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Notizen: Abstract. The aim of this study was to compare changes in periodontal status in a Swedish poplation over a period of 20 years. Cross-sectional studies were carried out in Jönköping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1). gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49%. in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. ID 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (≥4 mm). In 1993, 20%, 42%, and 67% of the individuals m groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with 〉20% bleeding sites and 〉10% sites with periodontal pockets ≥4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.

Notizen: Abstract The aim of this investigation was to study caries development between the ages of 15 and 20 yr in the same individuals. Data concerning 100 adolescents constituted the basic material. Eighty subjects could be re-examined 5 yr after the first examination. The moan number of teeth per subject was 27.) both in 1973 and in 1978. Four subjects (4%) in 1973 and three subjects (2.4%) in 1978 showed no decayed and/or filled proximal tooth surfaces. The prevalence of intact tooth regions was higher in the mandible than in the maxilla. Only one of the 73 subjects who were free from caries in the mandibular incisor/canine region at the basic examination developed new carious lesions in this region during the next 5-yr period. Analysis of the frequency distribution of the different caries diagnostic groups revealed that 32 subjects (40%) showed no change during the 5-yr period while 47 (58.7%) now belonged to a higher caries prevalence group. 3538 (80.7%) proximal surfaces were diagnosed as intact at the basic examination. The number of intact surfaces 5 yr later was 3107 (70.9%). In individuals with low and high numbers of decayed and/ or filled surfaces, respectively, there was a tendency towards a more pronounced individual caries progression in the group that showed the highest caries prevalence at the basic examination than in the group showing a low caries prevalence.

Notizen: Abstract – In 1973, a cross-sectional study on oral health status was performed on 1000 individuals in the age groups 3–70 years in Jönköping, Sweden. In 1983 and 1993, new cross-sectional studies were carried out in the age groups 3–80 years. The aim of the present study was to analyze caries prevalence and distribution in the three investigations 1973, 1983, and 1993 in the age groups 20–80 years. In the younger age groups (20–40 years), a larger proportion of individuals with good oral health was found in 1993 than in 1973 or 1983. A steady increase in the number of teeth in the age groups 40–80 years could be found, which was also reflected in the increasing number of decayed and filled tooth surfaces (DFS) in the same age groups. A marked decrease in proximal DFS in 20–50-year-olds in 1993 compared to 1973 and 1983 was found. However, a rather large and unchanging group of individuals suffering from severe caries was also observed. This situation demands an individualized caries treatment strategy based on risk assessment.

Notizen: Abstract – Four cross-sectional studies were carried out in 1973, 1978, 1983, and 1993 to collect clinical and radiographic epidemiological data on the dental health status of the inhabitants of Jönköping, Sweden. The aim of the present paper was to use these data to analyze trends in the development of caries among children and adolescents between 1973 and 1993. Approximately 500 randomly selected individuals evenly distributed among the age groups 3, 5, 10, 15, and 20 years participated in each study. The main results show that the numbers of caries-free individuals increased in all age groups. In 1993, the mean number of decayed and filled tooth surfaces in the primary (dfs) and the permanent (DFS) dentition in all age groups was less than half of that found in 1973. Most of this decrease took place during the first 5 years, i.e., between 1973 and 1978. Between 1978 and 1983, only minor changes were observed. There was a further reduction of approximately 30%–50% in dfs/DFS between 1983 and 1993 in 3-, 5-, 10-, and 20-year-olds. The frequency distributions of dfs/DFS for 5- and 15-year-olds revealed an increasing skewness over time: in 1993, a large majority of the children and adolescents had a low or moderate caries severity while only a small group had high scores of dfs/DFS.

Notizen: Aims: The objectives of the present, randomised clinical trial were (i) to evaluate the healing of periodontal intrabony defects at the distal aspect of mandibular 2nd molars using a resorbable polylactic acid (PLA) barrier and a non-resorbable polytetrafluoroethylene (e-PTFE) barrier and (ii) to compare the therapeutic effect of the bioresorbable versus the non-resorbable barrier.Method: 19 patients with intrabony defects distal to mandibular 2nd molars 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE270507:ges" location="ges.gif"/〉4 mm (on radiographs) were included in the study. The defects all remained 5 years after surgical removal of impacted 3rd molars. Following flap elevation and defect debridement, the defects were randomly covered with, either a resorbable PLA or a non-resorbable e-PTFE barrier. Flaps were repositioned and sutured to completely cover the barriers. Treatment was evaluated clinically after 1 year by measurements of probing depth (PD), probing attachment level (PAL), and probing bone level (PBL) and radiographically by measurements of bone levels on computer digitised images of radiographs taken immediately before and 1 year post-surgery.Results: Both treatments resulted in significant PD reduction, PAL gain, and bone fill. The total PD reduction was 5.3±l.9 mm for the PLA treated sites and 3.7±l.7 mm for the e-PTFE treated sites (p〈0.05). The corresponding values for PAL gain were 4.7±0.7 mm and 3.6±1.7 mm (p〈0.05) and for PBL gain 5.1±1.2 and 3.3±2.0 mm (p〈0.05). Radiographic bone fill averaged 3.4±l.2 for the PLA and 2.0±1.6 mm for the e-PTFE barriers (p〈0.05). Radiographic bone level measurements were significantly smaller than the corresponding clinical measurements, indicating that radiographs tend to underestimate bone fill.Conclusions: GTR treatment of deep intrabony defects distal to mandibular second molars using resorbable PLA barriers resulted in significant PD reduction, PAL gain and bone fill at least equivalent to the results obtained using non-resorbable e-PTFE barriers.

Notizen: 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.

Notizen: 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.

Notizen: 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.

Notizen: Abstract This study is an analysis of the findings in an epidemiologic investigation covering a random sample of 600 individuals aged 20–70 years resident in the city of Jönköping, Sweden. The frequency distribution of individuals according to severity of periodontal disease was determined. The analysis was based on clinical registration of gingivitis, pocket depths and qualitative and quantitative changes of the alveolar bone in a full mouth intraoral survey. In the age groups 20 and 30 years, 96% and 85 % of the individuals, respectively, had healthy periodontal tissues or were grouped as having gingivitis without signs of lowering of the periodontal bone level. In the age groups 40, 50 and 70 years none of the subjects was free from signs of gingivitis/periodontitis but, as for all age groups, strikingly few cases (at most 8%) of severe destructive periodontitis were found. The need for periodontal treatment is discussed as well as the role of specific etiologic agents in the development of destructive periodontal disease.

Notizen: Abstract The aim of this investigation was to study the periodontal status at the ages of 15 and 20 years in the same individuals. Gingival and periodontal data from 100 adolescents in 1973 constituted the basic material. Eighty subjects could rereexamined in 1978. The mean number of teeth per subject was 27.1 both in 1973 and in 1978. Three individuals in 1973 and two in 1978 had no bleeding gingival units. There was a decrease between 1973 and 1978 in the number of subjects with a high number of inflamed gingival units. The buccal and lingual surfaces also showed lower prevalence of gingivitis, while the proximal surfaces showed a slight increase in prevalence. The prevalence of surfaces with plaque in 1978 was decreased for buccal and lingual surfaces but slightly increased for proximal surfaces. Sixty-six individuals in 1973 and 71 in 1978 had no pocketing. Altogether 75 tooth surfaces with pocketing were diagnosed in 1973 and 21 in 1978. Most of the pockets were located at the proximal surfaces of the molars. Four individuals with infra bony defects in one to two sites were found in 1973 and five in 1978. No progression of the bony defects found in 1973 seemed to have occurred during the 5-year period. In spite o(the frequent proximal areas with gingivitis, very few 20-year-olds showed signs of marginal bone loss, which indicates that gingivitis does not necessarily lead to destructive periodontitis in young people.