Comparison of oral status in an adult population 35-75 year of age in the county of Dalarna, Sweden in 1983 and 2008.

UNLABELLED: The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50, 65 and 75 answered a questionnaire and were also clinically and radiographically examined.The number of edentulous individuals decreased from 15% in 1983 to 3% in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15% in 1983 to 2% in 2008. Individuals with moderate periodontitis decreased from 45% in 1983 to 16% in 2008. CONCLUSION: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated.This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

Porphyromonas gingivalis (Pg) a possible link between impaired oral health and acute myocardial infarction.

OBJECTIVE: To investigate if oral health parameters were impaired in patients with myocardial infarction (MI) and if there was an association with serum antibody levels against the periodontal pathogens Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa). METHODS: A case-control study consisting of 100 patients with MI and 100 age- and sex-matched controls from the same geographic area was investigated regarding oral health. RESULTS: The MI group had significantly more periodontal bone loss (PBL), number of deepened pockets (NDP), and bleeding on probing (BOP), and lower number of teeth (NT) than the controls. After adjustment for known cardiovascular risk factors NT, BOP, and NDP still remained significantly related to MI (p=0.014, p=0.02, and p=0.0069, respectively). IgG antibody levels against Pg were higher in subjects with MI (p=0.043), as well as in those with >4 deepened pockets (p=0.05), BOP>20% (p=0.001) and PBL (p=0.0003). However, indicating a causal pathway, the relationship between MI and Pg IgG disappeared when the oral parameters were included in the logistic regression model (p=0.69). No correlation was seen between MI and Aa in the present study. CONCLUSION: Patients with MI had an impaired oral health compared to controls. Furthermore, IgG levels against Pg were related to both MI and oral health, suggesting this pathogen as a possible link between oral health and CVD.

Five-year results from a randomized, controlled trial on early and delayed loading of implants supporting full-arch prosthesis in the edentulous maxilla.

OBJECTIVES: The overall aim was to compare the clinical outcomes of early and delayed implant loading in the totally edentulous maxilla during 5 years of function. MATERIALS AND METHODS: Twenty-four patients with edentulous maxillae were randomized in two groups and subjected to early (test, n=16) or delayed (control, n=8) loading. A total of 142 implants were placed and 139 implants (Straumann AG) were loaded with full-arch bridges and followed for 5 years. RESULTS: All patients received and maintained a fixed bridge throughout the study period. Five (5.3%) test implants in three patients and two (4.3%) control implants in two patients were lost during the 5 years (NS). There were no differences in implant stability as measured with resonance frequency analysis at 5 years. More bone loss occurred at test than at control implants, -0.8 mm (SD 1.2) vs. -0.3 mm (SD 1.1), respectively. However, test implants showed a more coronal marginal bone level than control implants after 5 years, 2.9 mm (SD 1.1) vs. 3.7 mm (SD 1.2) from the implant shoulder, respectively. No control implants and four (4.4%) test implants in three (18.8%) patients showed >3 mm bone loss after 5 years. Two of the latter implants in one patient also showed increased probing depths, bleeding at probing and plaque accumulation. Tooth fracture was the most common prosthetic complication. The use of lingual gold onlay effectively reduced the number of resin-related complications as opposed to a resilient mouth guard. CONCLUSIONS: The present randomized controlled trial showed no important differences between early and delayed loading of implants in the edentulous maxilla after 5 years of function. A favourable long-term marginal bone response to the sandblasted large-grit acid-etched (SLA) surface was observed. Technical complications were mainly resin-related which could be avoided by the use of a lingual gold onlay. It is concluded that early loading of SLA-surface implants for support of full-arch bridges represents a viable therapy for the totally edentulous maxilla.

A retrospective clinical study of wide-diameter implants used in posterior edentulous areas.

PURPOSE: The purpose of this study was to examine retrospectively the outcome of wide-diameter dental implants used to retain fixed restorations in the posterior segments of the maxilla and mandible. MATERIALS AND METHODS: Fifty-two patients were consecutively treated between 1997 and 2000 with 78 Wide-Platform (WP) Mk II implants in the posterior regions of the maxilla and/or mandible. All treated patients were called for a retrospective examination between September and November 2001. At the examination, data regarding general health and clinical and radiographic parameters were collected according to a strict protocol. Thirty-four women and 18 men with a mean age of 55 years (range 19 to 81 years) participated. Twenty-three WP implants were placed in the maxilla and 55 in the mandible. The mean time in situ was 33 months (range of 11 to 58 months). RESULTS: Of 78 implants, 8 had been lost by the time of reexamination. Five women lost 1 implant each in the maxilla, and 2 men lost 3 implants in the mandible. The survival rate was 89.8%. DISCUSSION: The results are encouraging because the WP implants were placed in rather unfavorable situations (generally poor bone quality, compromised bone volume, and larger occlusal forces). CONCLUSION: Based on the reported survival rate, wide-diameter implants present an acceptable treatment alternative.

A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with bovine hydroxyapatite and autogenous bone.

PURPOSE: The purposes of this study were 1) to evaluate the survival rate of implants placed in maxillary sinuses augmented with bovine hydroxyapatite and autogenous bone 6 months before implant surgery and 2) to estimate dimensional changes of the bone graft with time using a new radiographic method. PATIENTS AND METHODS: Thirty maxillary sinuses in 20 consecutive patients with severe resorption (mean, 3.8 mm of remaining alveolar bone) were augmented with a mixture of 80% bovine hydroxyapatite and 20% autogenous bone mixed with fibrin glue to enable the placement of screw-shaped dental implants. After 6 months of primary healing, 108 implants were placed and followed with clinical and radiographic examinations during the first year of loading. Measurements of changes in height, width, and length of the grafted material were made on tomographic Scanora (Soredex Orion Corporation Ltd, Helsinki, Finland) and panoramic radiographs taken 3 and 12 months after grafting and after 1 year of bridge loading. RESULTS: Ten implants in 6 patients were lost during the study (9 before loading and 1 after 1 year of functional loading), for a survival rate of 90.7%. All patients received fixed restorations, and the bridge survival rate was 100% after 1 year of loading. Small (<10%) but statistically significant dimensional changes in the grafted material were seen during the study period. CONCLUSIONS: Acceptable short-term results can be obtained with implants placed after the use of bovine hydroxyapatite and autogenous bone for maxillary sinus floor augmentation. These grafts show good resistance to resorption.