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  • 1. Hausmann, E
    et al.
    Allen, K
    Norderyd, J
    Ren, W
    Shibly, O
    Machtei, E
    Studies on the relationship between changes in radiographic bone height and probing attachment1994In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 21, no 2Article in journal (Refereed)
    Abstract [en]

    The aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the "side-by-side" technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p = 0.0001, r2 = 0.018) and between subject means (p = 0.0014, r2 = 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in combination.

  • 2.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Laurell, L
    Lundgren, D
    Frequency distribution of individuals aged 20-70 years according to severity of periodontal disease experience in 1973 and 1983.1992In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 19, no 4, p. 227-32Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare changes in periodontal status of a Swedish population over a 10-year period expressed as frequency distributions of individuals according to severity of periodontal disease experience. The study involved 600 randomly selected individuals evenly distributed into age groups 20, 30, 40, 50, 60 and 70 years, examined in 1973 and another randomly selected group of 597 individuals similarly age distributed and examined in 1983. Based on clinical data and full mouth intraoral radiographs all individuals were classified into 5 groups according to severity of periodontal disease experience. In 1983, 23% of the individuals were classified as having healthy periodontal tissues, group 1, compared to 8% in 1973. The changes were most pronounced in the age groups 20 and 30 years, among whom 58% and 35%, respectively, were registered as having healthy periodontium in 1983. The prevalence of individuals with gingivitis without signs of lowered periodontal bone level, group 2, was 22% in 1983 compared to 41% in 1973. In all, 49% of the dentate population in 1973 and 45% in 1983 showed no marginal alveolar bone loss. Moderate periodontal bone loss, group 3, was found in 41% of the population in 1983 compared to 47% in 1973. Among 30-, 40-, and 50-year-olds, there were more, and among 60- and 70-year-olds, fewer individuals in this group in 1983 compared to 1973. 96% of the dentate population were classified as belonging to groups 1, 2 or 3 in 1973 compared to 86% in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

  • 3.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Ljungquist, B
    Breivik, T
    The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age2002In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 3, p. 247-53Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Clinical observations and epidemiological studies suggest that experiences of negative life events, especially those manifested as depression, may contribute to an increased susceptibility to periodontal disease. OBJECTIVE: In the present study, the prevalence of some negative life events and psychological factors and their relation to periodontal disease were investigated. The sample consisted of individuals 50-80 years of age from an extensive cross-sectional epidemiological study performed in 1993 in the city of Jönköping, Sweden. METHOD: 298 dentate individuals from the Jönköping study were randomly selected. Clinical and radiographic examinations included registration of the number of existing teeth, plaque index, gingival index, pocket depth, and alveolar bone loss. In addition, a questionnaire about socioeconomic status, life events, and psychological and stress-related factors was used. RESULTS: The results revealed that, in addition to the well-documented periodontal disease risk factors such as increased age, oral hygiene status, and smoking, the loss of a spouse (being a widow or widower) and the personality trait of exercising extreme external control were also associated with severe periodontal disease. CONCLUSION: The findings support recent studies suggesting that traumatic life events such as the loss of a spouse may increase the risk for periodontal disease. Above all, the present results indicate that an individual's ability to cope with stressful stimuli (coping behavior), as measured by the beliefs of locus of control of reinforcements may play a role in the progression of periodontal disease.

  • 4.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Lundgren, Dan
    Asklöw, Barbro
    Borgklint, Gun
    Effect of three different dental health preventive programmes on young adult individuals: a randomized, blinded, parallel group, controlled evaluation of oral hygiene behaviour on plaque and gingivitis.2007In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, no 5, p. 407-415Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate, in young adults, the effect of different preventive programmes on oral hygiene and to determine whether the variables investigated are predictors of gingival health. MATERIAL AND METHODS: This randomized, blinded, parallel, controlled clinical study examined the effectiveness of three dental health programmes. Four hundred subjects aged 20-27 years, 211 males and 189 females, participated in the study. They were recruited from a Public Dental Service clinic and from a private dental practice in Jönköping, Sweden. The effect of the programmes on plaque and gingivitis was evaluated over a 3-year period. The programmes included activities that were adapted for individuals as well as for groups. The plaque indices (PLI) and gingival indices (GI) were used to evaluate the programmes. RESULTS: All programmes resulted in a decrease in PLI and GI. The greatest decrease was found in the group that was followed-up every 2 months. Professional tooth cleaning was non-significant for the clinical result. Gingival health at baseline, participation in any of the test programmes, and knowledge of the dental diseases caries, gingivitis or periodontitis were significant predictors of good gingival health. CONCLUSIONS: The study confirms the efficacy of three different preventive programmes in reducing supragingival plaque and gingival inflammation. Professional tooth cleaning provided no clinical benefit beyond that derived from individual and group-based health education.

  • 5.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Norderyd, O
    Slotte, C
    Thorstensson, H
    Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993.1998In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 25, no 7, p. 542-548Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare changes in periodontal status in a Swedish population over a period of 20 years. Cross-sectional studies were carried out in Jönköping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1), gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49% in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. In 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (> or =4 mm). In 1993, 20%, 42%. and 67% of the individuals in groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with >20% bleeding sites and >10% sites with periodontal pockets > or =4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.

  • 6.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Norderyd, O
    Slotte, C
    Thorstensson, H
    Oral hygiene and gingivitis in a Swedish adult population 1973, 1983 and 1993.1998In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 25, no 10, p. 807-812Article in journal (Refereed)
    Abstract [en]

    The periodontal condition of the inhabitants of Jönköping County, Sweden was followed for 20 years by means of 3 cross-sectional investigations performed in 1973, 1983, and 1993. The study comprised individuals in the age groups 20, 30, 40, 50, 60, and 70 years. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. All individuals participating in the studies were examined clinically and radiographically. They also filled out a questionnaire about dental care habits, socio-economic status, and general health. A clear reduction in the plaque score was seen between 1973 and 1983 in all age groups. With one exception, no further significant change in plaque levels was found between 1983 and 1993: the increase in plaque among the 20-year-olds was significant. In 1993 the mean % of surfaces with plaque was between 30% and 40% in all age groups. Gingivitis values corresponded well with the values of dental plaque; the same pattern with a clear reduction in gingivitis score was seen in all age groups between 1973 and 1983, and an increase in the mean frequency of gingival inflammation between 1983 and 1993 was seen in the 20-year age group. 30% of the individuals in this age group had more than 50% gingivitis in 1993 compared with 9% of the individuals in 1983. The 20-year-olds were further analyzed in a linear regression model using gingivitis as a dependent variable against some socio-economic, general health, and dental care variables associated with poor oral hygiene and gingivitis. In 1993, the most important explanatory variable was gender: significantly more males than females had higher gingivitis scores. The second most important explanatory variable was toothbrushing habits. Together they explained 10.9% of the variance. The multivariate analysis did not reveal approximal cleaning habits to be significant, probably due to their strong connection to gender and toothbrushing habits. In the 1983 sample, no significant explanatory variables were found. It was concluded from this data that it is important not only to renew but also to direct preventive guidelines more towards young adults who have no previous extensive experience of oral disease so that they will not be excluded from dental care and their dental health thereby jeopardised. In addition to preventive programmes aimed at the population as a whole, individual programmes based on risk targeting are also necessary to reduce the number of people developing dental disease and to increase the quality of dental care.

  • 7.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Norderyd, Ola
    Has the prevalence of periodontitis changed during the last 30 years?2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 8 Suppl, p. 338-345Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reviews global trends in the change in prevalence of periodontitis over the last 30 years. MATERIAL AND METHODS: The epidemiology of periodontal disease is briefly reviewed together with the current classification system and the clinical and radiographic diagnostic methodology in periodontal disease. RESULTS: This review identifies the very limited number of studies that provide prevalence data over time, and this data is discussed in comparison with those stemming from a few corresponding studies from countries outside Europe. CONCLUSIONS: The data indicate a possible trend of a lower prevalence of periodontitis in recent years.

  • 8.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Rolandsson, Margot
    Periodontal disease in relation to smoking and the use of swedish snus: epidemiological studies covering 20 years (1983-2033)2011In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, no 9, p. 809-816Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: Aim: The aim of the present study was to examine how deleterious current smoking and the use of Swedish moist snuff (snus) is for periodontal health compared with non-tobacco users. Materials and Methods: The studies comprised three epidemiological cross-sectional studies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40, 50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523, respectively. The participants were examined clinically and radiographically. Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocket depth (PPD)4 mm, height of the alveolar bone level and classification by periodontal disease experience. In addition, participants were asked about their tobacco habits. Results: Multiple logistic regression shows, after adjusting for age, gender and sociodemographic variables, that relative to non-tobacco users, cigarette smokers had statistically significant less gingivitis, a higher frequency of PPD4 mm and a higher incidence of severe periodontitis. There was no significant association between gingivitis, frequency of PPD4 mm and periodontal disease experience and snus use. Conclusions: Cigarette smokers were found to have a statistically significant higher risk of severe periodontitis than non-tobacco users and users of snus. Using snus did not seem to be a risk factor for periodontitis.

  • 9.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Sjödin, Bengt
    Norderyd, Ola
    Trends over 30 years, 1973-2003, in the prevalence and severity of periodontal disease.2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 5, p. 405-414Article in journal (Refereed)
    Abstract [en]

    AIM: The present investigation presents findings of the prevalence and distribution of gingivitis and periodontitis in a Swedish population over the 30 years 1973-2003. MATERIAL AND METHODS: Four cross-sectional epidemiological studies in 1973, 1983, 1993, and 2003 were performed in Jönköping, Sweden. Random samples of individuals aged 20, 30, 40, 50, 60, 70, and 80 years were examined clinically and radiographically. Diagnostic criteria were edentulousness, number of teeth, plaque, gingival status, probing pocket depth, gingival recession, alveolar bone level, and classification according to periodontal disease status. RESULTS: In all age groups, the number of edentulous individuals decreased dramatically and the number of teeth increased. Oral hygiene improved considerably. Over the 30 years, the proportion of periodontally healthy individuals increased from 8% in 1973 to 44% in 2003 and the proportion of individuals with gingivitis and moderate periodontitis decreased. There was a non-significant trend for the proportion of individuals with severe periodontal disease experience (Group 4) to decrease, while the proportion of individuals with advanced periodontitis (Group 5) remained unchanged. CONCLUSION: Oral hygiene and periodontal health improved significantly in the 20-80-year age groups over the 30 years 1973-2003.

  • 10. Karapataki, S
    et al.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Kugelberg, C F
    Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars2000In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 27, no 5, p. 325-332Article in journal (Refereed)
    Abstract [en]

    AIM: The purpose of this study was to study the healing, following guided tissue regeneration (GTR) treatment, of bone defects distal to mandibular 2nd molars (M2s) after surgical removal of impacted mesioangularly or horizontally inclined third molars (M3s) in patients > or = 25 years. METHOD: 20 patients with bilateral soft tissue impacted M3s were included in the split-mouth study. The 2 sites to be treated in each patient were randomised before the 1st operation as to which would undergo the test procedure and which would be the control site. After surgical removal of M3 at test sites, a resorbable polylactic acid (PLA) barrier was attached to M2 to cover the post-surgical bone defect. The flap was then replaced and sutured to cover the barrier. Control sites underwent the same procedure, as did the test sites, with the exception that no barrier was placed. The clinical examinations performed were oral hygiene pre- and 12 months postoperatively and probing pocket depth 12 months postoperatively. The alveolar bone level (ABL) at the distal surface of the M2, as determined from radiographs taken at suture removal and 12 months postsurgery, was chosen to be the primary response variable. RESULTS: Most bone defects showed healing up to 10%-20% of the tooth length at both test and control sites. 2 test and 2 control sites showed no improvement in the bone level. The mean values of bone healing registered in mm from the cemento-enamel junction (CEJ) were 2.6 +/- 2.19 SD and 3.0 +/- 2.20 SD for test and control sites, respectively. Different factors affecting the healing result are discussed.

  • 11. Laurell, Lars
    et al.
    Romao, Cristina
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Longitudinal study on the distribution of proximal sites showing significant bone loss2003In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, no 4, p. 346-352Article in journal (Refereed)
    Abstract [en]

    BACKGROUND, AIMS: In 1973, a random sample of 574 dentate individuals aged 15, 20, 30, 40, 50, and 60 years in the city of Jönköping, Sweden, were examined clinically and radiographically to assess oral health and overall treatment needs. Periodontal examination included registration of plaque, gingivitis, probing depths at four aspects of each tooth, and interproximal bone height measurements on full-mouth intraoral radiographs. In 1990, 17 years later, the same individuals were invited to participate in a new investigation. Of these, 433 (75%) agreed to participate in the investigation and were re-examined (Hugoson & Laurell 2000). The proximal alveolar bone height at all interproximal sites was measured and expressed as per cent of tooth length. Only teeth that were present in both 1973 and 1990 were included in the assessment of changes in bone score. From the age of 30 years, about 80% of the population had one or more sites with a bone loss of 2-3 mm or more. Seventeen per cent of the individuals had more than six such sites, indicating destructive periodontal disease. Bone loss occurred at sites both with and without previous bone loss. The present study was undertaken to test the hypothesis that sites with a bone loss of 10% or more of the tooth length (2-3 mm) during the 17 years were randomly distributed in the dentition. MATERIAL AND METHODS: Of the 13,197 sites examined in individuals 20-60 years at baseline, 1201 sites (9.0%) in 998 teeth with a bone loss corresponding to 10% or more of the tooth length were found and included in the analysis. A probability test for binomial distribution was used to test the null hypothesis that all teeth had the same risk of losing bone regardless of its position in the dentition. The valid risk for each tooth was 3.571% and the null hypothesis was rejected at the 95% confidence interval. RESULTS: Although all tooth types were affected by tooth loss, some teeth, namely 17, 16, 42, 41, and 31, showed a higher incidence of sites losing bone, whereas 46, 45, 44, and 36 had a lower incidence. Loser sites in smokers appeared more at random. CONCLUSION: Sites that will develop periodontal break-down over time may appear at random, although with higher risk at maxillary molars and lower incisors. For the early detection of destructive periodontitis, periodontal examination that includes all teeth should be made routine in every dental check-up.

  • 12. Norderyd, O
    et al.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Risk of severe periodontal disease in a Swedish adult population: A cross-sectional study1998In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 25, no 12, p. 1022-1028Article in journal (Refereed)
    Abstract [en]

    In this study, potential risk factors for severe periodontal disease were identified in a cross-sectional sample from the county of Jonkoping, Sweden. 547 adults 20-70 years of age were categorised clinically and radiographically by level of periodontal disease experience. These levels were used to divide the sample into groups--individuals without any reduction in periodontal bone level (60%) and those with severe periodontal bone loss (13%)--which were then used in univariate and multivariate logistic regression analyses as dependent variable. Demographic, socio-economic, general health, smoking habits, clinical, and dental care variables were used in the different regression analyses. In the univariate model, age (20-70 years) was found to be correlated with more severe periodontal disease experience (odds ratio: 1.13; 95% CI: 1.10-1.17). The association with periodontal disease was more pronounced for the older age groups (50, 60, and 70 years). A negative financial situation was also related to severe periodontal bone loss when regressed univariately (odds ratio 2.20 [95%: 1.04-4.68]). Moderate-heavy smoking (> or =10 cigarettes/day) appeared to be associated with severe periodontal destruction with an odds ratio of 9.78 (95% CI: 3.62-36.42). Of the clinical variables in the univariate model, higher mean levels of supragingival dental plaque and the presence of subgingival calculus were related to more severe periodontal disease with odds ratios of 1.02 (95%: 1.01-1.03) and 2.96 (95%: 1.50-5.88), respectively. When the same variables were regressed multivariately, age (continuous) (odds ratio 1.17 [95% CI: 1.12-1.22]), moderate-heavy smoking (odds ratio 11.84 [95% CI: 4.19-33.50]), and higher mean levels of plaque (odds ratio 1.02 [95% CI: 1.00-1.03]) remained significant. Light smoking (1-9 cigarettes/day) was not significantly associated with severe periodontal disease in the 2 regression models. The present study demonstrated that smoking, greater age, and higher mean levels of plaque are potential risk factors for severe periodontal disease in this specific population.

  • 13. Norderyd, O
    et al.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Grusovin, G
    Risk of severe periodontal disease in a Swedish adult population: A longitudinal study1999In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 26, no 9, p. 608-615Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify risk factors for severe periodontal disease progression in a Swedish adult population between the years 1973 and 1988-91. In 1973, a random sample of 474 dentate adults living in Jönköping County was examined clinically and radiographically. A questionnaire on demographic and socio-economic status, general health, and dental care habits was also used. During the years 1988-1991, 361 of the individuals examined in 1973 were re-examined. A total of 506 (6%) teeth or in average 1.4 teeth per subject were lost between the 2 examinations. 4 subjects had become completely edentulous. The mean loss of teeth in the different age groups 20-60 years was 0.2, 0.9, 1.4, 2.3, and 2.6, respectively. The periodontal bone level decreased by age both in 1973 and in 1988 91. The mean annual progression rate was 0.06 mm for all 357 individuals and varied between 0.04 and 0.07 mm per subject in the different age groups. The presence of periodontal disease progression was defined as bone loss of >20% at a proximal site between the 2 examinations. The most prevalent tooth types with bone loss of >20% at proximal sites were the maxillary and mandibular 2nd molars and the 1st maxillary molar, representing a % of 18.0, 12.8, and 13.5, respectively. The degree of association between severe periodontal disease progression and explanatory variables was investigated using logistic regression models. The dependent variable was no progression of periodontal disease or severe periodontal disease progression, i.e., subjects with periodontal bone loss >20% at > or =6 sites. Age was found to be correlated with severe periodontal disease progression by an odds ratio of 1.05 (CI: 1.02-1.07). The frequency of females in the group with severe bone loss was 58% and higher than in the non-progressing group, 50%. Only 9% in the group with no bone loss smoked as compared to 38% in the group of individuals with severe periodontal bone loss. % supragingival plaque, gingival inflammation, and deepened periodontal pockets (> or =4 mm) at baseline were related to severe periodontal disease progression by odds ratios of 1.03 (CI: 1.02-1.05), 1.01 (1.00-1.03), and 1.03 (1.00-1.05), respectively. In the multivariate logistic regression model, age (odds ratio 1.13 (CI: 1.06-1.19)), smoking (odds ratio 20.25 (5.07-80.83)), and % pockets > or =4 mm (odds ratio 1.15 (1.04-1.27)) remained significantly associated with severe disease progression. Furthermore, female gender and differences in income level appeared in the multivariate analysis to be related with severe bone loss, with odds ratios of 3.19 (CI: 1.02-9.97) and 8.46 (CI: 1.97-36.37), respectively.

  • 14. Starkhammar Johansson, Carin
    et al.
    Richter, Arina
    Lundström, Asa
    Thorstensson, Helene
    Ravald, Nils
    Periodontal conditions in patients with coronary heart disease: a case-control study.2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 3, p. 199-205Article in journal (Refereed)
    Abstract [en]

    AIM: This study examined periodontal conditions in patients with coronary heart disease (CHD) and subjects with no history of CHD. MATERIAL AND METHODS: Participants were 161 patients (40-75) with severe angina pectoris (diagnosed as CHD by coronary angiography) who subsequently underwent percutaneous coronary intervention and 162 control subjects with no history of CHD. Periodontal status was recorded. Bone loss was determined on radiographs. Periodontal disease experience was classified into five groups according to Hugoson & Jordan. RESULTS: Periodontal disease experience groups 4 and 5 were more common in the CHD group (25%) compared with the control group (8%). The mean bone level (the distance from the CEJ to the most coronal level of the alveolar bone) was 3.0+/-1.0 mm in CHD subjects and 2.6+/-0.8 mm in controls. CHD patients had significantly lower numbers of natural teeth, higher numbers of periodontal pockets 4-6-mm and higher bleeding on probing (%). In a stepwise regression analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07-15.90) for having CHD after controlling for smoking and age. CONCLUSION: Severe periodontal disease expressed by several clinical and radiographic parameters was more prevalent among subjects with CHD than among controls. Analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07-15.90) for having CHD after controlling for smoking and age.

  • 15. Thorstensson, H
    et al.
    Dahlén, G
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Some suspected periodontopathogens and serum antibody response in adult long-duration insulin-dependent diabetics.1995In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 22, no 6, p. 449-458Article in journal (Refereed)
    Abstract [en]

    The subgingival microflora and serum antibody response were examined in long-duration insulin-dependent diabetics and age- and sex-matched non-diabetics. The material consisted of 9 diabetics aged 40-49 years and 19 aged 50-59 years, 13 non-diabetics aged 40-49 years and 21 aged 50-59 years. The bacterial species studied (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Capnocytophaga spp, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia) were recovered in diabetics as well as in non-diabetics. Significantly more diabetics in both age groups harboured P. gingivalis compared to non-diabetics. Prevalence of P. gingivalis was associated with deepened periodontal pockets among non-diabetics but not among diabetics. In diabetics and non-diabetics, the serum antibody titres for most antigens were similar.

  • 16. Thorstensson, H
    et al.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Periodontal disease experience in adult long-duration insulin-dependent diabetics.1993In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 20, no 5, p. 352-358Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse periodontal disease experience in 40- to 70-year-old, sex-matched insulin-dependent diabetics and non-diabetics. The study involved 83 diabetics and 99 non-diabetics. The clinical and radiographic examination comprised recordings of number of teeth, presence of plaque, gingival conditions, probing pocket depth and alveolar bone level (main variable). Diabetics aged 40 to 49 years had more periodontal pockets > or = 6 mm and more extensive alveolar bone loss than non-diabetics in the same age-group. There was also a significantly higher number of subjects belonging to classification groups with severe periodontal disease experience among diabetics in that age-group. In the age-groups 50-59 and 60-69 years, no major differences were found. The disease duration in these 3 age groups was 25.6 years, 20.5 years and 18.6 years, respectively, and the age of onset thus appears to be an important risk factor for future periodontal destruction.

  • 17. Thorstensson, H
    et al.
    Kuylenstierna, J
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics.1996In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 23, no 3 Pt 1, p. 194-202Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to define a population of diabetics exhibiting an increased risk of developing severe periodontitis by comparing the medical status of 2 groups of diabetics, 1 with no/minor periodontal disease and 1 with severe periodontal disease. The case-control study consisted of 2 parts, a baseline study and a follow-up study. 39 case-control pairs were selected. They were adult, long-duration, insulin-dependent diabetics matched according to sex, age and diabetes duration. One individual in each pair (the CASE) exhibited severe periodontal disease while the other (the CONTROL) exhibited gingivitis or only minor alveolar bone loss. The median age of the cases was 58 years (range 36 to 70 years) and of the controls 59 years (range 37 to 69 years). The median disease duration in cases and controls was 24 years and 25 years, respectively. The median follow-up time was 6 years. The medical variables analysed were weight, insulin dose, systolic and diastolic blood pressure, vibratory threshold, triglycerides, total-cholesterol, HDL-cholesterol, creatinine, HbA1, proteinuria, ECG, retinopathy, stroke, transient ischemic attacks (TIA), angina, myocardial infarct, heart failure, hypertension, intermittent claudication, foot ulcer, death, cause of death, and smoking habit. Biochemical analyses and clinical variables used as a routine in the monitoring of diabetics failed to differentiate between diabetics with severe and minor periodontal disease. In the follow-up study, significantly higher prevalences of proteinuria and cardiovascular complications such as stroke, TIA, angina, myocardial infarct and intermittent claudication were found in the case group. An association between renal disease, cardiovascular complications and severe periodontitis seems to exist. This indicates that a closer cooperation between the diabetologist and the dentist is necessary in monitoring the diabetic patient.

  • 18.
    Wahlin, Åsa
    et al.
    The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Papias, Apostolos
    The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Faculty of Odontology, Malmö University, Malmö, Sweden.
    Norderyd, Ola
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Faculty of Odontology, Malmö University, Malmö, Sweden.
    Secular trends over 40 years of periodontal health and disease in individuals aged 20-80 years in Jonkoping, Sweden: Repeated cross-sectional studies2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 9, p. 1016-1024Article in journal (Refereed)
    Abstract [en]

    Aim: To assess trends over 40 years regarding prevalence and severity of periodontitis in a Swedish adult population.

    Materials and methods: Cross-sectional examinations using the same clinical protocol have been repeated every 10years (1973-2013) in a Swedish city with focus on periodontal disease in adults. Periodontal recordings included all teeth, excluding 3rd molars. Periodontal disease experience was classified (no/minor, moderate and severe).

    Results: The no/minor group increased from 43% in 1983 to 60% in 2013. There was a non-significant trend for a decrease of the severe group. Over the 40-year period, the number of teeth increased significantly and at the examination 2013, the severe group accounted for this increase. More than 60% of the study population in 2013 had no periodontal pockets (PD) 6mm. The number of PD 4mm and 6mm were unaltered between 2003 and 2013 in all age groups, except for the 20-year old individuals. This group showed a statistically significant increase of 4mm PD.

    Conclusions: The periodontal health has improved in the population over the 40 years. The number of teeth increased significantly in the population, and in 2013, this increase occurred entirely in the severe group. Finally, there was a trend toward diminished prevalence of severe periodontitis.

  • 19.
    Zasčiurinskienė, Eglė
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Orthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Basevičienė, Nomeda
    Department of Dental and Oral Pathology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Slotte, Christer
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bjerklin, Krister
    Department of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Orthodontic treatment simultaneous to or after periodontal cause-related treatment in periodontitis susceptible patients. Part I: Clinical outcome. A randomized clinical trial2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 2, p. 213-224Article in journal (Refereed)
    Abstract [en]

    Aim: To compare two treatment strategies regarding the effect of orthodontic treatment on periodontal status in patients with plaque-induced periodontitis.

    Subjects and Methods: This was a randomized clinical trial. Fifty periodontal patients were randomly assigned to the test or control groups according to periodontal treatment timing. All patients received supra- and subgingival debridement following baseline examination. Control group patients received cause-related periodontal treatment before the start of orthodontic treatment and which was performed simultaneous to orthodontic treatment for the test group patients.

    Results: No difference between the test and control groups was found regarding change of clinical attachment level (CAL) after periodontal–orthodontic treatment. Fewer sites with initial pocket depth (PD) of 4–6 mm healed after periodontal–orthodontic treatment in the test group (20.5%, IQR = 11.9%) in comparison with controls (30.4%, IQR = 27.1%) (p =.03). Anterior teeth [OR 2.5] and teeth in male patients [OR 1.6] had a greater chance for PD improvement ≥2 mm. Total periodontal–orthodontic treatment duration was significantly longer for the control group (p <.01).

    Conclusions: Both groups showed a gain of CAL and a reduction in sites with PD ≥ 4 mm. Orthodontic treatment, simultaneously to the periodontal treatment, could be used in the routine treatment of patients with plaque-induced periodontitis.

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