Radiographic Alveolar Bone Loss Research Articles

Correlation of C-Reactive Proteins With Chronic Periodontitis. A Prospective Study

Abstract Context: The C-reactive protein (CRP) is an acute-phase reactant protein that is produced in response to various inflammatory and noxious stimuli that include exposure to heat, traumatic conditions, varieties of infectious processes, and conditions of hypoxia. Estimation of CRP levels in serum samples helps in providing important information related to the diagnosis, monitoring, and treatment of inflammatory processes and various associated diseases. Materials and Methods: This prospective longitudinal study was designed to evaluate serum CRPs in subjects who were selected for study participation after fitting into inclusion criteria, which were as follows: a) study participants who were clinically diagnosed with chronic generalized periodontitis along with periodontal pocket depths of ≥5 mm and also radiographic alveolar bone loss; b) subjects within the age range of 35 to 55 years; and c) no smoking habit or use of tobacco in any other form. Results: Patients were assessed for clinical parameters such as gingival index, sulcular bleeding index, mean depth of periodontal pocket, and loss of clinical attachment. Blood was collected at required visits, and CRP was evaluated. Study evaluation periods were baseline (day 0), day 14 (2nd appointment), and day 45 (3rd appointment). Results: Statistically significant reductions in both clinical and serum CRP levels were obtained at subsequent appointments. Conclusion: This study has demonstrated and supported the evidence that serum CRPs act as a biomarker in determining the prognosis of chronic periodontitis patients after nonsurgical periodontal treatment.

ACES: A new framework for the application of the 2018 periodontal status classification scheme to epidemiological survey data.

To propose a framework for consistently applying the 2018 periodontal status classification scheme to epidemiological surveys (Application of the 2018 periodontal status Classification to Epidemiological Survey data, ACES). We specified data requirements and workflows for either completed or planned epidemiological surveys, utilizing commonly collected measures of periodontal status (clinical attachment levels [CAL], probing depths, bleeding on probing), as well as additional necessary variables for the implementation of the 2018 periodontal status classification (tooth loss due to periodontitis and complexity factors). Following detailed instructions and flowcharts, survey participants are classified as having periodontal health, gingivitis or periodontitis. Rates of edentulism must also be reported. In cases of periodontitis, instructions on how to compute the stage and extent are provided. Assessment of grade can be derived from CAL measurements (or from radiographic alveolar bone loss data) in relation to root length and the participant's age. ACES is a framework to be used in epidemiological studies of periodontal status that (i) have been completed, and in which stage and grade according to the 2018 classification are inferred retroactively, or (ii) are being planned. Consistent use of the proposed comprehensive approach will facilitate the comparability of periodontitis prevalence estimates across studies.

The impact of vitamin D on clinical parameters and bone turnover biomarkers in ligature-induced periodontitis: An experimental study in rats

Objectives and BackgroundVitamin D has been associated with an increased risk of tooth loss andtheseverity of periodontal diseases. This study aimed to evaluatethe effect ofvitamin Don the clinical, radiographic,and serum level changes of bone turnover biomarkers in ligature-induced periodontitis. MethodsA total of 28 rats were included in this study and divided into test groups:Vitamin D supplement (VS), Vitamin D deficient (VD),and control (CG). Ligature-induced periodontal tissue destruction was performed and kept for 21 days. Clinical attachment and radiographic changes were recorded, andserum samplesweretested for Osteoprotegerin (OPG), Dickkopf-1 (DKK1), Sclerostin (SOST), and Fibroblast growth factor 23 (FGF23) on the initial and final day of the study. ResultsGroups that were made VD exhibitedamore significant amountof clinical attachment loss (1.05 ± 0.50 mm)compared totheCG (0.83 ± 0.14 mm) and VS group(0.60 ± 0.13 mm), showing significant differences (p < 0.05). The radiographic alveolar bone loss amount was greater inthe VD groupcompared to the other groups. For serum level assessment,theVD groups also exhibited a statistically significantreduction inthelevels of OPG. They showed higherconcentrations ofDKK1, SOST,and FGF23than other groups,with significant differences (p < 0.05). ConclusionThe results revealed that Vitamin D mayplay a role inthe progression ofperiodontal disease. It was found to affect both clinical parameters and bone turnover biomarkers, suggesting its potential impact on the disease process.

Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis

AimsTo evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. MethodologyIndividuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro‑aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. ResultsThe mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). ConclusionCombined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.

Periodontitis is associated with an increased hazard of mortality in a longitudinal cohort study over 50 years.

To evaluate the association between periodontal disease and all-cause mortality in a longitudinal cohort study over 50 years. Participants (N= 1156) in the Veterans Affairs Dental Longitudinal Study, aged 25-85 years at enrollment in 1968, received comprehensive medical and oral exams approximately every 3 years through 2007. Periodontal status was defined using person-level, mean whole-mouth radiographic alveolar bone loss (ABL) scores using a five-point Schei ruler, each unit representing 20% increments of ABL. Time-varying Cox regression models estimated hazard ratios (HRs) for the association between continuous and categorical ABL and mortality, adjusting for covariates. Each one-unit increase in mean ABL score was associated with a 14% increase in the hazard of mortality (adjusted HR=1.14, 95% confidence interval [CI] 1.02, 1.27). When assessed categorically, HRs for average scores of 2 to <3 and 3 to ≤5 showed increasing associations with hazard of mortality, relative to 0 to <1 (adjusted HR=1.17, 95% CI 0.94, 1.46; and HR=1.65, 95% CI 0.94, 2.85, respectively). By contrast, we observed null associations for average scores of 1 to <2 relative to 0 to <1 (adjusted HR=1.00, 95% CI 0.86, 1.17). Time-varying periodontal status assessed using radiographic ABL was positively associated with all-cause mortality even after confounder adjustment.

Description of alveolar bone resorption in partially edentulous mandible of a female patient in panoramic radiograph

&#x0D; Objective: The purpose of this research was to determine alveolar bone resorption by measuring alveolar bone height in the mandible of partially edentulous female patients through panoramic radiograph&#x0D; &#x0D; &#x0D; Material and Methods: The method of this study was descriptive using 34 panoramic radiographs of partially edentulous mandible in female patients aged 20-45 years in Dental Radiology Installation of Unpad Dental Hospital from 2016 to 2017. Alveolar bone height was measured using Proximal RABL (Radiographic Alveolar Bone Loss) method with the help of Ez-Pax Plus software.&#x0D; &#x0D; &#x0D; Results: The highest average alveolar bone height was 3.5 mm and 12.96% of them occurred in 30-35 years age group. The lowest height was 3 mm with 10.98% occurred in 20-29 years age group.&#x0D; &#x0D; &#x0D; Conclusion: Alveolar bone height in partially edentulous mandible of female patients underwent resorption of mild classification according to proximal RABL method.&#x0D;

Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study.

ObjectiveWe aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan.BackgroundFew studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan.MethodsThe participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque.ResultsOf 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively.ConclusionThe absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.

Correction of Class II division 2 with crowding and bilateral fully transposed impacted mandibular canines

Abstract Background Maxillary canine impaction has been extensively reported, but studies of mandibular canine impaction are relatively few. Clinical studies and reports of experience treating mandibular canine impaction are of clinical benefit to both orthodontists and dentists. Aims This report introduces a Class II division 2 crowded case with severely impacted, fully transposed, mandibular canines treated by a non-extraction approach and mandibular arch expansion. Methods The completely transposed, impacted, mandibular canines were successfully aligned. The crowding was relieved by arch expansion and incisor proclination without obvious radiographic alveolar bone loss. The two severely labially displaced mandibular canines assisted in the expansion of the narrow mandibular arch. Results The maxillary and mandibular arches were expanded and well aligned, and Class II molar and canine relationships and a normal overjet and overbite were established. The mandibular canines were aligned in advantageous positions. There was no regional alveolar bone resorption around the mandibular canines. Conclusion The treatment approach provided an example of significant bone remodelling. Using the impacted mandibular canines for anchorage, the age of the patient provided an opportunity to adopt a relatively conservative and unique treatment approach which may be applied to relieve crowding.

"Differences of Annual Radiographic Alveolar Bone Loss Rates of Anterior and Posterior Teeth of Individuals Affected with Secondary Occlusal Traumatism between with and without Perioprosthetic Therapy"

"Differences of Annual Radiographic Alveolar Bone Loss Rates of Anterior and Posterior Teeth of Individuals Affected with Secondary Occlusal Traumatism between with and without Perioprosthetic Therapy"

Annually and Cumulative Radiographic Alveolar Bone Loss Rates using Digital Scanning Image for the Periodontal Disease Groups before and after Periodontal Treatment

The aim of the present study was to assess the cumulative radiographic alveolar bone loss (CRABL) and yearly radiographic periodontal attachment loss (YRABL) of periodontal disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standardized paralleling radiographs with separated periods of 5 years or more in Kaohsiung Medical University Hospital during 1981-2001, were collected for the past 20 years.&#x0D; The radiographic alveolar bone levels at mesial and distal aspects of teeth were assessed by measuring the distance between cemento-enamel junction and alveolar bone crest using an electronic digimatic caliper (EDC) under a 3.5X magnified radiographs.&#x0D; The results revealed that 1) patients with a periodic recall (3-4 times/yr.) showed a significantly lower loss rate than patients without periodic recalls; 2) mean CRPAL was highest in the generalized aggressive periodontitis (GAgP) group (5.52±3.27mm), then the chronic periodontitis (CP) group (4.82±3.47mm), and the localized aggressive periodontitis (LAgP) group (4.47±3.47mm) followed, and lowest in the periodontal healthy (PH) group (1.05±0.59mm); 3) mean YRPAL was the highest in the LAgP group (0.26±0.25mm/yr.), then the GAgP group (0.20±0.13 mm/yr.), and the CP group (0.12±0.09 mm/yr.) followed, and lowest in the periodontal healthy group (0.07±0.06 mm/yr.).&#x0D; It was concluded that: 1) sites with more advanced alveolar bone loss are more likely to undergo further breakdown; 2) patients with a periodic recall showed a significantly lower alveolar bone loss rate and bone gain, irrespective disease groups; 3) mean CPBLs was highest in the GAgP group; mean YRABLs was highest in the LAgP.

Vertical radiographic alveolar bone loss in smokers and non-smokers with periodontitis: A pilot study

Smoking is considered a potential risk factor for the prevalence and severity of vertical alveolar bone loss. An increased occurrence of vertical bone defects has been observed in cigarette smokers as compared to non-smokers. A study was undertaken to compare vertical interproximal alveolar bony defects in smokers and non-smokers with chronic periodontal disease. A convenient sample of 60 orthopantomographic records of patients with chronic periodontal disease was selected. 30 patients were smokers and 30 were non-smokers. Bone height measurements were made utilizing extraoral digital panoramic radiographs obtained from patients’ digital records. The prevalence and severity of vertical bone loss were determined in smoker patients and compared to non-smokers. Any associations with particular groups of teeth and smoking were investigated, as well as any related gender differences. A greater mean millimeter vertical bone loss was observed in smokers as compared to non-smokers (1.112±0.784 mm vs. 0.935±0.887 mm), however this finding was not statistically significant (p=0.418). An increased prevalence of vertical bone loss was found in smokers as compared to non-smokers (10.06% vs. 8.76% respectively). Premolar groups of teeth and specifically maxillary premolars were significantly more affected (1.416±1.234 mm; p=0.030; 1.619±1.816 mm; p=0.002 respectively). No significant gender-wise differences of mean millimeter vertical bone loss were found between the different groups of teeth in smokers as compared to non-smokers. The present study supports the role of smoking to be considered as a risk factor for the development of vertical alveolar bone defects. Smokers presented with more severe vertical radiographic alveolar bone loss as compared to non-smokers, including maxillary premolars being significantly more affected. Further studies are suggested including comparisons between various radiographic techniques (FMX, OPG, CBCT) in the detection of alveolar bone loss.

Association of periodontitis with oral malodor in Korean adults.

This study aimed to evaluate the association of periodontitis with the organoleptic score (OLS)-defined oral malodor after validating OLS with odoriferous sulfur compounds in mouth air among Korean adults. A total of 330 adults aged 47–86 years were recruited from the Yangpyeong health cohort, South Korea, in 2015. Oral malodor was assessed using a 6-point OLS by a trained dentist and validated with the concentrations of hydrogen sulfide (HS) and methyl mercaptan (MM) using a gas chromatographer. Periodontitis was measured by assessing the radiographic alveolar bone loss on digital orthopantomography. Statistical analyses including descriptive statistics, partial correlation, ANOVA, and multivariable logistic regression with putative confounders were applied. OLS was significantly correlated with the concentrations of HS and MM (partial r = 0.401 and 0.392, respectively; both p<0.001) after controlling for confounders. Individuals with periodontitis had 1.8 times the risk of OLS-defined oral malodor in multivariable models (adjusted odds ratio = 1.77 in the model with the number of teeth and 1.82 in the model with denture wearing; p = 0.047 and 0.035, respectively). Periodontitis was associated with OLS-defined oral malodor among Korean adults independent of known confounders. Periodontal conditions should be considered for clinical practice and research of oral malodor.

Annually Radiographic Periodontal Bone Loss Rates of Tooth Affected Severe Advanced Periodontitis with Secondary Occlusal Traumatism

Objective: The purpose of present study was to evaluate the differences of teeth using annually radiographic alveolar bone loss in cases involved severe advanced periodontitis with secondary occlusal traumatism among at the baseline of periodontal evaluation.

Periodontal status at diagnosis predicts non-disease-specific survival in a geographically defined cohort of patients with oropharynx squamous cell carcinoma

Background: The aim of this study was to examine periodontal status with a time-efficient screening method from a cohort of newly diagnosed oropharynx squamous cell carcinoma (OPSCC) patients and to study to what extent dental disease level predicted survival.Aims/objective: Can measuring level of dental pathology based on a blind investigation of a routine orthopantogram (OPG) obtained during diagnostic workup reveal prognostic information?Materials and methods: We included 97 patients diagnosed between 2003 and 2010. Radiographic alveolar bone loss was measured. At least 4 mm bone loss from cement–enamel junction on at least two teeth was registered as periodontal pathology. The number of missing and filled teeth (MFT), residual roots and apical radiolucencies were noted. Clinical data were determined through hospital patient records.Results: The horizontal bone loss discriminated between hr-HPV(+) versus hr-HPV(−) status, but secondary to age and smoking history at diagnosis. Vertical and horizontal bone loss predicted survival directly, and adjusted by gender, patient, smoking history, TN stage and hr-HPV tumor infection at diagnosis.Conclusions: Degree of periodontal OPG pathology at the time of OPSCC diagnosis to some extent predicted hr-HPV infection, but predicted non-disease-specific long-term survival.Significance: Degree of periodontal OPG pathology at diagnosis predicts prognosis.

Radiographic bone loss in a Scottish non-smoking type 1 diabetes mellitus population: A bitewing radiographic study.

The dental complications of uncontrolled diabetes include reduced salivary flow rate, candidiasis and periodontal manifestations. A recent meta-analysis concluded that diabetes patients have a significantly higher severity, but not extent, of destructive periodontal disease than non-diabetics. The authors reported that most type-1 diabetes studies using dental radiographic data have not controlled for confounding factors such as smoking. The aim of this cross-sectional study was to compare radiographic alveolar bone loss between type 1 diabetes (T1DM) and non-diabetes (NDM) participants in a Scottish non-smoking population. Digital bitewing radiographs for 174 Scottish adults never or ex-smoker (>5 years) participants (108 T1DM, 66 NDS), recruited from outpatient clinics throughout Greater Glasgow and Clyde, were included in the analysis. A single blinded, trained, and calibrated examiner recorded the radiographic bone loss seen on bitewing radiographs using the digital screen caliper (Screen Calliper ICONICO version 4.0 (Copyright (C) 2001-6 Iconico), New York). The bone loss was measured as the distance between the cemento-enamel junction (CEJ) and the deepest radiographic alveolar bone margin interproximally of each tooth. T1DM participants had more radiographic alveolar bone loss throughout the all teeth measured (median:1.27 mm versus 1.06 mm, P < 0.001) and more than a two-fold increase in the risk of having sites with ≥2 mm periodontal destruction (OR = 2.297, 95%CI 1.058 to 4.986, P = 0.036) compared with non-diabetes subjects. Patients suffering from type 1 diabetes are at higher risk of periodontitis even when controlling for multiple possible confounding factors and this difference can be detected on routine dental radiographs at an early stage. These data confirm radiographically the previously reported association between T1DM and periodontal bone loss.

Determination of the Influence of Chronic Periodontitis on Pulp Sensibility by Means of Electric and Thermal Cold Testing

IntroductionCommunication between pulp and periodontal tissue has been well established. However, it is unknown when periodontal disease begins to affect the clinical response of pulp tissue. The aim of this study was to assess the influence of periodontal severity on pulp sensibility by means of electric and thermal cold testing. MethodsThe teeth assessed in this study were allocated into 3 groups considering radiographic alveolar bone loss (ABL) as follows: slight periodontitis (SP, ABL ≤7 mm without reaching the apex, n = 25), moderate periodontitis (ABL >7 mm without reaching the apex, n = 23), and severe periodontitis (SvP, ABL >7 reaching the apex, n = 8). Gingival recession (GR), probing depth (PD), and clinical attachment level (CAL) were also measured. ResultsThe results showed higher levels of PD and CAL in the SvP group compared with the SP group (P < .05), with no significant difference in GR (P > .05). The SvP group showed significant ABL compared with the other groups (P > .05). The SP group showed a significant number of teeth with a positive pulp response, whereas the SvP group showed a significant number of teeth with a negative pulp response (P < .05); no significant differences were observed between the thermal cold and electric tests (P > .05). ConclusionsWithin the limits of this study, it can be concluded that pulp clinical involvement with a negative response to thermal cold and electric testing occurs only in the most advanced stage of chronic periodontitis with apical involvement.

Metacarpal Cortical Bone Area Predicts Tooth Loss in Men.

The relationship between bone mineral density and tooth loss in men is unclear. The aim of this retrospective cohort study was to determine if relative metacarpal bone area (MCA) predicts tooth loss in a cohort of 273 male participants in the Dental Longitudinal Study and Normative Aging Study of the Department of Veterans Affairs. Outer and inner cortical bone widths of the middle metacarpal of the nondominant hand were measured on anteroposterior hand radiographs approximately 11 y apart. Baseline MCA was computed and categorized into quartiles. The men were followed from 1971 to 2015. Incident tooth loss during 2 intervals was examined: concurrent with the MCA measurements and long term over the total follow-up (17 ± 7 y). Radiographic alveolar bone loss (ABL) was measured on periapical radiographs as a percentage of the distance from the cementoenamel junction to root apex, and the number of teeth with ABL >40% was computed. Negative binomial generalized linear regression models estimated the mean number of teeth with ABL >40% and the number lost (concurrent and total), controlling for age, smoking, number of teeth at baseline, percentage teeth with ≥1 decayed/filled surface, and years of follow-up. At baseline, MCA was inversely related to number of teeth with >40% ABL. Men in the lowest MCA quartile (Q1) lost the most teeth, both concurrent with MCA measurements and long term, but the association differed by caries level (≤55% or >55% decayed/filled teeth). At the low caries level, the numbers lost in Q1 were 29% greater than in the highest MCA quartile (Q4). At the high caries level, the numbers lost in Q1 were more than twice those in Q4. Associations were attenuated when further controlled for number of teeth with ABL>40%. These findings suggest that systemic bone status plays a role in tooth loss and that the association may be mediated by alveolar bone loss. Knowledge Transfer Statement: Low relative metacarpal bone area was related to loss of alveolar bone and incident tooth loss in men. This information extends previous research, primarily studies of women, showing that osteoporosis adversely affects oral health. Knowledge of a patient's systemic bone status may be important for managing his or her periodontal disease. Tooth loss in the absence of periodontal inflammation may signify systemic bone loss. Interprofessional communication is central to maintaining optimal oral and bone health.

Periodontitis is associated with the risk of subclinical atherosclerosis and peripheral arterial disease in Korean adults

Background and aimsWe aimed to evaluate the association of periodontitis with the development of early atherosclerotic vascular disease in Korean adults. MethodsIn this cross-sectional study, a total of 1343 adults aged over 40 years were recruited from a community-based cohort of Yangpyeong county, Korea, during the period 2010–2014. Only dentate individuals were included in the study. Subclinical atherosclerosis (SA) was defined as carotid intima-media thickness (cIMT)≥0.754 mm, as assessed bilaterally by B-mode ultrasound. Peripheral arterial disease (PAD) was defined as ankle-brachial index (ABI)≤1.0, as measured by Doppler. History of periodontitis was assessed by measuring the radiographic alveolar bone loss (RABL) on a digital dental panorama and was classified into three groups: normal, moderate and severe periodontitis (≥2 non-adjacent interproximal sites with RABL≥4 mm and 6 mm, respectively). The associations of periodontitis with SA and PAD were evaluated by multivariable logistic regression analysis and analysis of covariance, adjusted for age, sex, education level, tooth loss, smoking, drinking, exercise, obesity, triglycerides, HDL, LDL, hs-CRP, diabetes and hypertension. Stratified analyses were performed to identify specific risk groups. ResultsAfter controlling for confounders, severe periodontitis was associated with SA [adjusted odds ratio (aOR) = 1.55; 95% confidence interval (CI): 1.07–2.24] and PAD (aOR = 2.03; 95% CI: 1.05–3.93). These associations were highlighted in never-smokers. For increasing severity of periodontitis, the adjusted mean cIMT increased (p = 0.011) while that of ABI decreased (p = 0.033). ConclusionsOur data showed that periodontitis is a substantially important risk factor for atherosclerotic vascular disease among Korean adults.

Survival rate of teeth with periodontally hopeless prognosis after therapies with intentional replantation and perioprosthetic procedures - a study of case series for 5-12 years.

The purpose of the present study was to evaluate the longitudinal survival rate of the treatment of teeth affected with periodontally hopeless prognosis and secondary occlusal traumatism (SOT) using intentional replantation (IR) and periodontal prosthesis. We collected data from 17 individuals who received IR and participated in the study during 1995 to 2014. Of the 17 teeth affected by periodontally extreme conditions with deep angular bone defects, severe alveolar bone loss extending to or beyond the apex, and SOT, was recognized as having hopeless prognosis. Those teeth were treated sequentially using procedures that included basic periodontal therapy, therapeutic provisional prosthesis, IR, fixed dental prosthesis, crown and sleeve‐coping telescopic dentures (CSCTDs), or fixed prosthesis and CSCTD combined. Longitudinal assessments of clinical parameters and radiographic bone change before and after IR were evaluated. Clinical results showed that the overall cumulative survival rate of assayed teeth after IR therapy (5–12 years) was 88.2%. The mean (±SD) estimated radiographic alveolar bone loss was 12.7 ± 2.1 mm (88.5% ± 13.3%) of the root length, initially, and estimated radiographic alveolar bone gain was 4.0 ± 2.2 mm ultimately, in 17 replanted teeth with SOT. Only one tooth (5.9%) exhibited root resorption. Ankylosis was not observed during the study. Periapical radiographs demonstrated that satisfactory periodontal healing of lamina dura and bone fills occurred in all replanted teeth with SOT. Generally, tooth mobility and SOT were significantly improved after therapy. Most treated teeth functioned well and remained stable clinically throughout the periods of study. The present study documented a promising outcome for autogenous IR and periprosthetic therapy of 17 periodontally hopeless teeth for 5–12 years. The present study revealed good bone gain and elimination of SOT and prominent occlusal function. We concluded that the application of IR, minocycline‐HCL and periodontal prosthetic procedures later elevated the prognosis of these otherwise hopeless teeth with SOT, which are valuable options for retaining teeth with periodontally extreme situations.

Periodontitis and obstructive sleep apnea's bidirectional relationship: a systematic review and meta-analysis.

The aim of this study is to evaluate the association between periodontal disease and obstructive sleep apnea (OSA). Electronic search using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Central Trial Registry, Cochrane Database of Systematic Reviews, Scopus, and Embase was carried out for randomized controlled trials, longitudinal, cohort, case-control, and epidemiological studies on humans, published until October 2014. Manual searches were also performed. The participants considered were adult subjects with OSA and chronic periodontitis. The authors reviewed all articles and extracted data using a customized data abstraction sheet. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale. Six studies met the inclusion criteria set for this review. They evaluated the association between periodontal disease and OSA and the efficacy of periodontal interventions on OSA occurrence and severity. The periodontal disease outcome measures included clinical attachment loss, periodontal pocket depth, oral hygiene indices, radiographic alveolar bone loss, and salivary cytokines. Meta-analysis of four studies revealed a statistically significant association between periodontal disease and OSA (pooled odds ratio = 1.65, 95% confidence interval (CI) = 1.11, 2.46, P = 0.01). There is insufficient evidence on the efficacy of periodontal disease interventions. There is some evidence to a plausible association between periodontal disease and OSA. Evidence on the efficacy of periodontal disease interventions is insufficient. The causal-effect relationship of periodontal disease and OSA is debatable. Further research with case-control studies is warranted.