Prevalence of deep periodontal pockets in New Mexico adults aged 27 to 74 years

The purpose of this study was to describe the distribution of advanced periodontal destruction (pocket depth equal to or deeper than six mm) in continuous residents, aged 27 to 74 years, of Lordsburg and Deming, New Mexico. The distance from the free gingival margin to the base of the gingival crevice or pocket was measured on the facial and mesiofacial sides of six index teeth. The presence of supragingival calculus, subgingival calculus, and plaque, as well as gingival bleeding around the index teeth, also were evaluated. Of the 372 examinees, only 46 individuals (12.4 percent) had at least one deep pocket equal to or deeper than six mm on at least one site on the six index teeth. Age was significantly associated with prevalence of deep pockets, although about 80 percent of those aged 47 to 74 years did not have deep pockets. Of those with deep pockets, 89.1 percent had fewer than four tooth sites (out of 12) affected. The only significant risk factor of the presence of deep pockets, other than age, was the number of teeth with plaque accumulations. Age and the number of teeth with plaque explained only 10.5 percent of the variability in the prevalence of deep pocketing, suggesting that risk factors other than those included in this study may be important. The results of this study indicate that destructive periodontal disease occurs at selected sites within the mouth, and that about 87 percent of the adults over age 27, in this population, do not have deep pockets in the six index teeth examined.     

Dental health behaviors and periodontal disease indicators in Danish youths

The purpose of the present study was to analyse the epidemiologic relationship between dental health behaviors and periodontal disease. Indicators of periodontal disease in terms of bleeding and calculus were measured dichotomously (absence/presence). Periodontal pockets were as follows: normal pockets (0-3 mm), shallow pockets (4-5 mm), and deep pockets (6+ mm). The indicators were measured on 4 surfaces on 6 index teeth (16, 11, 26, 36, 31, 46) in 1984-85. The highest value for each tooth of bleeding (0/1), calculus (0/1) and pockets (0/1/2) was used for calculation of the bleeding index, the calculus index and the pocket index. The participation rate in 1984-85 was 86%, and the study population involved 368 males and 388 females. Information concerning dental health behavior was obtained both in childhood (1974) when the individuals were 9-10 years of age, and in adulthood (1984-85) when the individuals were 20-21 years of age. Information concerning dental health behaviors in adulthood, i.e., regularity of dental visits, frequency of tooth brushing, and regular use of interdental aids, was obtained through a self-administered questionnaire (1984-85). Dental health behaviors in childhood (1974) was operationalized as level of plaque, gingivitis, and dmfs. The results showed that dental health behaviors in childhood and in adulthood were together responsible for 9.4-13.8% of the variance in level of periodontal disease indicators. Determinants of early dental health behaviors in terms of plaque and dmfs at age 9-10 years were significant predictors in pocket index at age 20-21.(ABSTRACT TRUNCATED AT 250 WORDS)     

Microscopic spirochete counts in untreated subjects with and without periodontal tissue destruction

Abstract The purpose of the study was to determine microscopically the %s of spirochetes at sites without periodontal destruction in subjects with destructive periodontal diseases (cases) and in subjects free of it (controls), who had not received professional prophylaxis. From a sample of 164 individuals aged between 30–44 years living in rural and urban areas of Tanzania, cases and controls were selected. Cases (n=25) were selected who exihibited at least 3 teeth with pocket depth of >5 mm. The controls (n= 28) had no pockets deeper than 3 mm. From each subject, 1 subgingival plaque sample was taken at the mid point of the lingual surface of 1 of the upper premolars which showed bleeding on probing but no calculus and no pockets. In addition, one subgingival sample was obtained from a pocket. Pockets contained the highest %s of spirochetes, which confirms earlier findings. A significant difference in % of spirochetes between cases and controls was found at non-destructive sites, indicating a host effect on the subgingival microflora. However, the spirochete counts at non-destructive sites did not provide a reliable measure to identify subjects with destructive periodontal disease.     

Prevalence and severity of periodontal conditions among adults in urban and rural Morogoro, Tanzania

A study to assess the prevalence and severity of periodontal conditions among 809 adults in Tanzania was carried out in 1982 in Morogoro District. The prevalence of plaque (99.6%), calculus (95.7%) and gingivitis (93.8%) among them was high. The mean number of teeth per person with pockets between 3.5 and 5.5 mm was 3.5 for the urban and 4.2 for the rural population. Pockets of more than 5.5 mm were found on average in 0.1 (urban) and 0.2 (rural) teeth per person. In the 45+ age group on average 3.0 teeth per person were missing in urban areas and 6.9 teeth in rural areas. There were no statistically significant differences found in periodontal conditions between urban and rural adults, except for the 45+ age group. In this age group a higher mean number of teeth per person with recession, calculus, pockets, gingivitis and missing were found among the rural than the urban population. The study suggests that high prevalence of plaque, calculus and gingivitis at a young age, if untreated, does not lead for all persons to severe periodontal breakdown with ultimately tooth loss in old age in this population. Effects of the study in terms of planning primary health care teaching programs have been presented.     

Povidone-iodine as a periodontal pocket disinfectant

OBJECTIVES AND BACKGROUND: Povidone-iodine [polyvinylpyrrolidone-iodine complex (PVP-iodine)] might constitute a valuable adjunct to current periodontal therapy because of its broad-spectrum antimicrobial activity, low potential for developing resistance and adverse reactions, wide availability, ease of use, and low financial cost. This investigation employed a randomized, split-mouth study design to determine the microbiological and clinical effects of 10% PVP-iodine subgingival irrigation in periodontitis lesions showing radiographic evidence of subgingival calculus. METHODS: Sixteen adults having at least one periodontal pocket of 6 mm or more in each quadrant of the dentition and harboring one or more periodontopathic bacteria participated in the study. In each subject, a study site in each quadrant was randomly chosen to receive either subgingival irrigation with 10% PVP-iodine together with scaling and root planing, scaling and root planing alone, subgingival irrigation with 10% PVP-iodine, or subgingival irrigation with sterile saline. Prior to therapy and at 5 weeks post-treatment, microbiological culture was carried out without knowledge of the clinical status or the type of treatment rendered. A blinded clinical examiner determined presence of dental plaque, probing pocket depth, and gingival bleeding on probing. Microbiological and clinical data were analyzed using a repeated measures analysis of variance and Kruskal-Wallis rank test with the Tukey and Mann-Whitney post hoc tests. RESULTS: At 5 weeks post-treatment, subgingival irrigation with PVP-iodine together with scaling and root planing caused a 95% or greater reduction in total pathogen counts in 44% of pockets having >/= 6 mm depth whereas scaling and root planing alone, povidone-iodine irrigation alone and water irrigation alone caused 95% reduction of total pathogens only in 6-13% of similar study sites (P = 0.02). Reduction in mean pocket depth was 1.8 mm for the PVP-iodine/scaling and root planing group, 1.6 mm for the scaling and root planing group, and 0.9 mm for the PVP-iodine and the saline monotherapy groups, with statistical significance reached for the scaling and root planing group vs. the PVP-iodine group (P = 0.04) and for the scaling and root planing group vs. the saline group (P = 0.02). Reduction in visible dental plaque, which ranged from 38% to 62%, showed no significant differences among treatment groups. CONCLUSIONS: The addition of subgingival PVP-iodine irrigation to conventional mechanical therapy may be a cost-effective means of reducing total counts of periodontal pathogens and helping control periodontal disease. However, subgingival irrigation with PVP-iodine without concomitant mechanical debridement might not improve microbiological and clinical variables in comparison with saline irrigation, at least not in sites with radiographic evidence of subgingival calculus.     

Periodontal conditions, remaining teeth and oral hygiene habits in a group of Vietnamese refugees in Norway

Since 1975, about 3500 Vietnamese refugees have come to Norway. The purpose of the present study was to report on remaining teeth and periodontal conditions in a population of 200 adolescent and adult Vietnamese refugees. The mean number of remaining teeth ranged from 27.8 in the youngest age group to 24.6 in the oldest. This number of teeth is slightly lower than reported from Norwegian populations, but similar to other Asian populations. Almost all index teeth showed dental plaque, and subgingival calculus was observed in 9 of 10 teeth after the age of 20. Gingival bleeding was seen on all index sites of 26.5% of the subjects and all subjects above the age of 40 had gingivitis adjacent to one or more index teeth. There was a progression of probeable pocket depths with increasing age. In the oldest age group, 72.7% had pockets between 3.5 mm and 5.5 mm. The data indicated that if optimal conditions should be obtained, substantial resources would be required. In populations with limited resources and with relatively few subjects with severe periodontal breakdown, it is suggested that an identification of subjects "at risk" to be dentally handicapped through loss of teeth, should be a priority.     

Assessment of periodontal knowledge and periodontal status of an adult population in Jordan

The aim of this study was to assess periodontal knowledge and periodontal status in 20-60-year-old adult population in northern Jordan. A convenient sample consisting of 722 adults was included in this study. A questionnaire incorporating items related to socio-demographic and periodontal knowledge questions was completed before clinical examination, using the Community Periodontal Index of Treatment Needs (CPITN). The results showed that the proportions of subjects who reported bleeding gums, gums' irritation, rough tooth surface and gum disease decreased steadily with age, there is an evident linear trend with high statistical significant difference among various age groups (P < 0.001). Furthermore, the proportions of subjects who answered correctly the periodontal knowledge questions related to plaque definition and its role in disease aetiology and prevention, decreased with age, with a high significant difference for all knowledge questions (P < 0.001). The prevalence of subjects with healthy periodontium (score 0) decreased with age, being 41.1% among 20-29-year-old group and 11.1% in 50-60-year-old group. Similar trend was seen for bleeding on probing (score 1) whilst calculus deposit (score 2) was the major problem in all age groups over 29 years. The prevalence of periodontal pockets was relatively low, with a range of 4.5-18.6% for shallow pockets (score 3) and 2.9-11.1% for deep pockets in younger and older age groups, respectively. Younger age group had more healthy sextants than older age groups. In addition, sextants with bleeding on probing were highest in 20-29-year-old age group (1.8) compared with that in 50-60-year-old age group (0.60) whilst those with calculus deposits varied slightly among different age groups (1.50-1.65). Sextants affected by shallow or deep pockets increased steadily with age. Such a finding was also noted in excluded sextants, with an increase from 0.15 at 20-29 year-old group to 0.94 at the age of 50-60 years. It is concluded that health knowledge and status related to periodontal disease is still poor in northern Jordan. Therefore, dental health education provision is necessary to improve oral health knowledge and conditions among population in general and among older population in particular.     

Oral hygiene, gingivitis and periodontal breakdown in adult Tanzanians

This study describes the cross-sectional findings on dental plaque, calculus, gingivitis, loss of attachment, periodontal pockets and tooth loss in a population of adult Tanzanians aged 30–30 years. In all age groups more than 90% of all tooth surfaces exhibited plaque and 50–50% exhibited calculus deposits. Both plaque and calculus deposits were more extensive in the older age groups whereas gingival bleeding affected 30–30% of the surfaces in all age groups. Less than 35% of all surfaces exhibited a loss of attachment ≥4 mm and less than 10% had a loss of attachment exceeding 6 mm. Loss of attachment was accompanied by recession of the marginal gingiva and pockets deeper than 3 mm were present on less than 10% of all surfaces. The mean number of teeth present ranged from 23.9 in the oldest to 29.5 in the youngest age group. An interesting finding was that relatively few individuals accounted for most of the loss of attachment and periodontal pockets found in the study. Therefore, in future epidemiologic studies more emphasis should be put on the identification of these particularly susceptible subpopulations.     

Periodic subgingival antimicrobial irrigation of periodontal pockets

The present investigation was undertaken to study the clinical effect of professionally performed periodic subgingival irrigation per se and as an adjunct to scaling and root planing. 10 patients suffering from moderate-severe periodontal disease participated in the study. Following an initial 3-month period of supervised supragingival plaque control, a total of 102 periodontal sites with probing pocket depth greater than or equal to 6 mm and "bleeding on probing" were selected and subjected to a Baseline examination comprising assessments of oral hygiene and gingival conditions, probing depths and probing attachment levels. The pockets in the various jaw quadrants were randomly assigned to one of the following treatment groups: (1) periodic subgingival irrigation with hydrogen peroxide, (2) periodic subgingival irrigation with chlorhexidine, (3) periodic subgingival irrigation with saline and (4) no subgingival treatment. During the first part of the study (baseline-32 weeks), no mechanical debridement of the subgingival area was performed. The irrigation treatment was carried out by the operator 3 times per week during weeks 1 + 2 and 5 + 6 of the trial. In the 2nd part of the trial (32-52 weeks), the sites were subjected to scaling and root planing combined with professional irrigation during weeks 32-38. The previously non-irrigated control sites were not subjected to adjunctive irrigation when mechanically debrided. During the entire study, the patients were recalled for professional tooth cleaning once every 4 weeks. Re-examinations were carried out at 4, 6, 32, 40 and 52 weeks. The results revealed that repeated professional irrigation of unscaled periodontal pockets with chlorhexidine or hydrogen peroxide resulted in a temporarily reduced frequency of bleeding sites, but not in any clinically significant changes in probing assessments. A similar improvement of bleeding scores was observed in the saline-irrigated control group. Scaling and root planing, in combination with an optimal supragingival plaque control, resulted in a marked resolution of the clinical symptoms of periodontal disease. Adjunctive irrigation with chlorhexidine or hydrogen peroxide did not improve the healing result above and beyond that obtained after mechanical debridement alone or in combination with saline irrigation. Hence, the study failed to demonstrate that professionally performed periodic subgingival irrigation with chlorhexidine or hydrogen peroxide, used alone or in combination with thorough mechanical debridement, has a significant therapeutic effect.     

Validity of CPITN''s hierarchical scoring method for describing the prevalence of periodontal conditions

Abstract CPITN has been a frequently used index in periodontal epidemiology during the last decade. It was originally designed to describe treatment needs in populations. For this purpose, it was decided to record only the worst periodontal condition around each index tooth. Such a recording procedure can be regarded as a hierarchical scoring method. Recently, CPITN has been used and recommended for describing the prevalence of periodontal conditions. For this purpose, the index should give a valid estimate of the true periodontal conditions of the index tooth, and not only a recording of the worst condition. The aim of the present study was to test whether the hierarchical assumption of CPITN concerning treatment needs was valid for describing the prevalence of periodontal conditions in a Scandinavian population. The study population comprised 3330 persons from a rural and an urban area in the county of Trondelag, Norway. The clinical recording was carried out so that it was possible to analyze the indicators both hierarchically and non-hierarchically. The results showed that nearly all the CPITN indicators scored hierarchically gave a correct estimate of the prevalence of bleeding in the population. CPITN codes 3 and 4 overestimated the prevalence of calculus. The degree of overestimation varied by age and tooth type. Most overestimation of calculus occurred on molar teeth with pockets 3.5-5.5 mm and for individuals 13–14 yr of age. There was almost no overestimation of calculus for those aged 65 yr and above. The distribution of the different combinations of the indicators was fairly similar for all index teeth for codes 2, 3, and 4, with the exception of the mandibular incisor.     

Natural distribution of oral Actinobacillus actinomycetemcomitans in young men with minimal periodontal disease

A total of 1005 subgingival and extracrevicular samples from 201 male recruits, 18–25 yr old, were selectively cultivated for Actinobacillus actinomycetemcomitans. The organism was isolated in 55 subjects (27%); 9.5% of pooled subgingival plaque samples from first molars, 14% cheek mucosa, 20% dorsum of tongue and 20% saliva samples were culture-positive. In order to divide the study population into distinct clinical categories, cluster analysis was performed, based on previous caries experience, probing pocket depth categories, bleeding scores, visible plaque and calculus. Two clusters (n=86 and n=92, respectively) were identified with no or minimal periodontal disease (mean±standard deviation % of periodontal probing depth 1–2 mm 78.7±10.4% and 57.4±12.6%, respectively; virtually no periodontal probing/depth in excess of 4 mm) and a relatively low DMF-S (22±13). A third cluster (n=22) had, in contrast, a high DMF-S (47.7±173) and a relatively high % of periodontal pockets of ≥5 mm (5.9 ±5.2%). Prevalence of A. actinomycetemcomitans in this cluster was 41%, while the organism was found in 23% and 27% in the minimally diseased populations (p<0.15). Whereas no heterogeneity of associations between subgingival and extracrevicular occurrence of the organism could be ascertained in different clusters, the organism was significantly more often identified in extracrevicular material, especially dorsum of tongue samples, compared with subgingival plaque (McNemar's X²=12.45, p<0.001). Multiple linear regression analysis revealed the number of A. actino-mycetemcomitans positive samples as well as the % of sites bleeding on probing being positively associated with the % of sites with a probing pocket depth of ≥5 mm (R2=0.345, p≤0.0001). The present large-scale investigation points to the wide distribution of this putative periodontopathogen in young individuals with minimal periodontal disease.     

Improved metabolic control, clinical periodontal status and subgingival microbiology in insulin-dependent diabetes mellitus

The effect of improved metabolic control on the clinical periodontal condition and the subgingival microflora of diseased and healthy periodontal pockets in 6 ambulatory insulin-dependent diabetes mellitus (IDDM) patients was prospectively studied. Duplicate measurements with a time-interval of 3 days were made every 4 moths for assessment of the metabolic status, the clinical periodontal condition and the subgingival microflora. During the study, patients maintained personal oral hygiene measures as they usually did before the study. Neither supplementary dental prophylaxis nor oral hygiene measures were applied during the investigation. Long-term metabolic control (HbAlc) improved significantly with intensive conventional insulin treatment. Gingival redness decreased significantly whereas gingival swelling showed a not significant trend to decrease. It is suggested that microvascular changes associated with improved metabolic control in diabetes mellitus may mediate the observed change in gingival redness. No effect could be demonstrated for probing pocket depth, probing attachment level, bleeding on probing and the plaque index. Statistical analysis of the effect of improved metabolic control on the subgingival microflora revealed that only the % of streptococci increased significantly in diseased periodontal pockets. In general, no significant changes were found in either healthy or diseased pockets with regard to the bacterial flora associated with periodontal disease. The results of the present study indicate that improved metabolic control in IDDM patients may have no potential impetus for an improved clinical periodontal condition nor on the subgingival bacterial flora. It is concluded that the periodontal condition in IDDM patients may only ameliorate when local oral hygiene measures are applied.     

Relationship between periodontal disease and cirrhosis of the liver in humans

Abstract The periodontal condition of a well-described group of cirrhotic patients was compared with that of a control group, matched forage, sex ratio and socio-economic background, expressed as years of education. The test group comprised 30 cirrhotic patients, 35–64 years of age. The diagnosis cirrhosis of the liver was confirmed histologically, and no other systemic diseases were present. The material was grouped according to age, 35–44, 45–54 and 55–64 years of age. The examination included determination of tooth loss, a plaque index, a gingival index, retentive calculus, retentive decay and fillings, and loss of attachment. The amount of plaque was equal in test and control groups, whereas the cirrhotics had a higher degree of severity of gingival inflammation as well as a greater amount of subgingival calculus than the controls. Test and control groups exhibited no significant difference as regards loss of attachment and tooth loss, and similar correlations between loss of-attachment and age were demonstrated in the two groups. Patients suffering from cirrhosis for more than 3 years showed significantly greater loss, of attachment, as well as more plaque and calculus compared with those with a disease duration of less than 3 years. It is suggested that this aggravation of the periodontal condition is related to increasing neglect of the teeth, as the cirrhotic condition aggravates.     

The effect of periodontal parameters on the subgingival microbiota around implants

The study aimed to examine the relationship between the subgingival flora around implants and their periodontal parameters. Plaque samples from 561 implants (297 patients) were analyzed by means of differential phase contrast microscopy and compared with the sample site's probing depth. bleeding tendency on probing, and plaque and gingivitis indices. If possible, one implant with deep and one with shallow pockets were selected within the same patient. The impact of the intraoral exposure time on the microbial composition around the implants was examined cross‐sectionally, with the same group of patients. Only tendencies can be detected by the latter, and no concrete conclusions can be drawn. From the clinical parameters, increased probing depth was found to detrimentally increase the proportion of spirochetes and motile organisms, whereas the other parameters were found to be of minor importance. For partially edentulous patients only, there was a tendency for increased proportions of spirochetes and motile organisms the longer the intraoral exposure time. These observations emphasize the importance of the periodontal health of the remaining teeth (as a reservoir of pathogenic micro organisms) in partial edentulous patients rehabilitated by means of implants and indicate the importance of shallow pockets around imnlants (flan trimming when aesthetics and phonetics allow).     

Relation of diabetes control to periodontal pocketing and alveolar bone level

The periodontal health status of 50 diabetic and 53 control subjects was examined. The diabetic group was further divided into three subgroups according to the control of diabetes. There were no significant differences between the whole diabetic group and the control group as regards the frequency of pockets and alveolar bone level. A comparison between the controls and the diabetic subgroups revealed that the well-controlled diabetic patients had better periodontal health than the controls. Within the diabetic group, the prevalence of pockets declined as the control of diabetes improved; the decrease in the number of pockets on bleeding surfaces and on surfaces containing subgingival calculus was statistically significant. Better periodontal health seems to be connected with good control of diabetes, indicating better resistance of periodontal connective tissue and alveolar bone.     

Community periodontal index of treatment needs and prevalence of periodontal conditions

BACKGROUND/AIMS: In 1977, the World Health Organization (WHO) proposed a new index, the community periodontal index of treatment needs (CPITN) to evaluate the periodontal treatment needs of populations. The aim of this study is to compare different approaches of recording and presenting the CPITN. METHODS: A sample of 2110 subjects aged 35-44 years were examined between September 1994 and July 1995, throughout the province of Quebec, Canada. For each tooth (3rd molars excluded), the presence of bleeding and calculus, the level of epithelial attachment, and the depth of periodontal pockets were measured. Periodontal pocket depths were measured from the edge of the free gingiva, at 2 sites (mesiovestibular and vestibular), as well as all around the tooth. RESULTS: Only 8.5% of adults had at least one tooth with a 6 mm or deeper periodontal pocket when probing on 2 sites, whereas if probing is done all around the tooth, this percentage is 2.5x higher (21.4%). The partial recording of pocket depths (10 index teeth recommended by WHO, or 2 quadrants chosen at random) resulted in an underestimation of the prevalence of subjects with at least one tooth with a periodontal pocket (CPITN score 3 and 4). Among subjects with at least one tooth with a 6 mm or deeper periodontal pocket, 12% were not detected with the 10 index teeth recording, and 25% go undetected with the measure on 2 quadrants. Finally, using the % of subjects with periodontal pockets overestimates the prevalence of deep pockets compared with using sextants. Indeed, close to 30.0% of sextants have no treatment needs, whereas only 5.2% of subjects are in this category. Similarly, 7.7% of sextants have at least one tooth with a 6 mm or deeper periodontal pocket, yet there are 3x more subjects in this category (21.4%).     

Effect of nonsurgical periodontal therapy III. Single versus repeated instrumentation

Healing events following nonsurgical periodontal therapy were studied, comparing the effect of a single initial instrumentation to the effect of 3 instrumentations, each separated by 3 months. Incisors, cuspids and premolars with periodontal pockets up to 11 mm deep in 13 patients were treated by plaque control and supra- and subgingival debridement using ultrasonic instruments. A split mouth approach was used to compare the 2 frequencies of instrumentation. The results were evaluated by recording of plaque scores, bleeding on probing, probing pocket depths and probing attachment levels. A gradual and marked improvement of the periodontal conditions took place during the initial 9 months following start of therapy. During the remaining 15 months of the 24-month experimental period no further changes of the recorded parameters were noted. No differences in results could be observed when comparing the effects of a single versus repeated instrumentation. Thus, it appears that deep periodontal pockets in incisors, cuspids and premolars may be successfully treated by plaque control and 1 episode of instrumentation. The results also suggest that recurrence of disease due to subgingival recolonization by microorganisms during the healing phase may not be a major clinical problem.     

Scaling and root planing with and without periodontal flap surgery

Complete removal of calculus is a primary part of achieving a "biologically acceptable" tooth surface in the treatment of periodontitis. Rabbani et al. reported that a single episode of scaling did not completely remove subgingival calculus and that the deeper the periodontal pocket, the less complete the calculus removal. The purpose of the present study was to evaluate the effectiveness of scaling relative to calculus removal following reflection of a periodontal flap. Each of 21 patients who required multiple extractions had 2 teeth scaled, 2 teeth scaled following the reflection of a periodontal flap, and 2 teeth serve as controls. Local anesthesia was used. Following extraction, the % of subgingival tooth surfaces free of calculus was determined using the method described by Rabbani with a stereomicroscope. Results showed that while scaling only (SO) and scaling with a flap (SF) increased the % of root surface without calculus, scaling following the reflection of a flap aided calculus removal in pockets 4mm and deeper. Comparison of SO versus SF at various pocket depths for % of tooth surfaces completely free of calculus showed 1 to 3 mm pockets to be 86% versus 86%, 4 to 6 mm pockets to be 43% versus 76% and greater than 6 mm pockets to be 32% versus 50%. The extent of residual calculus was directly related to pocket depth, was greater following scaling only, and was greatest at the CEJ or in association with grooves, fossae or furcations. No differences were noted between anterior and posterior teeth or between different tooth surfaces.     

Partial indices as indicators of the severity and prevalence of periodontal disease

The purpose of this study was to analyse the reliability of partial examination in the assessment of the average severity and the prevalence of periodontal disease. A total of 126 subjects aged 15-30 years and 160 subjects aged 31-68 years were examined for the presence or absence of gingival bleeding, supra- and subgingival calculus and pocket depths of 4-5 mm or 6 mm and over on six surfaces of each remaining tooth. From this pool of data three sets of average severity and prevalence scores were extracted. One was based on the full mouth examination; one on observations made from the ten index teeth of the Community Periodontal Index of Treatment Needs (CPITN); and one on the six index teeth of the Periodontal Disease Index. Average severity scores were obtained as accurately from the six Ramfjord teeth as from full mouth examinations for all periodontal disease indicators except for 6 mm or deeper pockets. When the assessments were based on the ten CPITN index teeth, the average severity scores exceeded those based on full mouth examinations for all indicators recorded and the prevalence figures were higher than those based on the six Ramfjord teeth. Even with the CPITN there was an under-estimate of the proportion of individuals affected, ranging from 16 per cent for 4-5 mm pockets to 21 per cent for 6 mm and deeper pockets in the older age group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Tooth mortality and periodontal conditions in 60–80-year-old Chinese

Abstract — The study comprised 544 persons aged 60 yr or more from two urban Residential Areas and one rural village (including a nursing home) of Beijing area. Overall, the sample accounted for 81% of the total population of elderly aged 60 yr or more in the village/areas so defined. Each person was examined for dental status, plaque, calculus, gingivitis, loss of attachment, pocket depth and tooth mobility. Edentulousness was seen in 0–29% of trie persons examined, depending on age and sex. The mean number of teeth present ranged from 6.9 to 23.9, depending on age, sex, and area. The oral hygiene was poor; approximately 50% of all surfaces had immediately visible plaque deposits and calculus. About 50% of the surfaces had a loss of attachment ≥4 mm, while less than 15% presented pockets ≥4 mm. More than 50% of the individuals had loss of attachment ≥4 mm on more than 40% of their surfaces. The proportion of surfaces per person with loss of attachment ≥7 mm; and pockets ≥4 mm, respectively, showed a pronounced skewed distribution. These findings indicate that a subfraction of individuals is responsible for a substantial proportion of the severe periodontal breakdown leading to loss of teeth. This, in turn, raises important questions as to the most appropriate strategies for the prevention and control of periodontal diseases for the Chinese population.