Natural History Of Periodontal Disease Research Articles

Natural history of periodontal disease: The original Sri Lanka and Oslo studies.

Susceptibility to periodontal disease depends on individual factors within the host response to the bacterial challenge. The study of these factors requires longitudinal studies of an undisturbed development of the disease process. On the basis of the original longitudinal studies on the natural histology of periodontal disease staged in Sri Lanka and Oslo/Norway, several analyses of periodontal parameters and tooth status have been performed. The main findings were that in the first 20 years of complete absence of oral hygiene practices or preventive services attachment was lost at various rates. Three groups of subjects could be identified: rapidly progressing (RP) (8%), moderately progressing (MP) (81%), and subjects with no disease progression (NP) (11%). In the second two decades, the RP subjects have lost most of their teeth and no NP patients were identified anymore. The progression rate in these two decades was much slower, and the tooth mortality decreased. It could be predicted that subjects who had lost more than 2 mm at age 30 would not maintain a functional dentition at age 60. The corresponding control population in Oslo was used to study the influence of gingival inflammation on the initiation and progression of periodontal disease. The pattern and rates of attachment loss were identified in a population that was exposed to optimal and regular preventive services from age 3 onward. In the observation period of 26 years, it could be demonstrated that gingival inflammation varied little throughout adult life and always bleeding sites occurred consistently in 10% to 20%. The role of ongoing gingivitis in the pathogenesis of attachment loss was identified and also reflected stability whenever it was absent. Tooth mortality was only found in subjects with ongoing gingivitis. After 50 years of tooth age, 63% of the teeth were still maintained, while 99.8% were maintained after 50 years when gingival inflammation had been absent. Consequently, continuous gingivitis represented a risk factor for tooth loss.

The natural history of periodontal disease: The Java study-Origin, implementation, and results 35 years on.

This review describes the origin and results of the prospective longitudinal study to test potential prognostic indicators for periodontal breakdown in a population deprived of regular dental care. Experimental gingivitis studies in individuals highly susceptible or highly resistant to periodontitis showed that bleeding on probing developed quite differently: 50% versus 18% bleeding, respectively, after 18 days of no oral hygiene. This formed, together with other clinical and microbiological parameters, the basis for the 15-year prospective study in the Java tea worker population to test potential prognostic indicators for periodontal breakdown. Evaluation showed that during the 15-year observation period of this population aged 15-25 years at baseline, the number of teeth decreased and the periodontal condition deteriorated. Gingival recession showed no increase during the first 7 years of observation, whereas a sixfold increase had occurred thereafter. Attachment loss doubled during the first 7 years, but almost tripled thereafter. Risk markers for disease onset/progression during the first 7 years of observation were age, the number of sites with subgingival calculus, and the subgingival presence of Aggregatibacter actinomycetemcomitans. Over the full period of 15 years the number of sites with a pocket depth of at least 5 mm and the number of sites with recession were identified as risk markers and male gender as a risk determinant. The prevalence of severe periodontitis amounted to 20% in 2002. Analysis showed that, already at baseline and throughout the study period, the periodontal condition in these individuals was more severe compared with the other participants. In conclusion, characteristics of susceptibility to periodontitis are already apparent in young adulthood.

História Natural da Doença Periodontal: uma revisão sistematizada

Introdução: as doenças periodontais consistem em patologias de curso crônico, com etiologia multifatorial, podendo ocasionar diversos malefícios à saúde corporal, por estar associada a outras doenças sistêmicas. Objetivo: realizar uma revisão da literatura a respeito da História Natural da Doença Periodontal. Materiais e métodos: o estudo é caracterizado por uma revisão sistematizada da literatura, com base na temática das doenças periodontais. Foi adotada a base de dados Scielo como fonte de pesquisa, e delimitado o intervalo de publicação dos artigos entre 2015 e 2019. Resultados: foram encontrados 298 artigos e, após a aplicação dos critérios de elegibilidade, foram analisados 12 artigos. A partir daí, foi possível determinar a História Natural da Doença Periodontal, a partir dos períodos de pré-patogênese e patogênese, além do mapa conceitual e análise do modelo hipotético causal. Conclusão: foi possível considerar que as doenças periodontais estão relacionadas, sobretudo, à má higienização e falta de conhecimento, além de múltiplos fatores associados.

Radiographic and periodontal requirements of the American Board of Orthodontics: A modification in the case display requirements for adult and periodontally involved adolescent and preadolescent patients

The increased number of adults undergoing orthodontic treatment is one of the most dramatic changes in our specialty, at least partially due to the population's elevated awareness of dental esthetics. 1 Proffit W. Special considerations in comprehensive treatment for adults. in: Proffit W. Fields H.W. Contemporary orthodontics. 3rd ed. Mosby, St Louis2000: 644-674 Google Scholar Studies have shown an 800% increase in the number of adult orthodontic patients starting treatment between 1970 and 1990. 2 Vanarsdall R.L. Musich D.R. Adult interdisciplinary therapy: diagnosis and treatmen. in: Graber T.M. Vanarsdall R.L. Vig K.W.L. Orthodontics: current principles and techniques. 4th ed. Elsevier-Mosby, St Louis2005: 937-992 Google Scholar In conjunction with the rise in the adult patient pool, orthodontic treatment complexity has likewise increased. Periodontal involvement in adults as young as 18 years has been documented in over 50% of subjects and in most adult patients over 45 years of age. 3 Miller A.J. Brunelle J.A. Carlos J.P. Brown L.J. Loe H. Oral health of United States adults NIH publication 97-2868. National Institute of Dental Research, Bethesda, Md1987 Google Scholar Documentation of advanced periodontal disease has been shown to affect approximately 8% to 30% of the adult population, and many of these patients are unaware of it. 4 Papapanou P.N. Wennström J.L. Gröndahl K. A 10-year retrospective study of periodontal disease progression. J Clin Periodontol. 1989; 16: 403-411 Crossref PubMed Scopus (170) Google Scholar , 5 Löe H. Anerud A. Boysen H. Morrison E. Natural history of periodontal disease in man Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age. J Clin Periodontol. 1986; 13: 431-445 Crossref PubMed Scopus (574) Google Scholar It is logical that some patients who are prone to periodontal involvement will proceed with orthodontic therapy.

The natural history of periodontal disease in humans: risk factors for tooth loss in caries‐free subjects receiving no oral health care

No long-term studies have reported on risk factors for tooth loss in subjects without home or professional dental care. The purpose of this report is to identify potential risk factors for tooth loss among male Sri Lankan tea labourers who participated in a 20-year investigation of the natural history of periodontal disease. Data for this report were obtained from the 455 subjects who participated in multiple examinations over the 20-year period from 1970 to 1990. Analyses included data from interim examinations in 1971, 1973, 1977, 1982 and 1985. Oral health assessments included the following: (1) attachment levels in millimetres on all mesial and mesio-buccal surfaces, excluding third molars; (2) plaque index; (3) gingival index; (4) calculus index; (5) caries index; and (6) missing teeth. Other variables included age, history of smoking and betel nut use. Statistical analyses included descriptive statistics and multivariate repeated-measures modelling with generalized estimating equations. Tooth loss was significantly dependent upon interactions between the mean attachment loss and betel nut use (Z=3.40; p=0.0007) and history of missing teeth (Z=-3.70; p=0.0002). The effect of attachment loss on tooth loss was increased in the presence of betel nut and diminished when teeth were already missing at baseline. History of missing teeth, betel nut use and increasing attachment loss were significant predictors of tooth loss over time. Betel nut use increased the effect of attachment loss on loss of teeth, while history of missing teeth diminished the effect of attachment loss on tooth loss.

Fc γR genetic polymorphisms of periodontal disease in Korean population

Recent estimates indicates that the human genome contains about 25,000 to 35,000 genes1. Genes involved in complex multifactorial diseases such as high blood pressure, diabetes mellitus and periodontal disease, are often referred to as susceptibility genes (or more correctly susceptibility alleles). For these diseases, individuals who inherit susceptibility alleles will not develop disease unless they are exposed to deleterious environments. As for the periodontal disease, gram-negative anaerobic microorganisms, cigarette smoking, and poor oral hygiene are considered to be an important environmental risk factors2. After a 15-year longitudinal study of natural history of periodontal disease in man, Loe et al.3 were able to identify 3 different groups in individuals with poor oral hygiene and no access to dental care. Only 8% of subjects showed periodontal disease with a rapid progression and the majority of subjects (81%) showed moderate progression. However, 11% of subjects exhibited no progression at all even they did not perform any conventional oral hygiene measures, and consequently, displayed large aggregates of plaque, calculus and stain on their teeth. This variation is thought to be attributed to either unrecognized components of the environment or different susceptibility among individuals. This susceptibility could be considered as genetic factors. It has been recognized for years that aggressive periodontitis (formerly called juvenile periodontitis) aggregates in families4,5. In the aggregation study conducted in the US, the autosomal dominant mode was favored in AfricanAmerican and Caucasian families6. The estimated frequency of the disease allele, however, was significantly higher in AfricanAmericans and it reflects the higher prevalence of aggressive periodontitis in this group. Very few investigations have been performed

Longitudinal study on periodontal conditions in healthy elderly people in Japan.

A strategy for the control of periodontal disease progression is required to prevent tooth loss in older people. However, detailed epidemiological data on periodontal conditions in elderly people is limited. The purpose of the present study is to describe the natural history of periodontal disease and to evaluate the intraoral factors relating to the disease progression in systemically healthy elderly people. In the cross-sectional study, 599 and 162 subjects aged 70 and 80 years, respectively, were examined. Of those subjects aged 70 years, 436 (73%) participated in the 2-year longitudinal study. Pocket depth (PD) and attachment level (AL) were measured for all functioning teeth at six sites per tooth. In the cross-sectional study, AL of 4 mm or greater and 7 mm or greater were defined as moderate and severe disease, respectively. In the longitudinal study, a change in AL of 3 mm or greater at each site was defined as periodontal disease progression. In the cross-sectional study, 97.1% of the subjects had at least one site of AL of 4 mm or greater (4+ mm). The prevalence of AL of 7 mm or greater (7+ mm) was 47.9%, with 2.8 affected teeth per person in those with AL 7+ mm. These findings reveal that periodontal disease is extremely widespread in the elderly population. However, very few had many teeth with severe periodontal conditions. In the longitudinal study, 75.1% experienced attachment loss of 3 mm or greater (3+ mm) during the 2-year study period. Of those subjects who experienced attachment loss, a mean of 4.7 teeth exhibited attachment loss. Multivariate logistic regression showed that both the highest AL in each tooth at baseline and abutment teeth for removable partial dentures were significantly related to periodontal disease progression as well as tooth loss incidence. These results suggest that teeth with poor periodontal conditions as well as abutment teeth for removable partial dentures were significant intraoral factors relating to periodontal disease progression as well as tooth loss.

The natural history of periodontal disease in man. Risk factors for progression of attachment loss in individuals receiving no oral health care.

Few investigations have reported on risk factors for periodontal attachment loss over time in subjects with no home or professional dental care. The purpose of this report was to identify potential risk factors for progression of periodontal attachment loss among male Sri Lankan tea laborers who participated in a 20-year investigation of the natural history of periodontal disease. Data for this report were obtained from the 154 subjects who participated in the 1970 baseline and the final 1990 examinations and included data from their interim examinations performed in 1971, 1973, 1977, 1982, and 1985. Oral health assessments included: 1) attachment levels in millimeters on mesial and mesio-buccal surfaces of all but third molar teeth; 2) plaque index (PI); 3) gingival index (GI); 4) calculus index (CI); 5) caries index (DMFS); and 6) presence or absence of teeth. Other variables included age, history of smoking, and/or use of betel nut. Statistical analyses used multivariate repeated measures analysis of variance (ANOVA). The final adjusted model indicated that attachment loss increased significantly with age (X2 = 74.0; df = 1), GI (X2 = 45.5; df = 1), CI (X2 = 52.7; df = 1) and follow-up time (X2 = 219.8; df = 6, P<0.0001 for all variables). Age, GI, CI, and time were significantly associated with mean attachment loss over 20 years. Neither PI, history of smoking, or history of betel nut use were significantly associated with attachment loss over time.

The prevalence and natural history of periodontal disease in Britain from prehistoric to modern times.

To investigate the prevalence of periodontitis in British populations during the past 3000 years. To discuss the relevance of these findings to modern populations denied access to modern dental treatment. Observation and assessment of periodontal status of skeletal material using a recently developed method of assessment. Archaeological material from various collections throughout UK covering prehistoric, mediaeval and seventeenth to nineteenth century. 504 individuals. The periodontal status of individual septa was recorded as to whether they were healthy, had gingivitis or periodontitis. The prevalence of periodontitis among individuals and populations was assessed. The prevalence of periodontitis appears to have remained virtually constant during the past 3000 years in Britain, despite considerable changes in the oral environment. The significance of these findings in respect of untreated populations in underdeveloped countries today is considerable. It is considered essential that clinical and field studies record and report on oral environmental factors that may mimic or, by themselves, be responsible for periodontal attachment loss.

Prevalence and natural history of periodontal disease in prehistoric Scots (pre-900 AD).

The periodontal status of a Scottish prehistoric population was studied. No individual over the age of 10 yr had an entirely healthy periodontium. Gingivitis was the most widespread disease state in the adolescent and younger age groups. The progression towards periodontitis was at a constant rate and mirrored modern epidemiological studies. A small proportion of individuals proved to be either more susceptible or resistant to periodontal disease. There was no evidence of periodontal disease prevalence being higher than that of modern societies with access to dental treatment. Much can be learnt regarding the natural history of periodontal disease by the study of archaeological material.

Lost in the pocket: the current status of periodontal diagnosis

A number of "state of the art" diagnostic procedures based on data generated by technological advances in microbiology, immunology and molecular cell biology have been developed to assist the dentist in identifying patients at risk of acquiring periodontal disease or who are currently experiencing loss of periodontal attachment. This paper challenges the assumptions upon which these tests are based and presents an alternative hypothesis of the natural history of periodontal disease. This hypothesis considers the microflora of the oral cavity and the inflammatory response of the host to be part of an ecosystem which has evolved over many years of interaction and adaptation between unicellular and multicellular organisms. These interactions have resulted in the selection of biological strategies that provide intrinsic benefits to the host and to the microorganisms comprising the indigenous flora.

The natural history of periodontal disease. The correlation of selected microbiological parameters with disease severity in Sri Lankan tea workers.

The purpose of this study was to assess the prevalence of A. actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and their association with periodontal disease states in a population sample from Sri Lanka. Based on clinical parameters, a total of 536 sites in 268 male Sri Lankan tea workers were categorized as healthy, or showing gingivitis only, moderate or advanced periodontitis. Bacterial samples were obtained from all sites and the three target bacteria identified by indirect immunofluorescence. P. intermedia, P. gingivalis and A. actinomycetemcomitans were found in 76%, 40% and 15% of the subjects, respectively. Of the 536 periodontal sites, 10.5% were categorized with "no disease", 14% "gingivitis only": 59% with moderate and 16% with advanced periodontitis. The prevalence of P. gingivalis and P. intermedia was significantly higher in sites with moderate and advanced periodontitis than in sites with no disease or gingivitis only. A. actinomycetemcomitans was not found in healthy sites, but occurred with equal frequency in sites with gingivitis, moderate and advanced periodontitis. The association between these three bacteria and periodontal diseases in Sri Lankan tea laborers was similar to that described for other non-industrialized and industrialized countries.

Prevention of Periodontal Diseases in Adults: Strategies for the Future

Gingivitis and periodontitis are the most prevalent periodontal diseases in adults. Gingivitis is characterized by inflammation of the gingiva without loss of connective tissue attachment to the teeth while peridontitis results in loss of attachment and alveolar bone and may lead to tooth loss. Gingivitis is highly prevalent in adults in the United States, and up to 70% of adults have at least mild periodontitis. In only a small proportion of adults (<15%) does periodontitis progress to severe disease. The etiology of periodontal disease is infection with pathogenic dental plaque bacteria in a susceptible host. Strategies for preventing periodontal diseases therefore may intervene at the level of the initiation of the inflammatory process, or by preventing the progression of bone and attachment loss in periodontitis. Improved mechanical and chemical plaque control as well as improved restorative materials to facilitate plaque removal continue to enhance the patient′s ability to control the plaque bacteria. Strategies to target prevention to the patients who need it most include risk factor assessment, new diagnostic methods, and further elucidation of the natural history of periodontal disease. Further study of the etiology and pathophysiology of periodontitis will aid in the prevention of further destruction through targeted use of local and systemic antibiotics and well as drugs to aid in the host response. Ultimately research may yield multivalent vaccines to be used in high-risk patients.

Prevalence and natural history of periodontal disease in a London, Spitalfields, population (1645–1852 AD)

The periodontal health of an eighteenth century English population was investigated using a method of assessing the interdental septa for varying degrees of textural and architectural changes. It was found that, despite the fact that no effective dental treatment was available, the prevalence and distribution of periodontitis lesions were similar to those in modern English populations. The study confirmed the existence of susceptible and resistant subgroups of individuals and of teeth. The sixth decade appeared to have been a period of increased susceptibility to periodontitis. The findings do not support the view that periodontal disease is the primary cause of tooth loss in the uncared-for dentition.

Prevalence and natural history of periodontal disease in Scotland – The mediaeval period (900–1600 A. D.)

The periodontal status of a Scottish medieval population was studied. No individual over the age of 11 years had an entirely healthy periodontium. While gingivitis was widespread in the younger age groups, it was essentially a "contained" gingivitis which appeared to progress towards a periodontitis at a fairly constant but slow rate. The pattern of prevalence and distribution of gingivitis and periodontitis was similar to many modern epidemiological studies on natural dentitions but did not support the view that the prevalence of periodontitis in historic material was high. A small proportion of individuals appeared to be either susceptible or resistant to periodontal disease. It was concluded that the study of historic material provides valuable information with regard to the natural history of human periodontal disease.

Discussion: Natural history of periodontal disease in man

Journal of Clinical PeriodontologyVolume 13, Issue 5 p. 441-444 Discussion: Natural history of periodontal disease in man John C. Greene, John C. Greene Professor and Dean, School of Dentistry, University of California, San Francisco, CA, USASearch for more papers by this author John C. Greene, John C. Greene Professor and Dean, School of Dentistry, University of California, San Francisco, CA, USASearch for more papers by this author First published: May 1986 https://doi.org/10.1111/j.1600-051X.1986.tb01488.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume13, Issue5May 1986Pages 441-444 RelatedInformation

Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age.

This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14-46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well-trained and experienced periodontitis. Intra-examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (approximately 8%) with rapid progression of periodontal disease (RP), those (approximately 81%) with moderate progression (MP), and a group (approximately 11%) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was approximately 9 mm, the MP group had approximately 4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was approximately 13 mm and the MP group approximately 7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade.(ABSTRACT TRUNCATED AT 400 WORDS)

The natural history of periodontal disease in man

This report (the 4th in a series) waas derived from a longitudinal study of the development and progress of periodontla disease and resultant tooth loss. The first population group was established in Oslo, Norway in 1969 and Consisited of 565 male, nono‐dental students and academicians between 17 and 30+ years. A second group was establishe in Sri Lanka in 1970 and consisted of 480 male tea laborers between 15 and 30+ years. Both populations were examined 4 times and the time span between the first and fourth examinations was in Oslo 6 years ad 3 months, In Sri Lanka 7 years and 6 months. Each participant was scored for various disease parameters including the Plaque and Gingival Indices systems. The results show that for the 17 year old Norwegian the overall gingival state was good to excellent and comparable to that reported for Scandinavian dental students. There was no increase in prevalence and severity of gingival from the late teens to approximately 40 years of age. The 17 year old Sri Lankan's gingival health was considerably poorer, and a slight increase i GI levels occurred toward teh age of 40 years. In Norwegians, approximately 60–70 percent of all tooth surfaces did not have visible plaque and oral hygiene continued to improve towards 40 years of age. In the Sri Lankans, clinically recognized plaque regularly covered almost all tooth surfaces at 15 years old and no significant change occurred before 40 years of age.

The natural history of periodontal disease in man: the rate of periodontal destruction before 40 years of age

The natural history of periodontal disease in man: the rate of periodontal destruction before 40 years of age

The natural history of periodontal disease in man

The meaterial presented in this report was derived from an longitudinal studt of the development and progress of periodontal disease and resultant tooth loss. The first population group was established in Oslo, Norway in 1969 and consisted of 565 male, non_dental students and academicians between 17 and 30+years. a nad second group was established in Sri Lanka in 1970 and consisted of 480 male tea loborers between the first and fourth examination was in Oslo 6 years and 3 months, in Sri Landka 7 years and 6 months. Each participant was scored for various disease parameters and the number of permanent teeth (third molars excluded) was recorded at each examination. The results show that in these randomly sampled groups no one was edentulous. The 17 year old Norwegian had 27.4 teeth present out of 28 possible and no major loss of teeth occurred during the twenties and thirties. As the participants approched 40 years of age, the mean number of teeth present was 27.1 and the mean mortality rate was 0.01 teeth per year. The Sri Lankan 15 year old had 27 teeth present and the 40 year old had 25.6 teeth. The mean mortality rate ranged between 0.1 and 0.3 teeth per year. Teeth with deep periodontal lesions started to exfoliated in Sri Lankans as they approached 40 years of age.