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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Epidemiological studies in the sixties indicated that in patients older than 45 years periodontal disease was the major cause of tooth-loss, particularly in molars. However, improved prevention and enhanced dental awareness have now reduced both the incidence of periodontal disease and tooth-loss. Unfortunately, periodontal disease and tooth-loss still progress rapidly in a small group of patients. The currently used diagnostic parameters do not allow the early identification of this small group. Despite controlled periodontal treatment, loss of molars has remained twice as high as overall tooth loss. When all patients are divided into different perio-subgroups, molar loss tends to identify patients with a high periodontal risk. This conclusion can be drawn from the fact that furcation treatment is usually clinically successful, although calculus removal is insufficient. Early diagnosis of molar furcation involvement may help identify the small group of patients in which periodontitis may develop. The local morphological patterns may also contribute to rapid progression of the disease resulting eventually in loss of the molars. In such cases resective therapy is proposed instead of the usual open or closed scaling procedures.
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PMID:[Conventional surgical furcation therapy. Closed and open scaling]. 181 47

The reasons for extraction of teeth were determined in a Canadian population sample of 909 patients, ranging in age from 14 to 91 years. Caries was the primary cause of extraction (63%), followed by periodontitis (34%). For the adult age groups, the percentages were approximately the same. While periodontitis was the cause of one-third of the extractions, these occurred in only one-fifth of the population. Although there is a commonly expressed belief that periodontitis is the major cause of tooth loss in adults, a review of both historical and contemporary literature does not support this position. According to the current concept of the natural history of periodontal disease, only about one-fifth of the population, or less, is likely to have periodontitis severe enough to cause tooth loss. This view is consistent with data from this and most other studies on the reasons for tooth extraction.
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PMID:A study of the reasons for tooth extraction in a Canadian population sample. 186 89

Throughout the world the numbers of elderly are rapidly increasing. Survival to age 80 years and beyond is now commonplace in many industrialized nations. Of particular concern to the health professions is the previously unimagined growth in the population aged 80 years and over who are at increased risk of morbidity and disability. The rates of edentulism and tooth loss are rapidly declining with a consequent increase in the risk of developing periodontitis. Periodontal treatment and prophylaxis for the frail and the functionally dependent elderly involve a complete analysis of the physical and emotional status of the patient. The effects of chronic conditions, illnesses and medications on the ability of the older patient to accept treatment must be understood if periodontal care is to have a reasonable chance of success. In medically compromised patients and in patients who are unable to maintain oral hygiene, non-surgical periodontal therapy may be the best approach to treatment, although there are alternative routes to treatment as well as prevention. Periodontal diseases can be treated successfully in the aged and periodontal health can be sustained.
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PMID:Periodontal treatment and prophylaxis in the frail elderly. 191 79

Periodontitis, a common cause of tooth loss in adult populations, is an inflammatory response to the overgrowth of anaerobic organisms such as spirochetes and bacteroides and, in some cases, micro-aerophilic organisms in the subgingival plaque. In the present investigation, using a double-blind clinical design, we sought to determine whether 1 week of metronidazole treatment plus debridement of the tooth surfaces was superior to 1 week of placebo treatment plus debridement (positive control) in reducing the subsequent amount of periodontal surgery given to the patients. Thirty-nine patients were randomly assigned to either the metronidazole or placebo (positive control) groups. All patients were given the necessary scaling and root planing and were unsupervised in their usage of the medication. After the completion of this treatment, they were reexamined and it was found that the metronidazole regimen caused a significant reduction in surgical needs of about 5 teeth per patient compared to the positive control (difference before and after treatment 8.3 +/- 6.8 teeth metronidazole versus 2.9 +/- 4.8 positive control, P = 0.007). The difference between groups was maintained during the 2 to 3 years' recall period. Metronidazole had a significant effect on the site specific reduction of spirochetes: 90% of the sites in the metronidazole group versus 64% in the positive-control group had a decrease in the percentage of spirochetes (P less than 0.05). We conclude that systemic metronidazole given 250 mg tid for 7 days in conjunction with debridement of the tooth surfaces can significantly reduce the need for periodontal surgery compared to the standard regimen which included only debridement.
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PMID:Effects of metronidazole on periodontal treatment needs. 203 55

False assumptions have led to the widespread opinion that periodontitis of gingival origin is a ubiquitous disease and a common cause of tooth loss among ancient populations. Evaluation of dry skulls reveals that horizontal loss of crestal alveolar bone was unusual and of minor severity. Localized vertical bone defects of pulpal etiology were common and severe, often resulting in tooth mortality. The present paper identifies a number of factors that have contributed to the development of some important misconceptions about the nature of periodontal disease, its incidence, and its etiology.
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PMID:Periodontal defects of pulpal origin: evidence in early man. 219 77

Though gingivitis has a prevalence of close to 100 per cent in many populations, most forms of the 'disease' are self-limiting and reversible: tooth support and function are not compromised so the public health importance of the condition is questionable. Periodontitis occurs in a number of different clinical forms which may have quite different aetiological factors and--perhaps more importantly--host predispositions. Collectively, however, these diseases result in only a minority (approximately 5-20 per cent) of most populations which have been adequately surveyed having destructive periodontitis of a 'clinically significant' degree, i.e. with pockets over 6 mm, attachment loss over 4 mm or teeth requiring extraction because of their periodontal condition alone. Indeed, current evidence shows the reasons for tooth loss, though complex, to be primarily related to caries and its sequelae (both infective and iatrogenic). Indeed, in populations without access to dental health care services most people keep most of their teeth for most of their lives. Destructive periodontitis, therefore, is not the public health problem it was until recently assumed to be. Nevertheless, a prevalence of 5-20 per cent constitutes an endemic disorder of very significant proportion. The ability to identify such individuals in advance would be a major breakthrough, as would methods for detecting the intraoral sites of those individuals susceptible to breakdown, or undergoing a phase of active and destructive periodontitis. The former may be approached by genetic and general health screening, plus measurement of immune status to relevant microbial virulence factors; the latter by microbiological, biochemical and immunological screening of oral fluids--notably gingival crevicular fluid samples on a site specific basis.
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PMID:Detection of high-risk groups and individuals for periodontal diseases. 264 40

Of 219 elderly patients admitted consecutively to a geriatric hospital in Switzerland, 59.4% were edentulous. A high proportion of the dentate patients exhibited tooth loss patterns requiring free-end partial dentures in the maxilla (36.0%) or the mandible (69.7%). Of the remaining teeth, 29.3% were decayed, and 45.1% had severe periodontitis. Virtually all (97.8%) dentate and 31.5% of the edentulous subjects were judged to need some kind of dental treatment. In contrast, the subjective need for dental treatment was low in dentate (30.4%) and edentulous (13.1%) subjects. Prosthesis hygiene was poor in 73.8% of the 191 denture wearers whether they needed assistance with oral hygiene or not. The objectively-assessed need for a new prosthesis in edentulous patients was determined by income, marital status, and patient mobility, whereas the need for a prosthesis alteration was related to cognitive function. These findings should help to plan future dental prophylactic and therapeutic services in geriatric hospitals.
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PMID:Dental treatment needs in an elderly population referred to a geriatric hospital in Switzerland. 267 36

Records of 63 patients diagnosed as having moderate periodontitis who had been treated and maintained by scaling and root planing for 10 years or longer (mean 13.6 years, range 10 to 34 years) in dental school clinics were reviewed for tooth loss. The patients averaged 45 years of age (range 24 to 67 years) at the initial appointment, and 41 were female. Record audit determined type of periodontal treatment, total tooth loss, periodontally related tooth loss, loss of teeth with furcation invasion, plaque scores, and maintenance interval. Results of therapy were evaluated by groups on the basis of number of teeth lost. At the completion of active periodontal therapy 1,607 teeth were present in the patients. During the maintenance period, 115 teeth (7.1%) were lost and of these 88 (5.0%) were lost due to periodontal reasons. Maxillary and mandibular molar teeth, particularly maxillary second molars, were the teeth lost most frequently to periodontal disease. Of the 164 teeth initially indicated as having furcation invasion, 23% were subsequently lost. This retrospective study confirms the low rate of tooth mortality occurring when patients with periodontal disease are treated and kept on a maintenance program. Canines were the teeth least frequently lost.
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PMID:Tooth loss in patients with moderate periodontitis after treatment and long-term maintenance care. 267 3

Both demographic patterns and disease distribution are changing rapidly in the United States. These developments have led to the recognition that the epidemiology of many conditions is poorly understood, and that other research has thus been hindered. Four areas of epidemiological study were chosen for detailed analysis of how new technology will affect the conduct of future research. These areas, selected because information about them will be increasingly needed in an aging society, were periodontitis, temporomandibular disorders (TMD) and other orofacial pain, salivary gland disturbances, and health services research. The potential effect of new technology was examined in the short, intermediate, and long term. While the nature of epidemiological study is unlikely to change with the advent of new technology, the scope of potential studies will become broader. Advances in diagnostic techniques from elsewhere will permit far more precise diagnosis than is possible at present. Computer technology will permit an efficient system of epidemiological surveillance to provide current data on trends in tooth loss, caries, and periodontitis--data which will complement the results of national surveys. Analytical studies to produce hypotheses on the etiology of oral conditions, especially in such poorly-understood areas as chronic pain and TMD, will help direct clinical research in those areas.
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PMID:Advances in the epidemiological study of oral-facial diseases. 269 Aug 48

This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3-month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease.
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PMID:Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. 277 62


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