上海市在职成年人口腔保健与牙周健康状况的调查

目的:调查上海市不同职业在职成年人口腔卫生习惯和牙周健康状况,初步探讨口腔卫生习惯对牙周病流行情况的影响程度.方法:采取分层、整群、随机的抽样方法,通过问卷调查了解400名上海市不同职业在职成年人的口腔卫生习惯,检测简化口腔卫生指数(OHI-S)、牙龈指数(GI)、探诊出血(BOP)、牙周袋探诊深度(PD)、临床附着丧失(CAL)、松动度(Mobility,M)及余留牙数等指标以评价牙周健康状况.结果:上海市不同职业在职成年人口腔卫生习惯、口腔卫生状况及牙周健康状况有极显著差异;上海市成年人人群简化口腔卫生指数OHI-S=2.16±0.99,牙龈炎为中度流行(GI=1.23±0.50),牙周健康者比率为5.75%,牙周炎的患病率为71.5%.结论:上海市在职成年人口腔卫生习惯和口腔卫生状况与职业存在相关性;其牙周健康状况与职业也存在相关性;调查结果证实口腔卫生习惯是影响口腔卫生状况以及牙周病流行的一个至关重要的因素.     

上海市不同职业成人牙周健康状况抽样调查

目的抽样调查和分析400例上海市常住在职成年人牙周健康情况及相关因素。方法采用分层、整群、随机抽样方法,在郊区抽取农民200例,市区抽取职员和工人各100例,年龄25～59岁,男249例,女151例,进行问卷调查,并检查全口余留牙的牙龈指数(GI)、牙周探诊深度(PD)、临床附着丧失(CAL)、牙龈探诊出血(BOP)和松动度(mobility)情况。指数牙16、11、26、31、36和46,每个指数牙检查6个位点。采用SAS6.12软件包进行统计学分析。结果上海市成年人人群简化口腔卫生指数OHI-S=2.16±0.99,口腔卫生状况中等;人群牙龈指数GI=1.2227,牙龈炎为中度流行。上海市不同职业成年人牙周破坏程度有显著差异,其中职员的牙周破坏程度最轻;不同年龄组间也有极显著差异,高年龄组的牙周破坏重于低年龄组。轻、中度牙周炎146例,占36.5%,重度牙周炎140例,占35%。受检者中,接受过高中教育者317例,占79.25%;受过大学教育者79例,占19.75%;研究生文化程度者4例,占1%。患者受教育程度与牙周破坏的严重程度无显著相关性。400例被调查者中,330例从未接受过治疗,占82.5%;曾洁牙者70例,占12.5%;接受过正规的牙周治疗者仅13例,占3.25%。结论上海地区人群口腔卫生教育及牙周防病、治病意识还须加强。     

无锡市老年人牙周健康状况调查分析

目的:了解无锡市老年人牙周健康状况,为牙周疾病防治提供参考.方法:选择无锡市1156名65～74岁的老年人为调查对象,应用简化口腔卫生指数、牙龈指数、探诊出血、牙周袋探诊深度、临床牙周附着丧失、松动牙数及牙缺失数等,评价牙周健康状况.应用SPSS12.0软件包对数据进行t检验和x2检验.结果:无锡市老年人简化口腔卫生指数(OHI-S)为3.16±1.48,牙龈指数(GI)为1.33+0.54;牙龈探诊出血、牙周袋深度及牙周附着丧失等牙周健康状况未表现出显著的城乡差异.结论:无锡市老年人牙周健康状况不佳,应注重牙周病预防,普及和加强口腔健康教育.     

陕西出土 1000 年前人牙齿的牙周病状况研究

目的:调查距今 1100～1300年前出土人牙齿的牙周状况,探求牙周病的发生发展趋势.方法:观察记录了62例陕西长安区出土1000年前人骨架全部牙齿的牙周状况,进行统计学分析.结果:共有57个个体的529个牙齿患有牙周病,患牙占观察牙齿总数的83.84%,该人群牙周病的平均患病率为91.94%.56岁以上年龄组及36～55岁年龄组牙周病患病率(100%)>24～35岁年龄组(85.71%)>23岁以下年龄组(72.73%).牙周病的罹患累及各个牙位,其中尖牙的罹患率最高,中切牙的罹患率最低.所有上下颌对称牙位牙齿之间的患牙率及上下颌总的患牙率均没有显著性差异(p>0.05).男性牙周病患病率高于女性患病率(p<0.01).结论:研究1000年前人牙周疾病的一般情况,进而认识牙周病在人类进化过程中的发展变化规律,并为研究当时人类社会生产生活状况提供间接的实物证明.     

2005年广东省中老年人牙周健康状况抽样调查报告

目的 了解广东省35～44岁、65～74岁城乡人群牙周健康的现状,为广东省口腔卫生保健工作提供信息支持.方法 用多阶段分层等容量随机抽样方法,抽取广东省35～44岁、65～74岁城乡常住人口各720人,男女各半.按照<第三次全国口腔健康流行病学调查方案>用CPI探针检查全口牙牙周袋深度和半口牙的附着丧失.结果 35～44岁组、65～74岁组有浅牙周袋分别为24.31%、38.06%,浅牙周袋平均牙数分别为1.55、1.63颗.深牙周袋为5.97%、10.69%,平均牙数为0.14、0.15颗.附着丧失小于3 mm检出率分别为42.50%、4.44%,至少有1个牙位附着丧失≥4 mm的检出率为44.17%、74.58%,至少有1个牙位附着丧失≥6 mm的检出率为12.64%、41.39%.附着丧失4～5 mm的平均牙数分别为1.42、2.42颗.附着丧失6～8 mm的平均牙数分别为0.27、0.79颗.男性牙周袋、附着丧失检出率高于女性.结论 广东省中老年人的口腔健康广泛受牙周炎的影响.     

青海省人群牙周健康状况流行病学调查报告

目的了解青海省人群牙周健康的状况,为牙周疾病的防治提供基线资料。方法根据第三次全国口腔健康流行病学调查牙周状况的检查标准,采用多阶段、分层、等容量、随机抽样的方法,对青海省12、35～44和65～74岁3个年龄组的牙龈出血、牙结石、牙周袋及附着丧失等进行流行病学抽样调查。结果1）青海省12、35～44、65～74岁年龄组牙龈出血检出率分别为98.74%、97.84%和92.23%,牙结石检出率分别为89.76%、99.87%和92.87%。2）35～44岁年龄组浅牙周袋检出率为34.64%,深牙周袋检出率为5.58%;65～74岁年龄组浅牙周袋检出率为50.45%,深牙周袋检出率为13.12%。3）35～44岁年龄组附着丧失4～5、6～8、9～11、12 mm或以上的检出率分别为40.74%、18.78%、4.82%、1.78%;65～74岁年龄组附着丧失4～5、6～8、9～11、12 mm或以上的检出率分别为71.21%、51.34%、20.51%、7.01%。结论青海省人群口腔卫生状况很差,中老年人牙周袋及附着丧失的程度比较严重,必须加强对牙周疾病的预防。     

社区老年人牙周状况的认知调查及需求分析

目的:调查社区老年人牙周状况及口腔卫生保健的认知、态度和行为,为开展针对天津市社区老年人的口腔健康促进提供参考。方法:随机对天津市小白楼社区507位老年人进行问卷调查,并对其中335位志愿者进行牙周检查。结果:志愿者中牙周炎的患病率为100%,牙龈出血率66.6%,牙周探诊深度2.74±0.68mm,附着丧失3.94±1.07mm,牙周探诊深度和附着丧失男性均高于女性(P<0.05);问卷调查人群中刷牙次数≥2次/天者占71.8%,使用牙线、牙间刷的人分别占14.2%和1.2%;认为定期牙周检查必要的人占54.9%,但进行过牙周检查的人占21.7%。调查现场表示愿意接受口腔卫生宣教的人占83.5%,而且愿意接受定期社区口腔卫生检查的占85.7%。结论:老年人牙周炎患病率高且严重,口腔卫生保健认知不足,但有意愿接受口腔卫生教育和检查。多渠道开展口腔卫生宣教是必须的,并且需要加强定期社区口腔健康检查的服务。     

嵴上纤维环切辅助正畸压低牙周炎患牙的研究进展

随着人们对口腔健康及美观意识的提高,成年正畸患者逐渐增多,成年人的牙周状况较差,常有牙根暴露、附着丧失、松动度增加、前牙扇形移位等临床表现。近年来有研究报道,嵴上纤维环切术联合正畸治疗可以增加牙周炎患牙骨内根长、减少附着丧失、改善牙周炎患者的牙周状况和美观。本文就嵴上纤维环切术辅助牙周炎患牙正畸压低的背景、临床操作及效果作一综述。     

上海市65~74岁老年人失牙状况流行病学调查和危险因素分析

目的 了解上海市65~74岁老年人失牙状况分布特征,并分析失牙相关危险因素及其与牙周状况的关系,为今后开展口腔卫生保健工作提供依据。方法 按照第4次全国口腔健康流行病学调查要求,采取随机抽样方法,于2015年对上海市776名65~74岁年龄段老年人进行问卷调查和口腔检查。所得数据采用SPSS 21.0软件包进行非参数检验,对危险因素进行单因素分析,并通过Logistic回归模型进行独立危险因素分析。结果 上海市65~74岁年龄组老年人平均失牙数为5.94,平均缺失磨牙数为2.59。有牙周袋的老年人占42.3%,附着丧失≥4 mm的检出率为83.0%。男性失牙数和缺失磨牙数显著高于女性（P<0.05）。吸烟是非功能牙列的危险因素,吸烟量≥6支/d时,无法维持功能牙列的危险度是不吸烟人群的1.881倍（95%CI为1.231~2.872,P<0.01）。受教育年限≤6年及从事重体力劳动也是牙缺失的重要危险因素。结论 性别、口腔卫生习惯、吸烟、受教育程度、职业等因素是影响上海市65~74岁年龄组老年人牙缺失状况的重要因素。     

382名城乡结合地区老年人牙周病初步调查

目的:了解我院辖区内老年人牙周病的患病情况,为城乡结合地区开展老年口腔卫生宣教提供依据。方法:按照全国第3次口腔健康流行病学调查方法对我院辖区内的382名60岁以上老年人群进行牙周病患病情况调查。结果:382名老年人中,牙龈健康率为13.4%;牙龈出血率为70.2%;牙周袋形成率为53.9%;牙周附着丧失率为72.9%。结论:老年人牙周病患病率高,应采取措施改善城乡结合地区老年人牙周健康状况。     

Probing depth, attachment loss and gingival recession

The present investigation describes probing pocket depth, probing attachment level and recession data from 319 randomly selected subjects, aged 20-79 years, from Ushiku, Japan. The findings are reported as mean values, frequency distributions and percentile plots of the 3 parameters at buccal, interproximal and lingual surfaces of single rooted (incisors, canines, premolars) and molar teeth. Inter-as well as intra-examiner errors for probing pocket depth and probing attachment levels were assessed and found to be small. The data reported revealed that practically all subjects studied had one or more sites in the dentition affected by destructive periodontal disease and that the severity of disease increased with age. It was further observed that in each age group, molars had suffered more attachment loss than single rooted teeth and that the interproximal surfaces as a rule had lost more periodontal tissue support than corresponding buccal and lingual surfaces. The attachment loss difference observed between different surfaces of a given tooth or a group of teeth, however, was comparatively small. In the age groups between 20-59 years, advanced destructive periodontal disease was found in a small subgroup of the subject sample, while after the age of 60 years, widespread destructive periodontitis was common. An attempt was made to examine the progression of destructive disease with age by comparing the frequency distributions of sites with attachment loss of greater than or equal to 3 mm in subjects of different age groups. The data suggested that in younger subject groups, progression was confined to a subset of individuals, while in older age groups, more subjects and sites became involved. A major feature of destructive periodontal disease in older individuals was the accompaniment of attachment loss with recession at the gingival margin. Deep pockets were relatively infrequently detected, while advanced loss of attachment (with recession) occurred at many sites.     

Differing profiles of periodontal disease in two similar South Pacific island populations

Abstract The periodontal condition of a cross-section of individuals aged between 15–59 years was characterised from clinical and radiographic observations of dental calculus, gingival inflammation, the level of the gingival attachment, alveolar bone loss, teeth missing or requiring extraction for periodontal reasons. The common characteristics of the profile in Tonga and W. Samoa were a high prevalence of the factors common to periodontal disease: calculus and gingival inflammation; a progressive apical movement of the gingival attachment; and alveolar bone Joss. All these criteria showed a positive age dependency with calculus (particularly subgingival calculus) and gingival inflammation being very commonly associated with all tooth types at an early age, less than 30 years. Tooth loss observed was presumed to be previously associated with periodontal disease because the prevalence of dental caries was very low in both populations. Substantial differences were observed in the number of missing teeth between Tongan and Samoan populations, the Tongan subjects having a high rate of tooth loss. From radiographic interpretations of the periodontal conditions fewer subjects in Tonga were assessed as having no disease, and there was a higher prevalence of progressive destructive disease in Tonga than in W. Samoa. The proportion of subjects in both countries with no disease decreased rapidly with age. There was no evident explanation of the greater severity of disease in Tonga than in W. Samoa. The prevalence of microbial plaque, calculus and gingival inflammation was very high in all subjects at all ages particularly over 30 years in both populations.     

Progression of destructive periodontal diseases in three urban minority populations: role of clinical and demographic factors

BACKGROUND, AIMS: Differences in prevalence, severity and risk factors for destructive periodontal diseases have been reported for ethnic/racial groups. However, it is not certain whether this disparity is due to ethnicity/race or factors associated with ethnicity/race. Therefore, the present study addressed whether the rates of disease progression and clinical and demographic factors associated with disease progression varied among three ethnic/racial groups. METHODS: The study population consisted of 53 Asian-, 69 African- and 62 Hispanic-Americans. Clinical measurements included probing depth, attachment level, gingival erythema, bleeding upon probing, suppuration and plaque. Disease progression was defined as a > 2 mm loss of attachment 2 months post baseline. The demographic variables examined included occupational status, report of a private dentist, years resident in the United States and smoking history. RESULTS: The rate of attachment loss for the entire population was 0.04 mm or 0.24 mm/year. No significant differences were found among the three ethnic/racial groups. Variables associated with subsequent attachment loss for the entire population were age, male gender, mean whole-mouth plaque, erythema, bleeding upon probing, suppuration, attachment loss and probing depth, and belonging to the "unskilled" occupational group. No differences in risk profiles were found among the 3 ethnic/racial groups. Using stepwise logistic regression analysis, a model was developed to relate the clinical and demographic variables examined with subsequent attachment loss. The model indicated that prior attachment loss, gingival erythema, suppuration, being a current smoker and belonging to the "unskilled" occupational group conferred high risk of > 1 site of attachment loss of > 2 mm. CONCLUSIONS: The results of this study suggest that variables associated with ethnicity/race, such as occupational status, are largely responsible for the observed disparity in destructive periodontal disease progression in these populations.     

Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations

BACKGROUND, AIMS: Destructive periodontal diseases have been reported disproportionately more prevalent and severe in African-Americans relative to other American populations. Differences in subgingival microbiota and host immune response have also been reported for African-Americans, implying that risk factors for disease progression may also differ for these populations. Since it is not clear whether these differences are truly genetic or due to confounding variables such as social economic status, we examined a series of clinical, environmental, demographic, and microbiologic features associated with periodontal disease status in a group of 185 urban minority subjects resident within the greater New York metropolitan area. METHODS: The study population consisted of 56 Asian-American, 71 African-American and 58 Hispanic subjects. Clinical data recorded included pocket depth, attachment level, gingival erythema, bleeding upon probing, suppuration, and the presence of supragingival plaque. Environmental and demographic data recorded included smoking history, years resident in the United States, whether the subject reported a private dentist and occupational status. Subgingival plaque was sampled from the mesial aspect of all teeth exclusive of third molars and the levels of 40 subgingival species enumerated using checkerboard DNA-DNA hybridization. RESULTS: The African-American group had more missing teeth, deeper periodontal pocket depth and more attachment loss than the Asian-American or Hispanic groups. However, the African-American group were less likely to report having a private dentist, had a greater proportion of smokers and a greater proportion of unskilled individuals. The profile of subgingival species differed among the three ethnic/racial groups with A. actinomycetemcomitans, N. mucosa, S. noxia and T. socranskii significantly elevated in the Asian-American group and P. micros significantly elevated in the African-American group. When subset by occupational status, numbers of missing teeth, pocket depth, attachment level and prior disease activity were all found increased in the unskilled relative to the professional group. Local factors including the mean % of sites with plaque, marginal gingival erythema, bleeding upon probing and suppuration were also elevated in the unskilled group. The microbial profile differed among the 3 occupational groups with the unskilled group having elevated numbers of species associated with destructive periodontal diseases. CONCLUSIONS: Although greater destructive periodontal disease prevalence and severity were found in the African-American group, these results suggest that environmental and demographic variables, such as occupational status, may have a greater influence on risk indicators associated with disease prevalence and progression in these populations.     

Attachment level changes in destructive periodontal diseases

The present communication attempts to summarize some of the features of attachment loss which are of interest to the clinician and the statistician analyzing data from clinical trials. These include the measurements employed to detect changes in attachment level, the nature of the destructive disease process and the effects of therapy on the attachment level measurements. Although there are several difficulties associated with the attachment level measurement, at the present time it appears to be the best estimator of periodontal attachment available. The overall standard deviation of this measurement in greater than 46,000 replicate measurements at periodontal sites in 58 subjects was 0.78 mm (range 0.4 to 1.2 mm). In the periodontally healthy subject, the length of the attachment measured around 28 teeth is approximately 700 mm. Therefore, there are approximately 1400 adjacent points along the periodontal attachment where a measurement could be made using a periodontal probe with a 0.5 mm diameter tip. If 6 measurements were recorded per tooth, then approximately 12% of the possible probable points would be evaluated. Recent data indicate that destructive periodontal diseases progress with acute bursts of activity rather than as slowly progressive, continual processes. Such findings suggest new models of attachment loss progression. In one likely model, destructive periodontal diseases would progress by asynchronous bursts of activity at individual sites which occur with greater frequency during a finite period of time in an individual's life. 3 major patterns of attachment loss could be distinguished when frequency distributions of attachment level measurements were constructed for 61 destructive periodontal disease subjects. Pattern I (30 subjects) exhibited a bimodal distribution with localized destruction occurring at less than 34% of sites. Pattern II (14 subjects) exhibited more widespread disease (greater than 33% of sites affected) with a trimodal frequency distribution. Pattern III (17 subjects) exhibited a unimodal distribution in which virtually all sites were affected. The proportions of Fusobacterium nucleatum, Streptococcus intermedius and Eikenella corrodens in subgingival plaque samples were significantly elevated in sites of subjects with patterns II and III (the widespread disease groups). Bacteroides intermedius, Streptococcus uberis and Actinobacillus actinomycetemcomitans were elevated in sampled sites of localized disease subjects (pattern I). The effects of therapy by Widman flap surgery and systemic tetracycline were examined by several statistical analyses.(ABSTRACT TRUNCATED AT 400 WORDS)     

A longitudinal study of untreated periodontal disease

Abstract 1016 textile workers were examined during a baseline study in 1969/70. A follow-up examination in 1979/80 identified 82 subjects who had not been treated for periodontal disease in the intervening period. There were 39 male and 43 female subjects; the average age at the initial examination was 27.0 years. There was an average tooth loss of 2.5 (SEM 0.6) teeth per subject over the 10-year period. While periodontal disease was significantly related to oral hygiene at the outset, neither factor was significantly related to the degree of tooth loss. A detailed analysis of the dynamics of the periodontal condition was undertaken. The subsequent results are presented in the form of transition matrices and clearly illustrate both the progression of periodontal disease and the degree of tooth loss associated with each level of periodontal disease at the initial examination. The main findings are as follows. (a) Overall 6% of teeth initially free of periodontal disease (P.I.O.) were lost compared to 14% with destructive periodontal disease (P.I.6). (b) Progression of periodontal disease was slow for teeth initially free of periodontal disease and with mild gingivitis (P.1.0 and P.I.1) for all age groups. However severe gingivitis (P.1.2), resulted in more rapid deterioration of the supporting tissues in subjects over 35 years old at the final examination; 35% of such teeth changed to destructive periodontal disease (P. 1.6) compared to 17% of corresponding teeth for the under 35-year age group. In contrast, a poorer prognosis was found for the teeth with destructive periodontal disease (P.1.6) in the younger age group. (c) While the rate of progression of established periodontal disease was similar for anterior and posterior teeth, the onset of gingivitis was more pronounced in the latter.     

A 10-year retrospective study of periodontal disease progression Clinical characteristics of subjects with pronounced and minimal disease development

The present study reports on some characteristics of 2 groups of subjects, chosen from a sample of 191 dentate individuals who had been exposed to full-mouth intraoral radiographic examinations in 1975 and 1985. The 1st group, which comprised 14 subjects, had experienced pronounced loss of periodontal bone support during a 10-year period (mean longitudinal bone loss of 4.13 mm (S.D. 1.4]. The 2nd group of 14 subjects had suffered no or minimal periodontal disease progression (mean longitudinal bone gain of 0.35 mm (S.D. 0.7]. A clinical examination was performed in conjunction with the radiographic examination in 1985 and included assessment of plaque, gingivitis, bleeding on probing from the base of the pocket, probing depth and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and periodontal therapy received between 1975 and 1985 was obtained through a questionnaire. The results revealed that the 14 subjects who had experienced pronounced progression of periodontal disease had more plaque and gingivitis, deeper pockets and more attachment loss than the 14 subjects with minimal periodontal disease progression. Over the 10-year period, subjects in the "high rate" group had lost a mean of 6.8 teeth (S.D. 5.0) as compared to 4.1 teeth (S.D. 4.4) in the "low rate" group. The radiographic assessments of alveolar bone loss were strongly correlated with the assessments of probing attachment loss (r = 0.80, p = 0.0001). In 92% of the tooth sites examined, the difference between the radiographic and the clinical assessment was within 2 mm.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical and microbiologic study of periodontitis associated with Kindler syndrome

BACKGROUND: Little is known about the onset and prevalence of periodontal disease in patients with the rare Kindler syndrome, a genodermatological disorder. This study investigated the level of clinical periodontal attachment in relation to age and presence of putative periodontopathogenic bacteria in individuals with Kindler syndrome. METHODS: Eighteen individuals diagnosed with Kindler syndrome and 13 control subjects, aged 4 to 37 years, from rural Panama received a limited clinical periodontal examination. Subgingival samples were collected for identification of putative periodontal pathogens by polymerase chain reaction. RESULTS: Mild to severe gingivitis was a common finding in all adults of the study population. Seventy-two percent (13/18) of the Kindler patients and 46% (6/13) of the control subjects showed mild to severe periodontal disease (P = 0.001, chi-square test). The onset of periodontitis was earlier and the progression occurred at a faster rate in the Kindler group. There was a strong correlation (r = 0.83) between the level of attachment loss and age in the Kindler group and a weaker correlation (r = 0.66) in the control group. The appearance of gingival tissues suggested atypical periodontitis with spontaneous bleeding and fragile, often desquamative, gingiva. In periodontitis patients, Porphyromonas gingivallis and Diallster pneumosintes tended to occur more frequently in control individuals compared to those with Kindler syndrome. CONCLUSIONS: In the Kindler group, periodontitis had an onset in early teenage years and progressed more rapidly compared to non-Kindler individuals of the same geographic and ethnic group. Clinical and microbiological findings suggest atypical periodontitis in Kindler patients. We propose to include Kindler syndrome in the category of medical disorders predisposing to destructive periodontal disease.     

Methods of evaluating periodontal disease data in epidemiological research

The purpose of the present investigation was to examine the use of different methods of data analysis to examine the pattern of periodontal tissue destruction in a group of adults. A clinical examination was carried out on 319 subjects, 20-79 years of age, randomly selected from the population of the city of Ushiku, Japan. The following parameters were studied: missing teeth, plaque, gingivitis, probing pocket depth and probing attachment level. All surfaces of all teeth were examined. The data obtained were evaluated in 3 ways: (i) mean values for each of the clinical parameters were computed for each subject and age group, (ii) the frequency of subjects with one or more sites of attachment loss above certain thresholds was assessed, (iii) percentile plots were generated in such a way that for each age group the percent of sites in subjects with varying attachment levels could be determined. The results revealed that the subjects included in the study had poor oral hygiene, high frequency of gingivitis and loss of probing attachment which increased with age. The mean annual attachment loss for all tooth surfaces was calculated to be less than 0.1 mm. Severe periodontal tissue breakdown was not as common as might have been expected. Hence, the majority of the subjects in the 20-59 year age group had very little evidence of destructive periodontal disease. In these age groups, a comparatively small subfraction accounted for most of the disease detected. After the age of 60, periodontal disease appeared to be more widespread among the subjects examined.(ABSTRACT TRUNCATED AT 250 WORDS)     

Longitudinal study on periodontal conditions in healthy elderly people in Japan

OBJECTIVES: A strategy for the control of periodontal disease progression is required to prevent tooth loss in older people. However, detailed epidemiological data on periodontal conditions in elderly people is limited. The purpose of the present study is to describe the natural history of periodontal disease and to evaluate the intraoral factors relating to the disease progression in systemically healthy elderly people. METHODS: In the cross-sectional study, 599 and 162 subjects aged 70 and 80 years, respectively, were examined. Of those subjects aged 70 years, 436 (73%) participated in the 2-year longitudinal study. Pocket depth (PD) and attachment level (AL) were measured for all functioning teeth at six sites per tooth. In the cross-sectional study, AL of 4 mm or greater and 7 mm or greater were defined as moderate and severe disease, respectively. In the longitudinal study, a change in AL of 3 mm or greater at each site was defined as periodontal disease progression. RESULTS: In the cross-sectional study, 97.1% of the subjects had at least one site of AL of 4 mm or greater (4+ mm). The prevalence of AL of 7 mm or greater (7+ mm) was 47.9%, with 2.8 affected teeth per person in those with AL 7+ mm. These findings reveal that periodontal disease is extremely widespread in the elderly population. However, very few had many teeth with severe periodontal conditions. In the longitudinal study, 75.1% experienced attachment loss of 3 mm or greater (3+ mm) during the 2-year study period. Of those subjects who experienced attachment loss, a mean of 4.7 teeth exhibited attachment loss. Multivariate logistic regression showed that both the highest AL in each tooth at baseline and abutment teeth for removable partial dentures were significantly related to periodontal disease progression as well as tooth loss incidence. CONCLUSIONS: These results suggest that teeth with poor periodontal conditions as well as abutment teeth for removable partial dentures were significant intraoral factors relating to periodontal disease progression as well as tooth loss.