 3 years, and 1.3 mm after 5 years. Mean gain in clinical attachment level (CAL) was 4.2 mm at the 1-year, 4.1 mm at the 3-year, and 4.3 mm at the 5-year examination. Smoking significantly influenced CAL change at all re-examinations. FMPS were significantly correlated with radiographic defect depth at the 5-year examination and CAL with smoking and FMPS at the 3-year examination. CONCLUSION: Advanced periodontal defects can be successfully treated with the combined use of GTR barriers and bovine bone to substantially reduce PPD and achieve a stable, long-term gain of CAL.     

后牙种植单冠修复后局部咬合变化的四年前瞻性临床研究

目的:定量分析后牙种植单冠修复后4年患者口内局部 力分布与咬合时间的变化规律,为种植修复体的咬合设计、调整和长期维护提供参考。 方法:前瞻性收集2012年12月至2013年12月于北京大学口腔医学院·口腔医院修复科行后牙种植单冠修复的患者,分别于修复后2周和3、6个月以及1、2、3、4年复查,采用...