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  • 1.
    Adel-Khattab, Doaa
    et al.
    Ain Shams University, EGY.
    Montero, Eduardo
    University Complutense of Madrid, ESP.
    Herrera, David
    University Complutense of Madrid, ESP.
    Zhao, Dan
    University of Hong Kong, HKG.
    Jin, Lijian
    University of Hong Kong, HKG.
    Al-Shaikh, Zahra
    University of Giessen, DEU.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Kristianstad University, SWE.
    Meyle, Joerg
    University of Giessen, DEU.
    Evaluation of the FDI Chairside Guide for Assessment of Periodontal Conditions: A Multicentre Observational Study2021In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 71, no 5, p. 390-398Article in journal (Refereed)
    Abstract [en]

    Objective: There is a need to develop easy-to-use tools to screen periodontal condition in daily practice. This study aimed to evaluate the FDI World Dental Federation “Chairside Guide” (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening. Methods: Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis. Results: Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001). Conclusion: The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice. © 2020 The Authors

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  • 2.
    Ademovski, S. Erovic
    et al.
    Kristianstad Univ, Sect Hlth & Soc, S-29188 Kristianstad, Sweden..
    Lingstrom, P.
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Cariol, Gothenburg, Sweden..
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    The effect of different mouth rinse products on intra-oral halitosis2016In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 14, no 2, p. 117-123Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the effect of different mouth rinses 12 h after rinsing on genuine intra-oral halitosis. Materials and Methods: Twenty-four adults with halitosis were included in a double-blind, crossover, randomized clinical trial. Halitosis was evaluated 12 h after rinsing with placebo and five mouth rinse products containing zinc acetate and chlorhexidine diacetate; zinc lactate, chlorhexidine and cetylpyridinium chloride; zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol; zinc chloride and essential oil; and chlorine dioxide using the organoleptic method and a gas chromatograph. Test periods were separated by 1 week. Results: Hydrogen sulphide (H2S), methyl mercaptan (MM) and the organoleptic scores (OLS) were significantly reduced 12 h following rinsing with all substances compared to placebo (P < 0.05). H2S was more effectively reduced after rinsing with zinc acetate and chlorhexidine diacetate and zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol compared to rinsing with zinc chloride and essential oil (P < 0.05), and significantly lower values of MM were obtained after rinsing with zinc acetate and chlorhexidine diacetate compared to zinc lactate, chlorhexidine and cetylpyridinium chloride (P < 0.05). The percentage effectively treated individuals (H2S (<112 ppb), MM (<26 ppb) and OLS score <2) varied from 58% percentage (zinc acetate and chlorhexidine diacetate) to 26% (zinc chloride and essential oil). Conclusion: All treatments resulted in reduction in halitosis 12 h after rinsing compared to placebo. H2S and MM were most effectively reduced by zinc acetate and chlorhexidine diacetate.

  • 3. Ademovski, Seida Erovic
    et al.
    Lingström, Peter
    Winkel, Edwin
    Tangerman, Albert
    Persson, Rutger
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    Comparison of different treatment modalities for oral halitosis2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 3, p. 224-233Article in journal (Refereed)
    Abstract [en]

    Objectives. To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping. Materials and methods. Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography. Results. Twenty-one subjects with a mean age of 45.7 years (SD: +/- 13.3, range: 21-66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H2S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H2S and MM were found in the active rinse sequence with or without tongue scraping. Conclusion. The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.

  • 4.
    Ademovski, Seida Erovic
    et al.
    Kristianstad Univ, Sch Hlth & Soc, S-29188 Kristianstad, Sweden..
    Martensson, Carina
    Kristianstad Univ, Sch Hlth & Soc, S-29188 Kristianstad, Sweden..
    Persson, G. Rutger
    Kristianstad Univ, Sch Hlth & Soc, S-29188 Kristianstad, Sweden.;Univ Washington, Sch Dent, Dept Periodont, Seattle, WA 98195 USA..
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    The effect of periodontal therapy on intra-oral halitosis: a case series2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 5, p. 445-452Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.

  • 5. Ademovski, Seida
    et al.
    Persson, Gösta Rutger
    Winkel, Edwin
    Tangerman, Albert
    Lingström, Peter
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients-a randomized clinical trial2013In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 17, no 2, p. 463-473Article in journal (Refereed)
    Abstract [en]

    This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue. Material and methods: A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization. Results: No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone. Conclusions: VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied. Clinical relevance: Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

  • 6.
    Aeddula, Omsri
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Flyborg, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Larsson, Tobias
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Kristianstad University, SWE.
    A Solution with Bluetooth Low Energy Technology to Support Oral Healthcare Decisions for improving Oral Hygiene2021In: ACM International Conference Proceeding Series, Association for Computing Machinery (ACM), 2021, Vol. 1, p. 134-139Conference paper (Refereed)
    Abstract [en]

    The advent of powered toothbrushes and associated mobile health applications provides an opportunity to collect and monitor the data, however collecting reliable and standardized data from large populations has been associated with efforts from the participants and researchers. Finding a way to collect data autonomously and without the need for cooperation imparts the potential to build large knowledge banks. A solution with Bluetooth low energy technology is designed to pair a powered toothbrush with a single-core processor to collect raw data in a real-time scenario, eliminating the manual transfer of powered toothbrush data with mobile health applications. Associating powered toothbrush with a single-core processor is believed to provide reliable and comprehensible data of toothbrush use and propensities can be a guide to improve individual exhortation and general plans on oral hygiene quantifies that can prompt improved oral wellbeing. The method makes a case for an expanded chance to plan assistant capacities to protect or improve factors that influence oral wellbeing in individuals with mild cognitive impairment. The proposed framework assists with determining various parameters, which makes it adaptable and conceivable to execute in various oral care contexts 

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    ICMHI-OKA
  • 7. Aghazadeh, Ahmad
    et al.
    Persson, G. Rutger
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    A single-centre randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft: results after 12 months2012In: Journal of Clinical Periodontology, ISSN 0303-6979, Vol. 39, no 7, p. 666-673Article in journal (Refereed)
    Abstract [en]

    Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis. Material and Methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine-derived xenograft (BDX) and with placement of a collagen membrane. The primary outcome was evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results Twenty-two subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003) and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD = 5.0 mm, no pus, no bone loss and BOP at 1/4 or less sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95% CI: 1.010.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than AB. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.

  • 8.
    Aghazadeh, Ahmad
    et al.
    Tand & Implantat Specialistkliniken, SWE.
    Persson, G. Rutger
    Kristianstad University, SWE.
    Stavropoulos, Andreas
    Malmo University, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Reconstructive treatment of peri-implant defects - Results after three and five years2022In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 33, no 11, p. 1114-1124Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to assess the long-term efficacy of reconstructive treatment of peri-implantitis intraosseous defects. Material and Methods Peri-implant intraosseous defects were augmented using either an autogenous bone graft (AB) or a bovine-derived xenograft (BDX) in combination with a collagen membrane. Maintenance was provided every third month. Results In the AB group, 16 patients with 25 implants remained at year five. In the BDX group, 23 patients with 38 implants remained. Between baseline and year 5, bleeding on probing (BOP) and probing pocket depth (PPD) scores were reduced in both groups (p < .001). In the AB and BDX groups, mean PPD between baseline and year five was reduced by 1.7 and 2.8 mm, respectively. The difference between groups was significant (p < .001). In the AB group, the mean bone level change at implant level between baseline and years three and five was-0,2 and -0.7 mm, respectively. In the BDX group, the mean bone level change at implant level between baseline and years three and five was 1.6 and 1.6 mm, respectively. The difference between the groups was significant (p < .001). Successful treatment (no bone loss, no probing pocket depth (PPD) > 5 mm, no suppuration, maximum one implant surface with bleeding on probing (BOP) at year five) was obtained in 9/25 implants (36%) in the AB group and in 29/37 implants (78.3%) in the BDX group. Conclusions Reconstructive surgical treatment of peri-implant defects using BDX resulted in more predictable outcomes than using autogenous bone over 5 years.

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  • 9.
    Aghazadeh, Ahmad
    et al.
    Tand & Implantat Specialistkliniken, SWE.
    Persson, Rutger G.
    Kristianstad Univ, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis2020In: International Journal of Implant Dentistry, E-ISSN 2198-4034, Vol. 6, no 1, article id 33Article in journal (Refereed)
    Abstract [en]

    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.

  • 10.
    Alotaibi, Mohammad
    et al.
    Trinity College Dublin, IRE.
    Moran, Gary
    Dublin Dental University Hospital, IRE.
    Grufferty, Brendan
    Trinity College Dublin, IRE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Polyzois, Ioannis
    Trinity College Dublin, IRE.
    The effect of a decontamination protocol on contaminated titanium dental implant surfaces with different surface topography in edentulous patients2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 66-75Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate if it is possible to achieve complete decontamination of dental implant surfaces with different surface characteristics. Materials and methods: Twelve implant pieces with an Osseotite® surface and 12 implant pieces with a Ti-Unite® surface were attached on to the complete lower dentures of six patients and were allowed to accumulate plaque for 30 days. When retrieved, the implant decontamination protocol used, involved both mechanical (PeriBrush™) and chemical (3% H2O2) decontamination. The number of colony forming units per millilitre was determined and the dominant micro-organisms in selected samples was identified by 16s rRNA gene amplicon sequencing. The effect of the titanium brush on the implant surface was examined by SEM. Results: Complete decontamination was achieved in five out of 24 implants (four Osseotite® and one Ti-Unite®). The mean CFU/ml detected after decontamination were 464.48 for Osseotite® and 729.09 for Ti-Unite® implants. On the surface of the implants in which complete decontamination was not achieved, all of the predominant bacteria identified were streptococci except for one which was identified as micrococcus. SEM images revealed that the surface features of the decontaminated implants were not significantly altered. Conclusions: Mechanical decontamination using a titanium brush supplemented with chemical treatment for one minute (3% H2O2) can achieve complete decontamination of implant surfaces in edentulous patients. © 2018, © 2018 Acta Odontologica Scandinavica Society.

  • 11.
    Andersson, P.
    et al.
    Kristianstad Univ, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sjogren, P.
    Oral Care AB, SWE.
    Zimmerman, M.
    Oral Care AB, SWE.
    Dental status in nursing home residents with domiciliary dental care in Sweden2017In: Community Dental Health, ISSN 0265-539X, Vol. 34, no 4, p. 203-207Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the dental health status of elderly people in nursing homes receiving domiciliary dental care. Design: Case note review. Clinical setting: Nursing homes in 8 Swedish counties. Participants: Care dependent elderly people (>= 65 years). Methods: Clinical data, including the number of remaining natural teeth, missing and decayed teeth (manifest dental caries) and root remnants, recorded by dentists according to standard practices. Medical and dental risk assessments were performed. Results: Data were available for 20,664 patients. Most were women (69.1%), with a mean age of 87.1 years (SD 7.42, range 65-109). The mean age for men was 83.5 years (SD 8.12, range 65-105). Two or more medical conditions were present in most of the population. A total of 16,210 individuals had existing teeth of whom 10,974 (67.7%) had manifest caries. The mean number of teeth with caries was 5.0 (SD 5.93) corresponding to 22.8% of existing teeth. One in four individuals were considered to have a very high risk in at least one professional dental risk assessment category. Conclusions: Care dependent elderly in nursing homes have very poor oral health. There is a need to focus on the oral health-related quality of life for this group of frail elderly during their final period of life.

  • 12.
    Bengtsson, Viveca Wallin
    et al.
    Univ Kristianstad, SE-29188 Kristianstad, Sweden..
    Persson, G. Rutger
    Univ Kristianstad, SE-29188 Kristianstad, Sweden.;Univ Washington, Dept Periodont, Seattle, WA 98195 USA.;Univ Washington, Dept Oral Med, Seattle, WA 98195 USA..
    Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Blekinge Inst Technol, Sch Hlth Sci, Karlskrona, Sweden..
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    A cross-sectional study of the associations between periodontitis and carotid arterial calcifications in an elderly population2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, p. 115-120Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate if the presence of periodontitis is associated with carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population. Materials and methods. Study individuals were randomly selected from the Swedish civil registration database representing the aging population (60-96 years) in Karlskrona, Sweden. Bleeding on probing (BOP) and the deepest probing measurement at each tooth were registered. The proportions of teeth with a probing depth 5 mm and the proportion of teeth with bleeding on probing were calculated. Analog panoramic radiographs were taken and the proportion of sites with a distance 5 mm between the alveolar bone level and the cement-enamel junction (CEJ) were assessed. A diagnosis of periodontitis was declared if a distance between the alveolar bone level and the CEJ 5 mm could be identified from the panoramic radiographs at >10% of sites, probing depth of 5 mm at one tooth or more and with BOP at >20% of teeth. Results. Readable radiographs were obtained from 499 individuals. Carotid calcification was identified in 39.1%. Individuals were diagnosed with periodontitis in 18.4%. Data analysis demonstrated that individuals with periodontitis had a higher prevalence of carotid calcifications (Pearson (2) = 4.05 p < 0.05) and with a likelihood of 1.5 (95% CI = 1.0, 2.3, p < 0.05). Conclusions. Data analysis demonstrated a significant association between periodontitis and carotid calcification.

  • 13.
    Bengtsson, Viveca Wallin
    et al.
    University of Kristianstad, SWE.
    Persson, Gösta Rutger
    University of Kristianstad, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. Lund University, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health. University of Kristianstad, SWE, Dublin Dental Hospital Trinity College, IRL, The University of Hong Kong, HKG.
    Periodontitis related to cardiovascular events and mortality: a long-time longitudinal study2021In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 25, no 6, p. 4085-4095Article in journal (Refereed)
    Abstract [en]

    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. © 2021, The Author(s).

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  • 14. Bengtsson, VW
    et al.
    Persson, Rutger
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Assessment of carotid calcifications on panoramic radiographs in relation to other used methods and relationship to periodontitis and stroke: a literature review2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 6, p. 401-412Article, review/survey (Refereed)
    Abstract [en]

    Objectives. To assess the literature on carotid calcifications defined from panoramic radiographs (PMX) and concurrent diagnosis of stroke and periodontitis. Materials and methods. A literature search screening for publications using search terms such as PMX and carotid calcification, stroke and periodontitis was performed in November 2012. Results. A total of 189 articles were retrieved, among which 30 were included in the review. The sensitivity for PMX findings of carotid calcifications (CC) compared to a diagnosis by Doppler sonography varied between 31.1-100%. The specificity for PMX findings of carotid calcifications compared to a diagnosis by Doppler sonography varied between 21.4-87.5%. Individuals with CC findings from PMX have more periodontitis and risk for stroke. Conclusions. There is a shortage of well-designed studies in older dentate individuals assessing the associations between periodontitis and radiographic evidence of CC and in relation to stroke or other cardiovascular diseases.

  • 15. Berglund, Johan
    et al.
    Persson, Rutger
    Renvert, Stefan
    Persson, Rigmor
    Osteoporosis and peridontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge)2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 4, p. 201-207Article, review/survey (Refereed)
    Abstract [en]

    Abstract Objective. We assessed the relationships between (I) ultrasonography calcaneus T-scores (PIXI) and mandibular cortex characteristics on oral panoramic radiographs in older subjects; and (II) osteoporosis and periodontitis. Material and methods. We examined 778 subjects (53% women) aged 59-96 years. Periodontitis was defined by alveolar bone loss assessed from panoramic radiographs. Results. PIXI calcaneus T-values ≤-2.5 (osteoporosis) were found in 16.3% of women and in 8.1% of men. PIXI calcaneus T-values <-1.6 (osteoporosis, adjusted) were found in 34.2% of women and in 21.4% of men. The age of the subjects and PIXI T-values were significantly correlated in women (Pearson's r = 0.37, P < 0.001) and men (Pearson's r = 0.19, P < 0.001). Periodontitis was found in 18.7% of subjects defined by alveolar bone level ≥5 mm. Subjects with osteoporosis defined by adjusted PIXI T-values had fewer remaining teeth [mean difference 4.1, 95% confidence interval (CI) -1.1 to -6.5, P < 0.001]. The crude odds ratio (OR) of an association between the panoramic assessment of mandibular cortex erosions as a sign of osteoporosis and the adjusted T-value (T-value cut-off <-1.6) was 4.8 (95% CI 3.1-7.2, P < 0.001; Pearson χ(2) = 60.1, P < 0.001). A significant OR between osteoporosis and periodontitis was only found in women for the T-value cut-off ≤-2.5 (crude OR 1.8, 95% CI 1.1-3.3, P < 0.03). Conclusions. An association between osteoporosis and periodontitis was only confirmed in women. The likelihood that the mandibular cortex index agrees with adjusted PIXI T-values is significant.

  • 16.
    Criten, Sladjana
    et al.
    Kristianstad University, SWE.
    Andersson, Pia
    Kristianstad University, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Goetrick, Bengt
    Malmo University, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Bengtsson, Viveca Wallin
    Kristianstad University, SWE.
    Oral health status among 60-year-old individuals born in 1941-1943 and 1954-1955 and 81-year-old individuals born in 1922-1924 and 1933-1934, respectively: a cross-sectional study2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, no 11, p. 6733-6742Article in journal (Refereed)
    Abstract [en]

    Objective This study aimed to analyze the oral health status of four different birth cohorts: two cohorts of 60-year-olds born in 1941-1943 and 1954-1955 and 2 cohorts of 81-year-olds born in 1920-1922 and 1933-1934. Material and methods The study was based on data from an ongoing longitudinal population project, The Swedish National Study on Aging and Care (SNAC). Oral health status was repeatedly examined clinically and radiographically in 2001-2003 and 2014-2015, including 60- and 81-year-olds, in total 412 individuals. Statistical analyses were performed using independent-samples t test and Pearson's chi(2) test. Results More individuals were dentate in 2014-2015 compared to 2001-2003 in the two age groups: 60 and 81 years (p < 0.001 for both). The mean number of teeth increased in the 60-year-olds from 24.2 to 27.0 and in the 81-year-olds from 14.3 to 20.2. The numbers of at least one intact tooth increased for both age groups (p < 0.001 and p < 0.004, respectively). In the age groups 81 years, there was an increase in having at least one PPD >= 6 mm (p < 0.016) and bone loss >= 5 mm (p < 0.029) between the two examinations. No such differences were found in the age groups of 60 years. Conclusion Over 13 years, oral health improved for both 60- and 81-year-old age groups. The most significant changes were in the 81-year-olds where oral health had improved except for periodontal status.

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  • 17.
    Dalago, Haline Renata
    et al.
    Fed Univ Santa Catarina UFSC, BRA.
    Schuldt Filho, Guenther
    Fed Univ Santa Catarina UFSC, BRA.
    Rodrigues, Monica Abreu
    Paulista Univ UNIP, BRA.
    Renvert, Sterfan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Bianchini, Marco Aurelio
    Fed Univ Santa Catarina UFSC, BRA.
    Risk indicators for Peri-implantitis: A cross-sectional study with 916 implants2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 2, p. 144-150Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to identify systemic and local risk indicators associated with peri-implantitis. Material and methods: One hundred eighty-three patients treated with 916 osseointegrated titanium implants, in function for at least 1 year, were included in the present study. The implants were installed at the Foundation for Scientific and Technological Development of Dentistry (FUNDECTO) - University of Sao Paulo (USP) - from 1998 to 2012. Factors related to patient’s systemic conditions (heart disorders, hypertension, smoking habits, alcoholism, liver disorders, hepatitis, gastrointestinal disease, diabetes mellitus I and II, hyperthyroidism or hypothyroidism, radiation therapy, chemotherapy, menopause, osteoporosis, active periodontal disease, history of periodontal disease and bruxism), implant’s characteristics (location, diameter, length, connection, shape, and antagonist), and clinical parameters (wear facets, periodontal status on the adjacent tooth, plaque accumulation on the adjacent tooth, modified plaque index, sulcus bleeding index, probing depth, bleeding on probing, width of keratinized tissue and marginal recession). Results: An increased risk of 2.2 times for history of periodontal disease (PD), 3.6 times for cemented restorations compared to screw-retained prostheses, 2.4 times when wear facets were displayed on the prosthetic crown and 16.1 times for total rehabilitations when compared to single rehabilitations were found. Logistic regression analysis did not show any association between the implant’s characteristics and peri-implantitis. Conclusions: A history of periodontal disease, cemented prostheses, presences of wear facets on the prosthetic crown and full mouth rehabilitations were identified as risk indicators for peri-implantitis. Implants’ characteristics were not related to the presence of peri-implantitis. © 2016 John Wiley & Sons A/S.

  • 18.
    Erovic Ademovski, Seida
    et al.
    Högskolan Kristianstad, SWE.
    Mårtensson, Carina
    Högskolan Kristianstad, SWE.
    Persson, Gösta Rutger
    Högskolan Kristianstad, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis: A randomized clinical trial2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no 10, p. 1010-1019Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. Materials and methods: Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H2S) and methyl mercaptan (MM) concentrations in exhaled air. Results: A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p &lt;.01, respectively), H2S (p &lt;.001), and MM (p &lt;.01) in subjects’ exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H2S &lt; 112 ppb), compared to 43% in the placebo group. Conclusion: Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

  • 19. Figuero, Elena
    et al.
    Lindahl, Christel
    Marin, MJ
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Herrera, David
    Ohlsson, Ola
    Wetterling, Thomas
    Sanz, Mariano
    Quantification of Periodontal Pathogens in Vascular, Blood, and Subgingival Samples From Patients With Peripheral Arterial Disease or Abdominal Aortic Aneurysms2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 9, p. 1182-1193Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this investigation is to quantify periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, and Tannerella forsythia) in vascular, blood, and subgingival samples. As a secondary objective, two molecular bacterial identification methods (nested polymerase chain reaction [PCR] and quantitative PCR [qPCR]) are compared. Methods: Seventy consecutive patients provided a vascular lesion, a blood sample, and 36 subgingival samples. Bacterial DNA was extracted, and qPCR was used to determine the prevalence and amounts of the target pathogens in each sample. Nested PCR was performed only in the samples from vascular lesions. Periodontal examination was performed in 42 patients. Mann-Whitney U or x(2) tests were used to compare microbiologic results according to periodontal diagnosis. Results: All targeted periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia, or C. rectus) were detected in subgingival samples, with a prevalence rate of 72.2%, 47.2%, 74.3%, and 82.9%, respectively. In 7.1% and 11.4% of vascular and blood samples, bacterial DNA was detected. One patient was positive for A. actinomycetemcomitans in the three types of samples. No differences were found in the levels of targeted bacteria when comparing patients with and without periodontitis. Prevalence rates obtained with nested PCR were significantly higher than those obtained with qPCR. Conclusions: The presence of A. actinomycetemcomitans was demonstrated in vascular, blood, and subgingival samples in one of 36 patients. These results, although with a very low frequency, may support the hypothesis of a translocation of periodontal pathogens from subgingival microbiota to the bloodstream and then to atheromatous plaques in carotid or other peripheral arteries. Nested PCR is not an adequate method for identifying DNA of periodontal pathogens in low quantities because of the high number of false-negative results.

  • 20.
    Flyborg, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    The use of the intelligent powered toothbrush in health technology2022Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    BackgroundApplied health technology is a research field that ties together several disciplines to improve and preserve the health and quality of life of individuals and society. Helping especially elderly to meet the above goals is an important and necessary task and assistive technology and collection of health data are part of this work.

    AimsPaper I aims to investigate whether the use of a powered toothbrush could maintain oral health in a group of individuals with MCI and if changes in oral health affect various aspects of quality of life. Paper II and III aims to examine the capacity of a powered toothbrush as a carrier and mediator of health-related data.

    MethodsFor papers I and II, the participants were recruited from the Swedish site of the multicenter project Support Monitoring And Reminder Technology for Mild Dementia and for paper III from the Department of Health at Blekinge Institute of Technology. In all three papers, a powered toothbrush has been used as a tool, sensor carrier and transmitter of data. For Quality-of-life assessment two instruments are used, The QoL-AD and OHIP 14.

    ResultsBy introducing an intelligent powered toothbrush in the group of older individuals with mild cognitive impairment we have showed that they, regardless of cognitive level,improved their scores for plaque index, bleeding index and deepened periodontal pockets ≥ 4mm, over 12 months. The quality-of-life instrument related to oral health improved in parallel with the improvement in oral health. Furthermore, it is possible to use the intelligent powered toothbrush both as a carrier for healt related sensors and to transfer user data via Bluetooth technology to a single-core processor that stores or forwards the data via Wifi to an external computer for processing, analysis and storage. A fesibility study regarding temperature sensor for measuring body temperature during toothbrushing have been evaluated and found to be comparable to traditional oral temperature measurement.

     

    ConclusionsAn intelligent powered toothbrush is a well-functioning tool for maintaining oral health in older people with mild cognitive impairment as well as for collecting and transferring brush and health data to external units for storage and analysis. 

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  • 21.
    Flyborg, Johan
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Isaksson, Ulrika
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Measurement of body temperature in the oral cavity with a temperature sensor integrated with a powered toothbrush2023In: SN Applied Sciences, ISSN 2523-3963, E-ISSN 2523-3971, Vol. 5, no 1, article id 22Article in journal (Refereed)
    Abstract [en]

    This paper presents a method for collecting core body temperature data via a temperature sensor integrated into a powered toothbrush. The purpose is to facilitate the collection of temperature data without any extended effort from the user. Twelve participants use a powered toothbrush with a temperature sensor mounted on the brush head twice daily for two months. The obtained values are compared with those from a conventional fever thermometer approved for intraoral use. The results show that the temperature sensor–integrated powered toothbrush can measure the core body temperature and provide values comparable to those provided by a traditional oral thermometer. The use of the device can facilitate disease monitoring, fertility control, and security solutions for the elderly. © 2022, The Author(s).

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  • 22.
    Flyborg, Johan
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Larsson, Tobias
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health2024In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, no 1, article id 8Article in journal (Refereed)
    Abstract [en]

    Objectives: The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants’ self-estimated brush use. Materials and methods: Objective brush usage data was extracted from the participants’ powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants’ self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination. Results: Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC. Conclusions: Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use. Clinical relevance: Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment. Trial registration: ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023. © 2023, The Author(s).

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  • 23.
    Flyborg, Johan
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Use of a powered toothbrush to improve oral health in individuals with mild cognitive impairment2023In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 40, no 1, p. 74-82Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of the study is to investigate whether the use of a powered toothbrush could maintain oral health by reducing the dental plaque (PI), bleeding on probing (BOP), and periodontal pocket depth (PPD) ≥4 mm in a group of individuals with MCI and also if changes in oral health affect various aspects of quality of life.

    Background

    People with cognitive impairment tend to have poor oral hygiene and poorer Quality of life. In the present study, the participants were asked to use a powered toothbrush for at least 2 min morning and evening and no restrictions were given against the use of other oral care products. The participant survey conducted at each examination demonstrated that 61.2% of participants at baseline claimed to have experience of using a powered toothbrush, 95.4% at 6 months and 95% after 12 months. At the same time, the use of manual toothbrushes dropped from 73.3% to 44.7% from baseline to the 12-month check-up. This shows that several participants continue to use the manual toothbrush in parallel with the powered toothbrush, but that there is a shift towards increased use of the powered toothbrush. Removal of dental biofilm is essential for maintaining good oral health. We investigated whether using a powered toothbrush reduces the presence of dental plaque, bleeding on probing and periodontal pockets ≥4 mm in a group of older individuals with mild cognitive impairment.

    Materials and methods

    Two hundred and thirteen individuals with the mean age of 75.3 years living without official home care and with a Mini-Mental State Examination (MMSE) score between 20 and 28 and a history of memory problems in the previous six months were recruited from the Swedish site of a multicenter project, Support Monitoring And Reminder Technology for Mild Dementia (SMART4MD) and screened for the study. The individuals received a powered toothbrush and thorough instructions on how to use it. Clinical oral examinations and MMSE tests were conducted at baseline, 6 and 12 months.

    Results

    One hundred seventy participants, 36.5% women and 63.5% men, completed a 12-month follow-up. The use of a powered toothbrush resulted, for the entire group, in a significant decrease in plaque index from 41% at baseline to 31.5% after 12 months (P < .000). Within the same time frame, the values for bleeding on probing changed from 15.1% to 9.9% (P < .000) and the percentage of probing pocket depths ≥4 mm from 11.5% to 8.2% (P < .004). The observed improvements in the Oral Health Impact Profile 14 correlate with the clinical improvements of oral health.

    Conclusion

    The use of a powered toothbrush was associated with a reduction of PI, BOP and PPD over 12 months even among individuals with low or declining MMSE score. An adequately used powered toothbrush maintain factors that affect oral health and oral health-related Quality of Life in people with mild cognitive impairment.

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  • 24.
    Furundzic, Kristina
    et al.
    Skane Cty Publ Dent Serv, SWE.
    Malmberg, Joy
    Malmo Univ, SWE.
    Sandström, Boel
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Ericson, Dan
    Malmo Univ,SWE.
    Why Do Adolescents Use Fluoride Toothpaste?: A Qualitative Interview Investigation2020In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 18, no 3, p. 441-446Article in journal (Refereed)
    Abstract [en]

    Purpose: Fluoride toothpastes are effective in caries prevention. In legislation, regular fluoride toothpaste is a cosmetic product; adolescents use it for aesthetic purposes. In dentistry, fluoride toothpaste is considered a caries preventive drug recommended to patients for that reason. Knowledge is lacking concerning what motivates adolescents to use fluoride toothpaste. Dental professionals need to understand how to motivate a risk-group for caries development to use fluoride toothpaste frequently in order to effectively motivate patients to prevent tooth decay. The purpose of this study was to investigate what motivates adolescents to use fluoride toothpaste. Materials and Methods: The study was conducted at a high school in southern Sweden. The final sample consisted of 16 adolescents age 16 to 19. This study employed a qualitative design using semi-structured interviews. The data were analysed using manifest content analysis with an occasional inductive approach. Results: Reasons for why adolescents use fluoride toothpaste were found in four different categories: oral health, economy, upbringing and habit, social influences. Conclusion: There are reasons to believe that dental professionals might have missed important arguments for why adolescents use fluoride toothpaste. The participants mentioned oral health and aesthetics as important reasons for using fluoride toothpaste, as well as other more surprising factors such as financial reasons and social environment. There are thus more arguments for using fluoride toothpaste that adolescents value than the ones we believe dental professionals use.

  • 25.
    Gkikas, Georgios
    et al.
    Dublin Dent Univ Hosp, IRL.
    McLaughlin, Mark
    Dublin Dent Univ Hosp, IRL.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Polyzois, Ioannis
    Dublin Dent Univ Hosp, IRL.
    A Prospective Study Comparing the Effect of L-PRF and Porous Titanium Granules on the Preservation of the Buccal Bone Plate Following Immediate Implant Placement2020In: The international journal of periodontics & restorative dentistry, ISSN 0198-7569, E-ISSN 1945-3388, Vol. 40, no 5, p. 767-774Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the effect of an autogenous blood concentrate (L-PRF) with the effect of white porous titanium granules (WPTG) on buccal bone remodeling. These materials were used to graft the void between the implant and the buccal bone following immediate implant placement. Clinical measurements were made at two time points, and the mean buccal bone horizontal dimension at placement was 2.94 +/- 0.59 mm for L-PRF and 3.49 +/- 0.99 mm for WPTG. At reentry, the values were 1.19 +/- 0.90 mm and 2.12 +/- 0.87 mm, respectively. Overall, there was no difference observed in the performance of the two materials regarding buccal bone resorption.

  • 26. Hallström, H.
    et al.
    Lindgren, S.
    Widén, C.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Twetman, S.
    Probiotic supplements and debridement of peri-implant mucositis: A randomized controlled trial2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 1, p. 60-66Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis. Materials and methods. Forty-nine adult patients with peri-implant mucositis were consecutively recruited after informed consent. After initial mechanical debridement and oral hygiene instructions, the patients received a topical oil application (active or placebo) followed by twice-daily intake of lozenges (active or placebo) for 3 months. The active products contained a mix of two strains of Lactobacillus reuteri. Patients were clinically monitored and sampled at baseline and after 1, 2, 4, 12 and 26 weeks. The clinical end-points were pocket-probing depth (PPD), plaque index (PI) and bleeding on probing (BOP). In addition, the subgingival microbiota was processed with checkerboard DNA-DNA hybridization and samples of gingival crevicular fluid (GCF) were analyzed for selected cytokines with the aid of multiplex immunoassays. Results. After 4 and 12 weeks, all clinical parameters were improved in both the test and the placebo group. PPD and BOP were significantly reduced compared with baseline (p < 0.05), but no significant differences were displayed between the groups. The clinical improvements persisted 3 months after the intervention. No major alterations of the subgingival microflora were disclosed and the levels of inflammatory mediators in GCF did not differ between the groups. Conclusions. Mechanical debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo. © 2015 Informa Healthcare.

  • 27. Hallström, Hadar
    et al.
    Persson, G. Rutger
    Stromberg, Ulf
    Twetman, Svante
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Reproducibility of subgingival bacterial samples from patients with peri-implant mucositis2015In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, no 5, p. 1063-1068Article in journal (Refereed)
    Abstract [en]

    Objective The aim of the present study was to investigate the reproducibility of bacterial enumeration from subsequent subgingival samples collected from patients with peri-implant mucositis. Material and methods Duplicate microbial samples from 222 unique implant sites in 45 adult subjects were collected with paper points and analyzed using the checkerboard DNA-DNA hybridization technique. Whole genomic probes of 74 preselected bacterial species were used. Based on the bacterial scores, Cohen's kappa coefficient was used to calculate the inter-annotator agreement for categorical data. The percentage agreement was considered as "good" when the two samples showed the same score or differed by 1 to the power of 10. Results Moderate to fair kappa values were displayed for all bacterial species in the test panel (range 0.21-0.58). There were no significant differences between Gram-positive and Gram-negative species. The percentage of good agreement between the first and second samples averaged 74.7 % (n=74; range 56-83 %), while the proportion of poor agreement ranged from 1 to 19 % for the various strains. Conclusion While an acceptable clinical agreement was obtained in most cases, diverging bacterial scores may appear in subgingival samples collected at the same time point from patients with peri-implant mucositis. Clinical relevance The broad bulky base of implant crowns may present an obstacle for the collection of reproducible subgingival samples with paper points.

  • 28.
    Hallström, Hadar
    et al.
    Centre for Oral Health Sciences Malmö, SWE.
    Persson, Gösta Rutger
    Högskolan Kristianstad, SWE.
    Lindgren, Susanne
    Halland Hospital, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics: A randomized clinical trial2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no 12, p. 1285-1293Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate clinical, radiographic and microbiological outcome over 12 months following open flap debridement of peri-implantitis with or without antibiotics. Materials and methods: Peri-implantitis was surgically treated with or without Zithromax® in 19 control and 20 test individuals. Probing pocket depth (PPD), gingival inflammation (BOP), intra-oral radiographs and microbial samples were studied. Per protocol and intent-to-treat analyses were performed. Results: The mean difference (reduction) in PPD values between baseline and month 12 in the test and control groups was 1.7 mm (SD ± 1.1, 95% CI: 1.1, 2.3, p &lt;.001) and 1.6 mm (SD ± 1.5, 95% CI: 0.8, 2,4, p &lt;.001), respectively. Data analysis failed to show study group differences for BOP, PPD, radiographic bone level and microbial load. Successful treatment (per protocol: PPD ≤ 5 mm, no BOP, no suppuration and no bone loss ≥0.5 mm) at 12 months in test and control groups was 7/15 (46.7%) and 4/16 (25.0%). Bacterial load reduction was similar in study groups with a temporary reduction following treatment. Conclusions: Surgical treatment of peri-implantitis with adjunctive systemic azithromycin did not provide 1-year clinical benefits in comparison with those only receiving open flap debridement. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

  • 29. Hallström, Hadar
    et al.
    Persson, Rutger
    Lindgren, Susann
    Olofsson, Maria
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    Systemic antibiotics and debridement of peri-implant mucositis. A randomized clinical trial2012In: Journal of Clinical Periodontology, ISSN 0303-6979, Vol. 39, no 6, p. 574-581Article in journal (Refereed)
    Abstract [en]

    Background This RCT compared non-surgical treatment of peri-implant mucositis with or without systemic antibiotics. Materials and Methods Forty-eight subjects received non-surgical debridement with or without systemic Azithromax (R) (4 similar to days), and were followed during 6 similar to months. The checkerboard DNA-DNA hybridization method was used to analyse the microbiological material. Results Five subjects were excluded due to antibiotic medication during follow-up. At baseline,1 and 3 similar to months no group differences were found. Statistical analysis failed to demonstrate differences in probing pocket depths (PPD) values at 6 similar to months (Mean diff PPD: 0.5 similar to mm, SE: +/- 0.4 similar to mm, 95% CI: -0.2, 1.3, p similar to 0.16). Mean% implant bleeding decreased between baseline and month 6 from 82.6% to 27.3% in the test, and from 80.0% to 47.5% in the control group (p similar to 0.02). Throughout the study, no study group differences in bacterial counts were found. Conclusion No short-term differences were found between study groups. The clinical improvements observed at 6 similar to months may be attributed to improvements in oral hygiene. The present study does not provide evidence for the use of systemic antibiotics in treatment of peri-implant mucositis.

  • 30.
    Harrison, Peter
    et al.
    Dublin Dental University Hospital, Ireland.
    Madeley, Edward
    Dublin Dental University Hospital, Ireland.
    Nolan, Michael
    Dublin Dental University Hospital, Ireland.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Polyzois, Ioannis
    Dublin Dental University Hospital, Ireland.
    A longitudinal analysis of the impact of nonsurgical and surgical treatment of peri-implantitis upon clinical parameters and implant stability quotient values. A 2–3-year follow-up2024In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 10, no 1, article id e833Article in journal (Refereed)
    Abstract [en]

    Objectives: In this study, the aim was to investigate the medium- to long-term impact of peri-implantitis treatment upon clinical parameters and implant stability quotient values and to ascertain if magnetic resonance frequency analysis can be used as a diagnostic tool to demonstrate postoperative healing following treatment of peri-implantitis. Materials and Methods: A total of n = 26 patients (n = 86 implants) diagnosed with peri-implantitis were recruited for this prospective cohort study and four different treatment modalities were used. Baseline measurements of a number of clinical parameters as well as implant stability measurements in the form of ISQ were recorded. These measurements were repeated at 6, 12, and 24–36 months following treatment. Analysis of variance was performed for all implants treated as well as separately for each treatment modality. A regression model was also used to determine factors affecting ISQ measurements over time. Results: Treatment of peri-implantitis resulted in significant improvements of both average PPDs and BOP (p <.0001 and p <.01). ISQ values marginally improved initially for all treatment modalities, but improvement was only maintained for 2–3 years in treatment modalities I (+1.28), III (+1.49), and IV (+2.92). There was a statistically significant negative linear correlation between average PPD and the ISQ values recorded both at baseline (r = −.618, p < 0.0001) and at 2/3 years (r = −.604, p < 0.0001). Conclusion: Over the 2–3-year follow-up period, all four treatment modalities led to improved clinical and radiographic peri-implant parameters but implant stability posttreatment, as indicated by the fact that the recorded ISQ scores remained stable. As a result, use of MRFA as an adjunct to the traditionally used periodontal and radiographic tools for the evaluation of postoperative implant stability following the treatment of peri-implant disease cannot be recommended. © 2023 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.

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  • 31.
    Henricsson, Sara
    et al.
    Kristianstad University.
    Wallin Bengtsson, Viveca
    Kristianstad University.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Lundegren, Nina
    Malmö University.
    Andersson, Pia
    Kristianstad University.
    Self-perceived oral health and orofacial appearance in an adult population, 60 years of age2023In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037Article in journal (Refereed)
    Abstract [en]

    Objective: The study aimed to compare self-perceived oral health and orofacial appearance in three different cohorts of 60-year-old individuals. Method: A cross-sectional design, based on data obtained from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprised 478 individuals, from baseline, 2001–2003 (n = 191), 2007–2009 (n = 218) and 2014–2015 (n = 69). Comparisons were made within and between the cohorts, with bivariate analysis and Fisher's exact test. Statistical significance was considered at p < 0.05. Results: The result showed that a low number of the participants reported self-perceived problems with oral health. Of the problems reported, a higher proportion in cohort 2014–2015 (39.3%) experienced problems with bleeding gums. The experience of bleeding gums increased between the cohorts 2001–2003 and 2014–2015 (p = 0.040) and between 2007–2009 and 2014–2015 (p = 0.017). The prevalence of discomfort with sensitive teeth was experienced in 7%–32%. Twice as many women compared to men experienced discomfort in all cohorts (no significant differences between the cohorts). Satisfaction with dental appearance was experienced in 75%–84%. Twice as many women compared to men were dissatisfied with their dental appearance in 2001–2003 (p = 0.011) and with discoloured teeth (p = 0.020). No significant differences could be seen between the cohorts regarding discomfort with dental appearance or discoloured teeth. Conclusion: The 60-year-olds irrespective of birth cohort, perceived their oral health and orofacial appearance as satisfactory. © 2023 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.

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  • 32.
    Hirooka, Hideaki
    et al.
    Tohoku Univ, JPN.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Diagnosis of Periimplant Disease2019In: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 28, no 2, p. 144-149Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this review is to describe the current guidelines for the differential diagnosis of periimplant diseases. Materials and Methods: Synopsis reviews were conducted to define the differential diagnosis of periimplant disease through an electronic literature search in MEDLINE up to February 2018. Discussion: Periimplant mucositis is defined by the presence of bleeding and/or suppuration on gentle probing with or without an increased probing depth compared with previous examinations and by the absence of bone loss beyond crestal bone-level changes resulting from initial bone remodeling. Periimplantitis is defined by the presence of bleeding and/or suppuration on gentle probing with an increased probing depth compared with previous examinations and by the presence of bone loss beyond crestal bone-level changes resulting from initial bone remodeling. Thus, a combination of clinical registrations (probing pocket depth, bleeding on probing, and presence of pus) combined with radiographic signs of possible bone loss is needed for differential diagnosis. Conclusions: An accurate baseline registration at the time of placement of the prosthesis (probing pocket depth and bone level) with ongoing yearly monitoring is essential for diagnosis and appropriate disease management.

  • 33.
    Hussain, Badra
    et al.
    Univ Oslo, Norway.
    Haugen, Havard Jostein
    Univ Oslo, Norway.
    Aass, Anne Merete
    Univ Oslo, Norway.
    Sanz, Mariano
    Univ Oslo, Norway.
    Antonoglou, Georgios N.
    Univ Complutense, Spain.
    Bouchard, Philippe
    Rothschild Hosp, France.
    Bozic, Darko
    Univ Zagreb, Croatia .
    Eickholz, Peter
    Goethe Univ Frankfurt, Germany.
    Jepsen, Karin
    Univ Hosp Bonn, Germany.
    Jepsen, Soeren
    Univ Hosp Bonn, Germany.
    Karaca, Ebru Ozkan
    Yeditepe Univ, Turkiye.
    Kuru, Bahar Eren
    Yeditepe Univ, Turkiye.
    Nemcovsky, Carlos E.
    Tel Aviv Univ, Israel.
    Papapanou, Panos N.
    Columbia Univ, USA.
    Pilloni, Andrea
    Sapienza Univ Rome, Italy.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Roccuzzo, Mario
    Univ Turin, Italy.
    Sanz-Esporrin, Javier
    Univ Complutense Madrid, Spain.
    Spahr, Axel
    Univ Sydney, Australia.
    Stavropoulos, Andreas
    Univ Geneva, Switzerland.
    Verket, Anders
    Univ Oslo, Norway.
    Vrazic, Domagoj
    Univ Zagreb, Croatia.
    Lyngstadaas, Stale Petter
    Univ Oslo, Norway.
    Peri-Implant Health and the Knowing-Doing Gap-A Digital Survey on Procedures and Therapies2021In: FRONTIERS IN DENTAL MEDICINE, ISSN 2673-4915, Vol. 2, article id 726607Article in journal (Refereed)
    Abstract [en]

    Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed.Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey.Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3-6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health.Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.

  • 34.
    Isehed, Catrine
    et al.
    Umeå universitet, SWE.
    Holmlund, Anders
    Uppsala Universitet, SWE.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Svenson, Björn
    Postgraduate Dental Education Center Örebro, SWE.
    Johansson, Ingegerd
    Umeå universitet, SWE.
    Lundberg, Pernilla
    Umeå universitet, SWE.
    Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis: A randomized controlled trial2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 10, p. 863-873Article in journal (Refereed)
    Abstract [en]

    Objective: This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri-implantitis alone or in combination with enamel matrix derivative (EMD). Methods: Twenty-six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD. Bone level (BL) change was primary outcome and secondary outcomes were changes in pocket depth (PD), plaque, pus, bleeding and the microbiota of the peri-implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months. Results: In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD, the number of osseous walls in the peri-implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram−/anaerobic microbial flora and presence of bleeding and pus, with a cross-validated predictive capacity (Q2) of 36.4%. Similar, but statistically non-significant, trends were seen for BL, PD, plaque, pus and bleeding in univariate analysis. Conclusion: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.

  • 35. Jansåker, Ann-Marie Roos
    et al.
    Lindahl, Christel
    Persson, Rutger
    Renvert, Stefan
    Long-term stability of surgical bone regenerative procedures of peri-implantitis lesions in a prospective case-control study over 3 years2011In: Journal of Clinical Periodontology, ISSN 0303-6979, Vol. 38, no 6, p. 590-597Article in journal (Refereed)
    Abstract [en]

    To evaluate the extent of bone fill over 3 years following the surgical treatment of peri-implantitis with bone grafting with or without a membrane. Material and Methods In a non-submerged wound-healing mode, 15 subjects with 27 implants were treated with a bone substitute (Algipore (R)) alone and 17 subjects with 29 implants were treated with the bone substitute and a resorbable membrane (Osseoquest (R)). Implants with radiographic bone loss >= 1.8 mm following the first year in function and with bleeding and/or pus on probing were included. Following surgery, subjects were given systemic antibiotics (10 days) and rinsed with chlorhexidine. After initial healing, the subjects were enrolled in a strict maintenance programme. Results Statistical analysis failed to demonstrate changes in bone fill between 1 and 3 years both between and within procedure groups. The mean defect fill at 3 years was 1.3 +/- (SD) 1.3 mm if treated with the bone substitute alone and 1.6 +/- (SD) 1.2 mm if treated with an adjunct resorbable membrane, (p=0.40). The plaque index decreased from approximately 40-10%, remaining stable during the following 2 years. Conclusion Defect fill using a bone substitute with or without a membrane technique in the treatment of peri-implantitis can be maintained over 3 years.

  • 36.
    Jepsen, K.
    et al.
    Univ Bonn, Dept Periodontol Operat & Prevent Dent, D-53111 Bonn, Germany..
    Jepsen, S.
    Univ Bonn, Dept Periodontol Operat & Prevent Dent, D-53111 Bonn, Germany..
    Laine, M. L.
    Univ Amsterdam, Dept Periodontol, Acad Ctr Dent Amsterdam, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Moin, D. Anssari
    Univ Amsterdam, Dept Periodontol, Acad Ctr Dent Amsterdam, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Pilloni, A.
    Univ Roma La Sapienza, Sect Periodont, Rome, Italy..
    Zeza, B.
    Univ Roma La Sapienza, Sect Periodont, Rome, Italy..
    Sanz, M.
    Univ Complutense Madrid, ETEP Etiol & Therapy Periodontal Dis Res Grp, Madrid, Spain..
    Ortiz-Vigon, A.
    Univ Complutense Madrid, ETEP Etiol & Therapy Periodontal Dis Res Grp, Madrid, Spain..
    Roos-Jansaker, A. M.
    Publ Dent Hlth Serv, Dept Periodontol, Kristianstad, Sweden.;Kristianstad Univ, Dept Oral Sci, Kristianstad, Sweden..
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health. Publ Dent Hlth Serv, Dept Periodontol, Kristianstad, Sweden.;Kristianstad Univ, Dept Oral Sci, Kristianstad, Sweden.;Blekinge Inst Technol, Karlskrona, Sweden.;Univ Dublin Trinity Coll, Sch Dent Sci, Dublin 2, Ireland..
    Reconstruction of Peri-implant Osseous Defects: A Multicenter Randomized Trial2016In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, no 1, p. 58-66Article in journal (Refereed)
    Abstract [en]

    There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group (P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD <= 4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).

  • 37.
    Monje, Alberto
    et al.
    Univ Int Catalunya, ESP.
    Amerio, Ettore
    Univ Int Catalunya, ESP.
    Cha, Jae Kook
    Yonsei University, KOR.
    Kotsakis, Georgios
    University Texas Hlth Sci Ctr San Antonio, USA.
    Pons, Ramon
    Univ Int Catalunya, ESP.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanz-Martin, Ignacio
    Univ Int Catalunya, ESP.
    Schwarz, Frank
    Goethe University, ESP.
    Sculean, Anton
    University Bern, CHE.
    Stavropoulos, Andreas
    Tarnow, Dennis
    Columbia University, USA..
    Wang, Hom-Lay
    University Michigan, USA.
    Strategies for implant surface decontamination in peri-implantitis therapy2022In: International journal of oral implantology, ISSN 2631-6420, Vol. 15, no 3, p. 213-249Article, review/survey (Refereed)
    Abstract [en]

    Peri-implantitis is an infectious disease that leads to progressive bone loss. Surgical therapy has been advocated as a way of halting its progression and re-establishing peri-implant health. One of the most challenging but crucial tasks in the management of peri-implantitis is biofilm removal to achieve reosseointegration and promote the reduction of peri-implant pockets. A wide var-iety of strategies have been used for implant surface decontamination. Mechanical means have been demonstrated to be effective in eliminating calculus deposits and residual debris; however, the presence of undercuts and the grooves and porosities along the roughened implant surface make it difficult to achieve an aseptic surface. In conjunction with mechanical measures, use of chemical adjuncts has been advocated to dilute bacterial concentrations, destroy the bacteria's organic components and eliminate endotoxins. Pharmacological adjuncts have also been recommended to diminish the bacterial load. Other strategies, such as use of lasers, implantoplasty and electrolysis, have been suggested for implant surface decontamination to promote predictable clinical and radiographic outcomes.

  • 38.
    Nilsson, Helena
    et al.
    Halland Hospital, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Longitudinal evaluation of periodontitis and development of cognitive decline among older adults2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 10, p. 1142-1149Article in journal (Refereed)
    Abstract [en]

    Aim: To determine whether having periodontitis is associated with cognitive decline among older adults. Material and Methods: A prospective population study of older adults, Swedish National Study on Ageing and Care, (SNAC) provided repeated registrations of cognitive functions. Cognitive decline was defined as ≥3-points deterioration from a predetermined level at baseline, using the Mini-Mental State Examination (MMSE). Between 2001 and 2003, 715 individuals had a medical as well as a clinical and radiographic dental examination. The individuals were re-examined after 6 years. Periodontitis was defined as ≥4 mm bone loss at ≥30% of tooth sites. Social variables were captured from questionnaires. Results: The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of periodontitis and cognitive decline after adjustments of confounding factors of importance. Conclusions: A history of periodontitis may be of importance for cognitive functions among older adults. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

  • 39.
    Nilsson, Helena
    et al.
    Hallands sjukhus, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Longitudinal evaluation of periodontitis and tooth loss among older adults2019In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 46, no 10, p. 1041-1049Article in journal (Refereed)
    Abstract [en]

    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. © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

  • 40.
    Nilsson, Helena
    et al.
    Halland Hospital, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Renvert, Stefan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Periodontitis, tooth loss and cognitive functions among older adults2018In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 22, no 5, p. 2103-2109Article in journal (Refereed)
    Abstract [en]

    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. © 2017 Springer-Verlag GmbH Germany, part of Springer Nature

  • 41. Persson, Gösta Rutger
    et al.
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    Cluster of Bacteria Associated with Peri-Implantitis2014In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 16, no 6, p. 783-893Article in journal (Refereed)
    Abstract [en]

    Information on the microbiota in peri-implantitis is limited. We hypothesized that neither gender nor a history of periodontitis/smoking or the microbiota at implants differ by implant status. Materials and Methods: Baseline microbiological samples collected at one implant in each of 166 participants with peri-implantitis and from 47 individuals with a healthy implant were collected and analyzed by DNA-DNA checkerboard hybridization (78 species). Clinical and radiographic data defined implant status. Results: Nineteen bacterial species were found at higher counts from implants with peri-implantitis including Aggregatibacter actinomycetemcomitans, Campylobacter gracilis, Campylobacter rectus, Campylobacter showae, Helicobacter pylori, Haemophilus influenzae, Porphyromonas gingivalis, Staphylococcus aureus, Staphylococcus anaerobius, Streptococcus intermedius, Streptococcus mitis, Tannerella forsythia, Treponema denticola, and Treponema socranskii (p<.001). Receiver operating characteristic curve analysis identified T. forsythia, P. gingivalis, T. socranskii, Staph. aureus, Staph. anaerobius, Strep. intermedius, and Strep. mitis in peri-implantitis comprising 30% of the total microbiota. When adjusted for gender (not significant [NS]), smoking status (NS), older age (p=.003), periodontitis history (p<.01), and T. forsythia (likelihood ratio 3.6, 95% confidence interval 1.4, 9.1, p=.007) were associated with peri-implantitis. Conclusion: A cluster of bacteria including T. forsythia and Staph. aureus are associated with peri-implantitis.

  • 42. Persson, Rutger
    et al.
    Berglund, Johan
    Persson, Ringmor
    Renvert, Stefan
    Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis2011In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 48, no 3, p. 552-556Article in journal (Refereed)
    Abstract [en]

    PURPOSE: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. MATERIALS AND METHODS: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. RESULTS: 788 Caucasians (52.4% women, overall mean age: 76years, S.D.±9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3years. Calcaneus PIXI T-values<-1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p<0.001). Older persons with osteoporosis had more severe periodontitis (p<0.01). Periodontitis defined by ≥30% of sites with ≥5mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p<0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value<-2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p<0.001). CONCLUSIONS: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures.

  • 43. Persson, Rutger
    et al.
    Jansåker, Ann-Marie Roos
    Lindahl, Christel
    Renvert, Stefan
    Microbiologic results after Non-surgical Erbium-doped:Yttrium, aluminum, and garnet laser or Air-abrasive treatment of Peri-implantitis: A randomized clinical trial2011In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 82, no 9, p. 1267-1278Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of this study is to assess clinical and microbiologic effects of the non-surgical treatment of peri-implantitis lesions using either an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser or an air-abrasive subgingival polishing method. Methods: In a 6-month clinical trial, 42 patients with periimplantitis were treated at one time with an Er:YAG laser or an air-abrasive device. Routine clinical methods were used to monitor clinical conditions. Baseline and 6-month intraoral radiographs were assessed with a software program. The checkerboard DNA-DNA hybridization method was used to assess 74 bacterial species from the site with the deepest probing depth (PD) at the implant. Non-parametric tests were applied to microbiology data. Results: PD reductions (mean - SD) were 0.9 - 0.8 mm and 0.8 - 0.5 mm in the laser and air-abrasive groups, respectively (not significant). No baseline differences in bacterial counts between groupswere found. In the air-abrasive group, Pseudomonas aeruginosa, Staphylococcus aureus, andStaphylococcus anaerobius were found at lower counts at 1 month after therapy (P <0.001) and with lower counts in the laser group for Fusobacteriumnucleatumnaviforme( P = 0.002), and Fusobacterium nucleatum nucleatum (P = 0.002). Both treatments failed to reduce bacterial counts at 6 months. Porphyromonas gingivalis counts were higher in cases with progressive peri-implantitis (P <0.001). Conclusions: At 1 month, P. aeruginosa, S. aureus, and S. anaerobius were reduced in the air-abrasive group, and Fusobacterium spp. were reduced in the laser group. Six-month data demonstrated that both methods failed to reduce bacterial counts. Clinical improvements were limited.

  • 44. Prendergast, Virginia
    et al.
    Jakobsson, Ulf
    Renvert, Stefan
    Blekinge Institute of Technology, School of Health Science.
    Hallberg, Ingalill
    Effects of a Standard Versus Comprehensive Oral Care Protocol Among Intubated Neuroscience ICU Patients: Results of a Randomized Controlled Trial2012In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 44, no 3, p. 134-146Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n = 25) in intubated patients in a neuroscience ICU in a 2-year randomized clinical trial. Oral health was evaluated based on the Oral Assessment Guide (OAG) on enrollment, the day of extubation, and 48 hours after extubation. There were no significant differences in the frequency of the oral care protocol. Protocol compliance exceeded 91% in both groups. The total OAG score and all eight categories significantly deteriorated (Friedman test, p < .001, Bonferroni corrected) in the standard oral care group and did not return to baseline after extubation. Large effect sizes were present at all three points in this group. The total OAG score deteriorated during intubation within the comprehensive protocol group (Friedman test, p < .004) but returned to baseline status after extubation. In four categories, the ratings on tongue, mucous membranes, gingiva, and teeth did not deteriorate significantly over time. Published oral care protocols are substandard in promoting and maintaining oral health in intubated patients. A comprehensive oral care protocol, using a tongue scraper, an electrical toothbrush, and pharmacological moisturizers, was more effective for oral hygiene throughout intubation and after extubation than manual toothbrushing alone.

  • 45.
    Renvert, Stefan
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Aghazadeh, Ahmad
    Hallström, Hadar
    Persson, Gösta Rutger
    Factors related to peri-implantitis: a retrospective study2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 4, p. 522-529Article in journal (Refereed)
    Abstract [en]

    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.

  • 46. Renvert, Stefan
    et al.
    Berglund, Johan
    Opalainska, Teresa
    Persson, Ringmor
    Persson, Rutger
    Heel DXA T-scores and panoramic radiographs in the prediciton of hip and hand fractures2009In: Journal of Clinical Periodontology, wiley , 2009, Vol. 36, no suppl. 9Conference paper (Refereed)
  • 47.
    Renvert, Stefan
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Giovannoli, Jean-Louis
    University of Corsica, FRA.
    Roos-Jansåker, Ann-Marie
    Public Dental Services, Karlskrona, SWE.
    Rinke, Sven
    University Medical Center, Goettingen, DEU.
    Surgical treatment of peri-implantitis with or without a deproteinized bovine bone mineral and a native bilayer collagen membrane: A randomized clinical trial2021In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 48, no 10, p. 1312-1321Article in journal (Refereed)
    Abstract [en]

    Aim: To assess whether the use of deproteinized bovine bone mineral (DBBM) and native bilayer collagen membrane (NBCM) improved healing of peri-implantitis-related bone defects at 12 months. Materials and methods: In a multi-centre, randomized clinical trial, 32 individuals received surgical debridement (control group [CG]), and 34 received adjunct use of DBBM and NBCM (test group [TG]). Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUP), recession (REC), cytokines (IL-1β, IL-1RA, IL-6, IL-8, IL-12, IP10, PDGF-BB, TNF-α, VEGF), and patient-reported outcomes (PROs) were evaluated at 3, 6, 9, and 12 months. Results: RDF at the deepest site amounted 2.7 ± 1.3 mm in TG and 1.4 ± 1.2 mm in CG (p <.0001). PPD was reduced by 1.9 mm in TG and 2.3 mm in CG (p =.5783). There were no significant differences between groups regarding reductions of BOP, SUP, REC, cytokines levels, or oral health impact profile (OHIP)-14 scores at 12 months. Successful treatment (RDF ≥ 1.0 mm, PPD ≤5 mm, ≤1/4 site with BOP grade 1, no SUP) was identified in 32% in TG and 21% in CG. Conclusions: DBBM and NBCM resulted in significantly more RDF than debridement alone. No difference was found in any clinical parameters or PROs between the groups. ClinicalTrials.gov Identifier: NCT02375750. © 2021 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.

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  • 48.
    Renvert, Stefan
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Hirooka, Hideaki
    Tohoku Univ, JPN.
    Polyzois, Ioannis
    Dublin Dent Univ Hosp, Trinity Coll, IRE.
    Kelekis-Cholakis, Anastasia
    Univ Manitoba, CAN.
    Wang, Hom-Lay
    Univ Michigan, USA.
    Diagnosis and non-surgical treatment of peri-implant diseases and maintenance care of patients with dental implants: Consensus report of working group 32019In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 69, p. 12-17Article in journal (Refereed)
    Abstract [en]

    The following consensus report is based on four background reviews. The frequency of maintenance visits is based on patient risk indicators, homecare compliance and prosthetic design. Generally, a 6-month visit interval or shorter is preferred. At these visits, peri-implant probing, assessment of bleeding on probing and, if warranted, a radiographic examination is performed. Diagnosis of peri-implant mucositis requires: (i) bleeding or suppuration on gentle probing with or without increased probing depth compared with previous examinations; and (ii) no bone loss beyond crestal bone level changes resulting from initial bone remodelling. Diagnosis of peri-implantitis requires: (i) bleeding and/or suppuration on gentle probing; (ii) an increased probing depth compared with previous examinations; and (iii) bone loss beyond crestal bone level changes resulting from initial bone remodelling. If diagnosis of disease is established, the inflammation should be resolved. Non-surgical therapy is always the first choice. Access and motivation for optimal oral hygiene are key. The patient should have a course of mechanical therapy and, if a smoker, be encouraged not to smoke. Non-surgical mechanical therapy and oral hygiene reinforcement are useful in treating peri-implant mucositis. Power-driven subgingival air-polishing devices, Er: YAG lasers, metal curettes or ultrasonic curettes with or without plastic sleeves can be used to treat peri-implantitis. Such treatment usually provides clinical improvements such as reduced bleeding tendency, and in some cases a pocket-depth reduction of <= 1 mm. In advanced cases, however, complete resolution of the disease is unlikely.

  • 49.
    Renvert, Stefan
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Ioannis, Polyzois
    Persson, Rutger
    Treatment modalities for peri-implant mucositis and peri-implantitis2013In: American Journal of Dentistry, ISSN 0894-8275, Vol. 26, no 6, p. 313-318Article, review/survey (Refereed)
    Abstract [en]

    To review treatment modalities used for pen-implant mucositis and peri-implantitis. Methods: A literature search was performed in PubMed for articles published until May 2013 using peri-implantitis and pen-implant mucositis and different modalities of treatment as search terms. The search was limited to the English literature. Titles and abstracts were searched in order to find studies eligible for the review. Results: The present review reported that treatment of pen-implant mucositis lesions using mechanical therapy is possible. The additional use of professionally delivered antimicrobials has commonly failed to show additional benefits as compared to mechanical debridement alone. The scientific evidence on the efficacy of non-surgical and surgical therapies in the treatment of peri-implantitis is limited. Complete resolution of peri-implantitis using mechanical, laser, or photodynamic therapy does not seem to result in a predictable outcome. Following surgical interventions around implants diagnosed with peri-implantitis, clinical improvements as judged by reductions of probing depths and bleeding on probing have been reported. Bone or bone substitutes have been used in attempts to regenerate bone loss around implants. When regenerative modalities have been employed, radiographic evidence of defect fill has been reported. Few long term follow up studies on the treatment of peri-implantitis are available. Positive treatment results can be maintained over a period of 3-5 years. Regardless of the treatment performed, adequate plaque control by the patient is fundamental to treatment success. If the patient cannot obtain an adequate level of oral hygiene, the infection around the implants will reoccur.

  • 50. Renvert, Stefan
    et al.
    Lindahl, Christel
    Jansåker, Ann-Marie Roos
    Lessem, Jan
    Short-Term Effects of an Anti-Inflammatory Treatment on Clinical Parameters and Serum Levels of C-Reactive Protein and Proinflammatory Cytokines in Subjects With Periodontitis2009In: Journal of Periddontology, ISSN 0022-3492, Vol. 80, no 6, p. 892-900Article in journal (Refereed)
    Abstract [en]

    Background: Periodontal disease is the most common multifactorial disease, afflicting a very large proportion of the adult population. Periodontal disease secondarily causes increases in the serum levels of C-reactive protein (CRP) and other markers of inflammation. An increased level of CRP reflects an increased risk for cardiovascular disease. The aim of the current randomized clinical trial was to evaluate the short-term effect of a combination of dipyridamole and prednisolone (CRx-102) on the levels of high-sensitivity (hs)-CRP, proinflammatory markers in blood, and clinical signs of periodontal disease. Methods: Fifty-seven patients with >= 10 pockets with probing depths >= 5 mm were randomized into two groups in this masked single-center placebo-controlled study: CRx-102 (n = 28) and placebo (n = 29). hs-CRP levels, inflammatory markers (interleukin [IL]-6, -1 beta, -8, and -12, tumor necrosis factor-alpha, and interferon-gamma [IFN-gamma]), bleeding on probing (BOP), and changes in probing depths were evaluated. The subjects received mechanical non-surgical therapy after 42 days, and the study was completed after 49 days. Results: At day 42, the differences in the hs-CRP, IFN-gamma, and IL-6 levels between the two groups were statistically significant (P<0.05), whereas no difference was found for the other inflammatory markers. There was no change in probing depth or BOP between the two groups. Conclusion: The administration of CRx-102 resulted in significant decreases in hs-CRP, IFN-gamma, and IL-6, but it did not significantly change BOP or probing depths.

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