Distribution Of Periodontitis Research Articles

Accuracy of Estimating Periodontitis and Its Risk Association Using Partial-Mouth Recordings for Surveillance Studies: A Systematic Review and Meta-Analysis.

Objectives Our aim is to conduct an up-to-date systematic review and meta-analysis pertaining to the accuracy of using the partial-mouth recording protocol (PRP) in surveillance studies to estimate the periodontitis prevalence, extent, severity, and its risk associations. Methods Medline and Embase databases were searched for studies which assessed the periodontitis prevalence, severity, extent, or its risk associations using PRPs versus full-mouth recording protocols (FRPs); searches were conducted up until May 26, 2021. The risk of bias and the applicability of the studies were assessed using the QUADAS-2 tool. Both qualitative data synthesis and quantitative data synthesis were performed, and comparisons were done for the accuracy and precision of PRPs for different periodontitis outcomes. The study's protocol was registered through the International Platform of Registered Systematic Review and Meta-analysis Protocols (registration number: INPLASY202160032). Results A total of 14 studies were included. The studies had a considerable degree of heterogeneity, along with a moderate risk of bias and applicability concerns. Several factors influenced the accuracy or precision of using PRPs, including the age, distribution of periodontitis in the studied population, PRP selection, total PRP sites, the threshold for minimum sites with CAL, and the severity of periodontitis case definitions. Overall, the PRP with the highest accuracy and precision mainly included (1) a full-mouth protocol at the following partial sites: mesiobuccal-midbuccal-distolingual (MB-B-DL), mesiobuccal-distolingual (MB-DL), mesiobuccal-midbuccal-distobuccal (MB-B-DB), mesiobuccal-distobuccal (MB-DB), and 84 sites using the random site selection method (RSSM) and (2) random-half-mouth (RHM) protocols. Conclusions The PRPs with the highest overall accuracy and precision in estimating the periodontitis prevalence, extent, severity, and risk associations included the full-mouth assessment at the following partial sites: MB-B-DL, MB-DL, MB-B-DB, MB-DB, and 84 sites using RSSM and RHM protocols.

Association between age, gender and education level with the severity of periodontitis in pre-elderly and elderly patients

Background: As individuals grow older, they may be more susceptible to chronic diseases, which can affect their overall health. Periodontitis, for instance, is one of the most common oral diseases that result from prolonged exposure to pathogens. The main etiology of periodontitis is dental biofilms, but several risk factors may also affect the progression of the disease. Purpose: The study aimed to determine whether there was an association between age, gender and education level and the severity of periodontitis using the 2017 American Academy of Periodontology (AAP) classification. Methods: A retrospective analytical study was used to determine the stage and grade of periodontitis in relation to age, gender and education level. Secondary data in the form of medical record status was analysed using software applications. Results: The distribution of periodontitis was 66.7% in pre-elderly patients (45–59 years), 61.5% in male subjects and 39.7% in individuals with middle education levels. Using chi-square analysis, the severity of periodontitis showed a statistically significant correlation with age (p=0.01) and gender (p=0.003). In contrast, the level of education was not statistically correlated to the severity of periodontitis (p=0.887). The percentage of stage IV grade B was highest in elderly patients (65.38%), while stage IV grade C was the highest in male subjects (41.67%). Conclusion: The study showed that age and gender significantly influenced the occurrence and severity of periodontitis, while education level showed the opposite.

Global Prevalence of Periodontal Disease and Lack of Its Surveillance.

Background Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. Objective To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. Methods This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. Results Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. Conclusions Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.

Periodontal Status of Patients Undergoing Hemodialysis Therapy in a Tertiary Level Hospital of Nepal

Introduction: Periodontitis is a chronic inflammation of the supporting structures of the teeth. It has been shown to be associated with systemic diseases including cardiovascular and respiratory diseases, diabetes mellitus and preterm birth. Conflicting reports on the relationship of chronic renal failure patients and periodontal diseases are present in the literature. No previous study has been reported in renal patients in Nepalese population. Hence this study was done to assess the oral hygiene and periodontal conditions in hemodialysis patients in a Tertiary level hospital in Nepal.Methods: Descriptive observational study in which hemodialysis cases were assessed for periodontal parameters including Oral Hygiene- Simplified Index (OHI-S), Plaque Index (PI), Gingival Index (GI), Probing pocket depth (PPD) and clinical attachment level (CAL).Results: A total of 30 patients (20 male, 10 female; mean age 51.06±14.37 years) were assessed. Mean OHI-S, PI, GI, PPD and CAL were 4.02±0.89, 1.93±0.27, 1.57±0.28, 2.09±0.19 and 2.18±0.42, respectively. The distribution of periodontitis was 10% severe, 46.66% moderate and 43.33% mild periodontitis.Conclusions: Hemodialysis patients showed poor oral hygiene and moderate and periodontitis. Hence periodic assessment and periodontal treatment may prevent further complications in these patients.

Epidemiology of Periodontal Disease

Epidemiology is the study of health and disease in populations and of how these states are influenced by biology, heredity, and physical and social environment, as well as personal behavior. Advances in research over recent years have led to a fundamental change in our understanding of the periodontal diseases. As recently as the mid-1960s, the prevailing model for the epidemiology of periodontal diseases included the following precepts: (1) all individuals were considered more or less equally susceptible to severe periodontitis; (2) gingivitis usually progressed to periodontitis with consequent loss of bone support and eventually loss of teeth; (3) susceptibility to periodontitis increased with age and was the main cause of tooth loss after age 35–55. Since the development of this paradigm, advances in the understanding of periodontal diseases have led this disease model to be reevaluated. Current knowledge has shown that periodontitis does not present a linear progression and is not age dependent. Moreover, its distribution and severity are strongly influenced by host susceptibility and risk factors. Several epidemiological studies evaluating destructive periodontal diseases have been pursuing associations in the incessant identification of risk factors for these diseases. Analytical epidemiology seeks to identify the risk factors associated with a disease, to quantify the strength of those associations and to estimate whether an association is causal. An understanding of risk factors can lead to theories of causation and then to treatment protocols for clinicians to use in their daily practice. The essential features of epidemiology as a method of research, when compared to clinical research and case studies, are that (1) groups rather than individuals are the focus of study; (2) persons with and without a particular disease (e.g., periodontal diseases) and with and without the exposure of interest are included, rather than just patients. The study of population groups rather than individuals is to allow for valid estimates while accounting for normal biological variation (e.g., some individuals form dental biofilm readily; others do not). Broadening a study to include those with and without a disease can provide a reference point against which a risk is quantified. Under such background, this special issue was designed to summarize the current status of periodontal epidemiology. Thus, we have invited authors to submit original research articles and analysis that seek to clarify aspects of the epidemiology of periodontal diseases and the relevant related factors. As a result, various interesting and scientifically significant papers have been accepted. This special supplement presents manuscripts reporting information about the prevalence and distribution of periodontitis, as well as their associations with risk factors. In addition several studies reported tooth loss, one of the most visible results of the evolution of periodontitis that causes physiological and psychological impacts on patient's life. These papers represent an exciting and insightful observation into the state of art, as well as emerging future topics, in this important interdisciplinary field. We hope that this special issue would attract a major attention of the peers.

Periodontal disease in pregnancy is a risk factor for preeclampsia

Many recent studies have evaluated the relation between periodontitis and pregnancy complications. This study aimed to examine the association between preeclampsia and periodontitis in Indian women. A total of 130 pregnant women were enrolled between 26-32 weeks of gestation. Oral health examinations were performed at recruitment and again within 48 hours of delivery to determine the presence and/or progression of periodontitis in all subjects. Pocket depth, clinical attachment loss (CAL), and gingival index were measured in all subjects. There was significant (p < 0.05) difference between the preeclampsia and normotensive groups in the distribution of periodontitis both at recruitment and after delivery. Multiple logistic regression demonstrated that periodontitis both at enrolment (OR = 5.78, 95% CI 2.41-13.89) as well as within 48 hours of delivery (OR = 20.15, 95% CI 4.55-89.29), may be associated with an increased risk of preeclampsia.

Risk factors and prevalence of periodontitis in community‐dwelling elders in Mexico

The objective of this study was to determine whether an association existed between chronic systemic diseases/conditions, risk factors common in old age, and the extent and severity of chronic periodontal disease. Sociodemographic and lifestyle characteristics were examined by contrasting rural, urban-marginal, and urban social environments in Central Mexico. Data were analysed with Analysis of Variance, chi2 tests, and multivariable logistic regression. A total of 473 adults 60 years old and over were interviewed; 315 were also examined and underwent laboratory assays (participation rate, 66%); women, 62%; mean age 73+/-8 years; 23% edentulous. The distribution of periodontitis by sociodemographic variables showed differences across locales (73% low-urban, 57% middle-urban, 29% rural). The regression model indicated that periodontitis was more frequently associated with low-urban locale, higher systolic blood pressure, higher body mass index, and worse calculus readings, with an interaction whereby being obese and having a high calculus index was associated with a high probability of having periodontitis. Overall periodontal conditions were fair. While we identified oral, systemic, and social variables that modulated the experience of periodontitis, it would appear that urban, low social class elders appeared to have worse periodontal conditions.

The periodontal disease status of the historical population of Assos

The science of anthropology obtains data on health, disease and death from ancient populations. Research on the skeletal remains of human teeth and surrounding tissues provides useful information on the evolutionary perspective of dental and periodontal diseases. The aim of this study was to determine the prevalence and severity of periodontal diseases in the skeletal remains of 33 Assos inhabitants of the 4th century BC. Three age groups were constituted for the studied population. Periodontal disease status was determined based on the textural and architectural variations of the interdental septum and the extent of bone loss. It was found that the prevalence of periodontal diseases increased with age. The severity of periodontal bone loss also increased with age and the mean alveolar bone loss between age groups was statistically significant (P = 0.004). This analysis of the dental health of ancient populations provides insights into the aetiology, patterns and distribution of periodontitis, which has a very complex disease pathogenesis. Copyright © 2005 John Wiley & Sons, Ltd.

Radiography of spontaneous periodontitis in dogs.

The pattern and distribution of periodontitis were investigated in 162 randomly selected dogs available for necropsy in veterinary practice. There were 82 males and 80 females of 50 different breeds (150 dogs were pure-bred and 12 were mongrels, aged between 7 months and 14 yr. Presence of periodontitis was determined by assessment of alveolar bone loss on radiographs of the skulls and jaws. Periodontitis occurred frequently with increasing age, although the prevalence varied markedly among and within different breeds. Of the breeds most represented in the sample, periodontitis was most frequently seen in poodles and dachshunds but was rarely recognized in German shepherd dogs. Regardless of age, the vast majority of the dogs displayed either one or both of two different radiographic patterns of alveolar bone loss. One pattern was characterized by slight, horizontal alveolar bone loss involving interradicular and interdental areas. The other pattern was one of predominantly crater-like, or narrow, vertical bone defects which, when advanced, often extended around a single root or tooth to surround the root apices. The two types of patterns did not seem to be breed-dependent. The posterior maxillary and mandibular premolars and molars were the most frequently affected teeth. Alveolar bone loss was most severe in the maxilla, while corresponding bone loss in the mandible was more often related to increasing age.

Personal risk factors for generalized periodontitis

Periodontitis is generally considered to be a consequence of an unfavourable host-parasite interaction in which bacteria are the determinants of disease. An intense search continues for the bacteria, specific or non-specific, that are responsible for periodontitis and various forms of the periodontal diseases have been associated with, and are widely believed to be caused by, specific bacterial groups. However, the distribution of periodontopathic bacteria is far wider than the distribution of periodontitis, indicating that the association between bacteria and periodontitis is weak. This paper proposes a paradigm for the etiology of generalized periodontitis in which 'host' factors are not only those triggered by bacteria (the agent) but are also those personal factors that influence the outcome of the host/parasite relationship. The personal factors that diminish the efficiency of host defense may include psycho-social stress from the social environment, factors from the lifestyle such as diet, smoking and alcoholism and systemic factors such as intercurrent disease or deficiencies within the immune/inflammatory system. A model is described in which the interaction of personal factors with the social environment provides the potential for the initiation of periodontitis. Biological variation is significant and the combination of factors that cause generalized periodontitis or any other chronic disease in one individual may not result in dental or any other chronic disease in another.