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Notes: Abstract The influence of the water irrigating device. Water Pik®, on the accumulation of plaque and development of gingivitis has been studied using the model, “experimental gingivitis in man”. The investigation was carried out on 41 patient volunteers whose teeth were thoroughly scaled and polished during a 4-week period of intensive oral hygiene preceding each experimental period. Gingival exudation. Plaque Index and Gingival Index were registered at the beginning of the experimental periods. The participants were then divided into four groups. Groups A and B abandoned all forms of active oral hygiene. Group A, however, were given Water Pik devices as the only oral hygiene aid. Groups C and D continued to clean their teeth using a toothbrush and Group C were given Water Pik devices as a supplementary aid. After 14 days, gingival exudation. Plaque Index, Gingival Index and soft tissue injuries were registered. The results showed that, while both groups A and B demonstrated extensive plaqtie deposits and gingivitis, these were present to a significantly lesser degree in Water Pik users. The toothbrushing groups (C and D) failed to demonstrate any further reduction of plaque or gingivitis when Water Pik was introduced as an additional measure. No soft tissue injuries were found.

Notes: Abstract A multifactorial approach has been used to identify some predictors of postoperative intrabony defects (IBD) on the distal surface of the adjacent second molar (M2) after impacted lower third molar (M3) surgery. The material consisted of 215 lower third molar removals, performed on 144 persons (age range 16–53 years; mean 27.2 years). The postoperative examination took place 2 years after impaction surgery and included both clinical and radiographic variables. Statistically significant (5% significance level) predictors of IBD found in stepwise multiple regression analyses were: (1) preoperative intrabony defect M2 distal; (2) age at the time of surgery; (3) size of contact-area M3/M2; (4) root resorption M2 distal; (5) probing dept distal surface of adjacent first molar postoperatively; (6) pathological follicle M3. The regression model with IBD as regressand produced a total R2 of 0.45. When the regressand was the difference between IBD and the preoperative intrabony defect, the regression analysis explained 62% of the variance (R2=0.62). These regression models explained the variance in terms of the size of the remaining postoperative intrabony defect as well as in terms of periodontal healing after impacted lower third molar surgery.

Notes: Abstract This study was performed to elucidate the effect of periodontal treatment on the sinus mucosa. 21 patients with periodontal lesions of the upper molars and/or premolars and chronic mucous membrane thickening in the maxillary sinus diagnosed radiographically participated in the study. No teeth in the regions studied showed pulpal or periapical changes. Altogether, the patients exhibited 36 maxillary sinuses with mucous membrane thickening. 15–20 months after the final periodontal treatment, a marked reduction of the plaque index, gingival index and probing depth was recorded. Radiographic examination of the sinus mucosa before and after periodontal treatment showed that successful periodontal treatment in all quadrants resulted in normalisation of the sinus mucosa. Periodontal treatment was not successful in 2 quadrants. In one of these cases the thickness of the mucosa was unchanged and in the other case, further thickening of the mucosa seemed to have occurred. The study shows that severe periodontitis of the upper molars and/or premolars may initiate mucous membrane thickening in the maxillary sinus, and that successful periodontal treatment results in normalisation of the sinus mucosa.

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

Notes: Abstract. In this study, potential risk factors for severe periodontal disease were identified in a cross-sectional sample from the county of Jönköping, Sweden, 547 adults 20–70 years of age were categorised clinically and radiographically by level of periodontal disease experience. These levels were used to divide the sample into groups – individuals without any reduction in periodontal bone level (60%) and those with severe periodontal bone loss (13%) – which were then used in univeriate and multivariate logistic regression analyses as dependent variable. Demographic, socio-economic, general health, smoking habits, clinical, and dental care variables were used in the different regression analyses. In the univariate model, age (20–70 years) was found to be correlated with more severe periodontal disease experience (odds ratio: 1.13; 95% CI; 1.10–1.17). The association with periodontal disease was more pronounced for the older age groups (50, 60, and 70 years), A negative financial situation was also related to severe periodontal bone loss when regressed univariately (odds ratio 2.20 [95%: 1.04–4.68]). Moderate-heavy smoking (3=10 cigarettes/day) appeared to be associated with severe periodontal destruction with an odds ratio of 9.78 (95% CI: 3.62–36.42), Of the clinical variables in the univariate model, higher mean levels of supragingival dental plaque and the presence of subgingival calculus were related to more severe periodontal disease with odds ratios of 1.02 (95%: 1.01–1.03) and 2.96 (95% 1.50–5.88), respectively When the same variables were regressed multivariately, age (continuous) (odds ratio 1.17 [95% CI: 1.12–1.22]). moderate-heavy smoking (odds ratio 11.84 [95% CI: 4.19–33.50]), and higher mean levels of plaque (odds ratio 1.02 [95% CI: 1.00–1.03]) remained significant. Light smoking (1–9 cigarettes/day) was not significantly associated with severe periodontal disease in the 2 regression models. The present study demonstrated that smoking, greater age, and higher mean levels of plaque are potential risk factors for severe periodontal disease in this specific population.

Notes: Background, aims: This investigation was performed to assess longitudinal changes in periodontal bone height in an adult population over a period of 17 years.Methods: In 1973, a random sample of 1000 individuals aged 3–70 years in the city of Jönköping, Sweden, was examined clinically and radiographically to assess dental status and treatment needs. Out of the 574 dentate individuals 15–60 years, 433 accepted the invitation and were re-examined in 1989–91, 4 were edentulous and the study therefore finally included 429 dentate individuals. The examination included full mouth plaque and gingivitis scores and bone height measurements on full mouth intra-oral radiographs. All age groups except the youngest had very good oral hygiene with 50% or more having plaque and gingivitis scores below 20%.Results: From the age of 20, there was a general pattern of bone height reduction over time corresponding to an annual loss of around 0.1 mm. From the age of 30 years, about 80% of the population had one or more sites with bone loss of 10% or more. Very few individuals, about 5%, exhibited an individual mean bone loss of 2 mm or more. 17% had 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE27009665:ges" location="ges.gif"/〉6 such sites indicating destructive periodontal disease. These individuals and sites could not be identified in advance based only on previous disease experience.

Notes: Abstract A 6-year follow-up study was carried out on 28 patients fitted with removable partial dentures. Prior to the prosthetic treatment all patients were given oral hygiene instruction and periodontal therapy where indicated. The removable partial dentures were carefully planned and designed. During the follow-up period the patients were examined at yearly intervals when remotivation, scalings, conservation and prosthetic adjustments were carried out as required. Patient cooperation was excellent and no significant deterioration of the periodontal status of the remaining teeth could be found, In addition the number of newly registered carious lesions was low. A certain degree of deterioration of occlusion, articulation, stability and clasp retention of the dentures fitted did occur, however.

Notes: Abstract The apically repositioned flap procedure, by definition, implies that the mucogingival junction (MGJ) is shifted into an apical location. That this actually would be the case has never been shown in long-term studies. The 13 subjects in the present study had during the years 1964–1965 received treatment of moderately advanced periodontal disease (probing pocket depths ≤5 mm) in the lower jaw. An apically repositioned flap (ARF) procedure was applied in the left or right half of the mandible and a gingivectomy (GE) was performed in the contralateral side. Starting in December 1981, the patients were recalled for clinical and radio-graphic determination of long-term results. The width of the band of keratinized gingiva was measured clinically and the distance from the MGJ to the lower border of the mandible (LBM) was measured from orthopantomograms. Slightly less keratinized gingiva was observed on the sides where GE had been used. There was no statistically significant difference in the orthopantomographic distance from the MGJ to the LBM between ARF and GE operations. The results indicate that the apically repositioned flap procedure does not result in a permanent apical shift of the MGJ.

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

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