Aim
To evaluate pattern of change in periodontal variables and tooth loss in a twelve‐year follow‐up study of older adults living in Sweden.
Methods
In a prospective population study of older adults, ...a clinical examination and radiographic dental examination were performed at baseline (2001–2003) and after 12 years (2013–2015). In 375 individuals, the number and proportion of sites with a distance ≥4 mm and ≥5 mm from cemento‐enamel junction to the bone level, the number and proportion of teeth with pockets ≥5 mm and number of teeth lost were calculated. Dental caries was registered. Periodontitis was defined as having ≥2 sites with ≥5 mm distance from cemento‐enamel junction to the marginal bone level and ≥1 tooth with pockets ≥5 mm.
Results
A diagnosis of periodontitis was evident in 39% of the individuals, and 23% of the individuals lost ≥3 teeth over the study period. The proportion of sites with ≥4 mm and ≥5 mm bone loss increased with age, while the proportion of teeth with pockets remained stable. Periodontitis was the strongest predictor for losing ≥3 teeth, OR 2.9 (p < .001) in the final model.
Conclusions
Periodontitis is a risk factor for future tooth loss among older adults.
Renvert S, Polyzois I, Claffey N. How do implant surface characteristics influence peri‐implant disease? J Clin Periodontol 2011; 38 (Suppl. 11): 214–222. doi: 10.1111/j.1600‐051X.2010.01661.x.
...Objectives: To review the literature on how implant surface characteristics influence peri‐implant disease.
Material and Methods: A search of PubMed and The Cochrane Library of the Cochrane Collaboration (CENTRAL) as well as a hand search of articles were conducted. Publications and articles accepted for publication up to March 2010 were included.
Results: Thirteen studies were selected for the review. Human studies: To date, few studies have investigated if such differences occur. Limited data suggest that smooth surfaces may be less affected by peri‐implantitis than rough surface implants. Animal studies: In ligature‐induced peri‐implantitis studies, no difference between surfaces has been reported. In a spontaneous progression model of peri‐implantitis, there was a suggestion that the progression was more pronounced at implants with a porous anodized surface.
Conclusion: The current review revealed that only a few studies provided data on how implant surfaces influence peri‐implant disease. Based on the limited data available, there is no evidence that implant surface characteristics can have a significant effect on the initiation of peri‐implantitis.
Objectives: The aim of this study was to analyse the proportions of peri‐implant lesions at implants after 9–14 years of function.
Material and Methods: Two hundred and ninety‐four patients underwent ...implant therapy during the years 1988–1992 in Kristianstad County. These individuals were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 218 patients with 999 implants were examined clinically and radiographically.
Results: Forty‐eight per cent of the implants had probing depth 4 mm and bleeding on probing (peri‐implant mucositis). In 20.4% of the implants, the bone level was located 3.1 mm apical to the implant shoulder. Progressive bone loss (1.8 mm) during the observation period was found in 7.7% of the implants. Peri‐implantitis defined as bone loss 1.8 mm compared with 1‐year data (the apical border of the bony defect located at or apical to the third thread, i.e. a minimum of 3.1 mm apical to the implant shoulder), combined with bleeding on probing and or pus, were diagnosed among 16% of the patients and 6.6% of the implants.
Conclusion: After 10 years in use without systematic supportive treatment, peri‐implant lesions is a common clinical entity adjacent to titanium implants.
Objectives
Retrospectively, we assessed the likelihood that peri‐implantitis was associated with a history of systemic disease, periodontitis, and smoking habits.
Methods
Data on probing pocket depth ...(PPD), bleeding on probing (BOP), and radiographic bone levels were obtained from individuals with dental implants. Peri‐implantitis was defined as described by Sanz & Chapple 2012. Control individuals had healthy conditions or peri‐implant mucositis. Information on past history of periodontitis, systemic diseases, and on smoking habits was obtained.
Results
One hundred and seventy‐two individuals had peri‐implantitis (mean age: 68.2 years, SD ± 8.7), and 98 individuals (mean age: 44.7 years, SD ± 15.9) had implant health/peri‐implant mucositis. The mean difference in bone level at implants between groups was 3.5 mm (SE mean ± 0.4, 95% CI: 2.8, 4.3, P < 0.001). A history of cardiovascular disease was found in 27.3% of individuals with peri‐implantitis and in 3.0% of individuals in the implant health/peri‐implant mucositis group. When adjusting for age, smoking, and gender, odds ratio (OR) of having peri‐implantitis and a history of cardiovascular disease was 8.7 (95% CI: 1.9, 40.3 P < 0.006), and odds ratio of having a history of periodontitis was 4.5 (95% CI 2.1, 9.7, P < 0.001). Smoking or gender did not significantly contribute to the outcome.
Conclusions
In relation to a diagnosis of peri‐implantitis, a high likelihood of comorbidity was expressed by a history of periodontitis and a history of cardiovascular disease.
Objective
This study aims to evaluate the potential association between periodontitis, the number of teeth and cognitive functions in a cohort of older adults in Sweden.
Material and methods
In ...total, 775 individuals from 60 to 99 years of age were selected for the study. A clinical and radiographic examination was performed. The number of teeth and prevalence of periodontal pockets and bone loss was calculated and categorised. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and clock test. The education level was obtained from a questionnaire. Data were analysed using chi-square tests and multivariate logistic regression.
Results
Age and gender were associated with the prevalence of bone loss. Age and education were associated with lower number of teeth. Gender was also associated with the presence of pockets. The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of bone loss, the number of teeth and the outcome on MMSE test. This association remained even after adjustment for age, education and gender. Tooth loss was also associated with lower outcome on clock test. Presence of periodontal pockets ≥ 5 mm was not associated with cognitive test outcome.
Conclusions
A history of periodontitis and tooth loss may be of importance for cognitive functions among older adults.
Clinical relevance
Diseases with and inflammatory profile may have an impact on cognitive decline.
Within the next 40 years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health‐care providers and governments ...worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥ 80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio‐economic factors, general health status and multiple‐drug therapies will, in the future, be an important part of the management of periodontitis in older adults.
Objective
The present study assessed if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases, or at a higher risk of death for 17 years.
...Material and methods
At baseline individuals ≥ 60 received a dental examination including a panoramic radiograph. Periodontitis was defined as having ≥ 30% sites with ≥ 5-mm distance from the cementoenamel junction to the marginal bone level. Medical records were annually reviewed from 2001 to 2018. Findings from the medical records identifying an ICD-10 code of stroke and ischemic heart diseases or death were registered.
Results
Associations between periodontitis and incidence of ischemic heart disease were found in this 17-year follow-up study in all individuals 60–93 years (HR: 1.5, CI: 1.1–2.1,
p
= 0.017), in women (HR: 2.1, CI: 1.3–3.4,
p
= 0.002), and in individuals 78–96 years (HR: 1.7, CI: 1.0–2.6,
p
= 0.033). Periodontitis was associated with mortality in all individuals (HR: 1.4, CI: 1.2–1.8,
p
= 0.002), specifically in men (HR: 1.5, CI: 1.1–1.9,
p
= 0.006) or in ages 60–72 years (HR: 2.2, CI: 1.5–3.2,
p
= 0.000). Periodontitis was more prevalent among men (OR: 1.8, CI: 1.3–2.4,
p
= 0.000).
Conclusions
Individuals with periodontitis have an increased risk for future events of ischemic heart diseases and death.
Clinical relevance
Improving periodontal health in older individuals may reduce overall mortality and ischemic heart diseases. Both dental and medical professionals should be aware of the associations and ultimately cooperate.
Objectives: The aim of this review was to search the literature for the existing evidence of re‐osseointegration after treatment of peri‐implantitis at contaminated implant surfaces.
Material and ...Methods: A search of PubMed as well as additional hand search of articles were conducted. Publications and articles accepted for publication up to November 2008 were included.
Results: A total of 25 animal studies fulfilled the inclusion criteria for this review. Access surgery with closed healing has been observed to positively influence the rate of re‐osseointegration when compared with non‐surgical decontamination of the implant surface with open healing. Open debridement including surface decontamination may result in re‐osseointegration and this integration was more pronounced on rougher than on smooth implant surfaces. The adjunctive use of regenerative procedures resulted in varying amounts of re‐osseointegration.
Conclusions: Re‐osseointegration is possible to obtain on a previously contaminated implant surface and can occur in experimentally induced peri‐implantitis defects following therapy. The amount of re‐osseointegration, varied considerably within and between studies. Implant surface characteristics may influence the degree of re‐osseointegration. Surface decontamination alone can not achieve substantial re‐osseointegration on a previously contaminated implant surface. No method predictably accomplished complete resolution of the peri‐implant defect.
Objectives
To assess if (I) the alveolar bone defect configuration at dental implants diagnosed with peri-implantitis is related to clinical parameters at the time of surgical intervention and if ...(II) the outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment.
Materials and methods
In a prospective study, 45 individuals and 74 dental implants with ≥ 2 bone wall defects were treated with either an autogenous bone transplant or an exogenous bone augmentation material. Defect fill was assessed at 1 year.
Results
At baseline, no significant study group differences were identified. Most study implants (70.7%,
n
= 53) had been placed in the maxilla. Few implants were placed in molar regions. The mesial and distal crestal width at surgery was greater at 4-wall defects than at 2-wall defects (
p
= 0.001). Probing depths were also greater at 4-wall defects than at 2-wall defects (
p
= 0.01). Defect fill was correlated to initial defect depth (
p
< 0.001). Defect fill at 4-wall defects was significant (
p
< 0.05).
Conclusions
(I) The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration, (II) 4-wall defects demonstrated more defect fill, and (III) deeper defects resulted in more defect fill.
Objectives: To review the literature on non‐surgical treatment of peri‐implant mucositis and peri‐implantitis.
Material and Methods: A search of PubMed and The Cochrane Library of the Cochrane ...Collaboration (CENTRAL) as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included.
Results: Out of 437 studies retrieved a total of 24 studies were selected for the review. Thus the available evidence for non‐surgical treatment of peri‐implant mucositis and peri‐implantitis is scarce.
Conclusions: It was observed that mechanical non‐surgical therapy could be effective in the treatment of peri‐implant mucositis lesions. Furthermore, the adjunctive use of antimicrobial mouth rinses enhanced the outcome of mechanical therapy of such mucositis lesions. In peri‐implantitis lesions non‐surgical therapy was not found to be effective. Adjunctive chlorhexidine application had only limited effects on clinical and microbiological parameters. However, adjunctive local or systemic antibiotics were shown to reduce bleeding on probing and probing depths. Minor beneficial effects of laser therapy on peri‐implantitis have been shown; this approach needs to be further evaluated. There is a need for randomized‐controlled studies evaluating treatment models of non‐surgical therapy of peri‐implant mucositis and peri‐implantitis.
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