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Biomedical subjects

J Ainamo

Publications and source records attributed to J Ainamo.

At least 19 recordsLinked to original sources

Periodontal conditions in insulin-dependent diabetes mellitus.

In the present investigation, the frequency and severity of periodontal disease was assessed in a group of 71 patients with a mean duration of 16.5 years of insulin-dependent diabetes mellitus (IDD). The diabetics, aged 17-63 years, were under treatment at the diabetic outpatient clinic of the III Department of Medicine, University Central Hospital of Helsinki and at two clinics of the Helsinki Health Centre. Based upon their long-term medical records, 44 individuals were assessed to have a poorly controlled insulin-dependent diabetes mellitus (PIDD). At baseline of the present study, the PIDD group had a mean blood glucose level of 11.8 mmol/l and a mean glycosylated hemoglobin (HBA1) level of 10.7%. 27 subjects were classified as having a controlled insulin-dependent diabetes mellitus (CIDD). For each individual, site-specific recordings were made for the plaque index, gingival index, pocket depth, loss of attachment, bleeding after probing, gingival recession and radiographic loss of alveolar bone. Under similar plaque conditions, adult subjects with a long-term PIDD were found to have lost more approximal attachment and bone than subjects with a CIDD (P = 0.046, P = 0.019). These differences were not equally obvious when the subjects were classified according to the history of medical complications, such as retinopathies, neuropathies and nephropathies.

Adolescent

Location of the mucogingival junction 18 years after apically repositioned flap surgery.

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

Aged

Clinical responses to subgingival application of a metronidazole 25% gel compared to the effect of subgingival scaling in adult periodontitis.

A newly developed metronidazole 25% dental gel was compared with subgingival scaling in the treatment of adult periodontitis. 206 patients in 9 centres participated in the study. Probing pocket depth (PPD) and bleeding on probing (BOP) were recorded before treatment and 2, 6, 12, 18, and 24 weeks after the treatment. All patients had at least 1 tooth in each quadrant with a PPD of 5 mm or more. The treatments consisted of 2 applications of dental gel (days 0 and 7) in 2 randomly selected quadrants (split mouth design) and 2 sessions of subgingival scaling (1 quadrant on day 0, and 1 quadrant on day 7). Instruction in oral hygiene was given 2 weeks after completed treatment. The average PPD and the average frequency of BOP were calculated over all sites with initial PPD of 5 mm or more. PPD and BOP were thus, at each examination, calculated from the same sites. The mean PPD was 5.9 mm before gel application and 5.8 mm before scaling (p = 0.31). BOP was 88% in both treatment groups. 24 weeks after the treatment, PPD and BOP were significantly reduced in both groups and for both parameters (p < 0.01). PPD was reduced by 1.3 mm after gel application and 1.5 mm after scaling; BOP was reduced by 32% and 39%, respectively. The difference between the treatments was statistically significantly, but considered as clinically unimportant.

Adult

Significance of epidemiologic research in the understanding of periodontal disease.

This review describes the development of periodontal index systems which during the last 50 yr have made it possible to gradually expand our understanding of the etiology and pathogenesis of periodontal diseases. Modern epidemiologic research on the prevalence and severity of periodontal diseases is based on a substantial amount of scientific data collected since the early 1940's. The work of a number of innovative researchers has eventually resulted in the clarification of one unsolved problem after the other. At the same time new ideas have been developed for the inclusion of public health aspects in the epidemiologic analyses. The assessment of periodontal treatment needs has become an issue of great importance in many countries of the world and has initiated a discussion and studies on the role of the possibilities for self-assessment of treatment needs. A completely new area of interest has developed when recent epidemiologic surveys demonstrated a substantial increase in the numbers of elderly people together with a substantial increase in the number of teeth per elderly person.

Epidemiologic Methods

Rapid periodontal destruction in adult humans with poorly controlled diabetes. A report of 2 cases.

Out of a pool of 12 middle-aged or elderly diabetic patients demonstrating rapid periodontal break-down, the 2 oldest cases with follow-up periods of 19 and 16 years are described. The common feature of all 12 patients was that they were either unaware of or unable to control their diabetic condition at the time of the active stage of their periodontal disease. The bone loss progressed in spite of specialist periodontal care and the patients again responded to treatment only after their elevated blood glucose levels had been brought back to normal. Thus, the rapid periodontal breakdown was not found to be associated with the diabetic condition per se, but rather with the hyperglycemia. This clinical follow-up study does not answer the question of whether rapid periodontal destruction occurs in all patients with poorly controlled diabetes. Neither do the observations imply that rapid bone loss would be pathognomic of high blood glucose levels. However, the observations seem to suggest that there may be an inter-relationship between rapid periodontal breakdown and elevated blood glucose levels. Therefore, any sudden change towards an increased progression rate of periodontal breakdown at adult age, as observed from periodic radiographs with intervals of only a few years, should be followed up with a medical examination in order to outrule or verify the possibility of a high blood glucose level.

Aged

Optimal dosage of chlorhexidine acetate in chewing gum.

In a previous study, 800 mg pieces of sorbitol-flavored gum, each piece containing 5 mg chlorhexidine (CHX) acetate, when chewed 2 at the time 5 x daily, were found to have an excellent plaque growth inhibiting effect. The aim of Trial 1 of the present study was to assess whether chewing only 2 x daily, 2 pieces of the same concentration CHX gum for about 10 min would be as effective. 6 dental students participated in the 3 x randomly crossed over double-blind clinical trial. During the 5-day chewing periods, no other oral hygiene measures were allowed. The Hibitane Dental (HD) rinse was used as a positive and the gum base containing neither CHX nor the sweetening agent as a negative control. At the end of each test period, recordings were made for the plaque index (PII), the plaque wet weight (PWW) and the relative area of plaque covered tooth surface (plaque area %). Chewing of CHX gum twice daily inhibited plaque growth as effectively as the HD rinse. The aim of Trial 2 was to assess the antiplaque effect of lower concentration CHX gums with, hopefully, a less unpleasant taste. For this trial, 8 dental students were recruited to chew 2 x daily during 6-day periods two 800 mg pieces of sorbitol-flavored gum, each piece now containing either 5 mg, 4 mg or 3 mg CHX acetate. The effect of these dosages did not differ from the effect of the HD rinse.(ABSTRACT TRUNCATED AT 250 WORDS)

Chewing Gum

[Periodontal treatment needs in a Spanish school population].

The aim of this study was to assess the periodontal treatment needs of the population under 20 years of age in Spain. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated using the Community Periodontal Index of Treatment Needs (C.P.I.T.N.). In the first age group (7 years), 12% presented calculus or overhanging restorations, and 45% had bleeding upon probing only. In the age group of 12 years the proportion of individuals with calculus, overthanging restorations or moderate pocket depths was 39%, while 38% had gingivitis as their highest treatment need. In the oldest group (15-19 years) the number of subjects with bleeding upon probing decreased to 17%, while the percentage of individuals having moderate pockets, calculus or overhanging restorations increased to 67%. 1% of this youngsters had pockets of 6 mm. or over. At age 7, only 30% had "acceptable gingival health", and no more than 15% of the 18 year-olds reached this condition.

Adolescent

[Periodontal treatment needs in a Spanish school population. 2. Intraoral distribution of different signs].

The aim of this study was to assess the prevalence of the different periodontal disease indicators used in the C.P.I.T.N. per sextant in the Spaniard population under 20 years of age. We have examined a randomly chosen sample of 1450 school-aged individuals, 7, 12 and 15 to 19 years old. We have observed a healthy periodontium more frequently in the upper anterior region, calculus predominates in the lower incisors close followed by molars, and periodontal pockets of 4 mm or deeper were commonly found in the molar regions. We could'nt detect important deviations from this distribution pattern in the different age groups or between males and females.

Adolescent

[Prevalence of caries in Spanish school children and youth of 7, 12 and 15 to 19 years of age].

The aim of this study was to assess the dental caries prevalence and severity of the population under 20 years of age in Spain. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated, registering the decayed, extracted or filled teeth for primary and permanent dentition. Average D.M.F.T. for 7, 12 and 15-19-years-old were 1.5, 3.5 and 6.6 respectively. A comparison of the results with those of previous studies showed that the average D.M.F.T. scores have decreased since 1984. We have also observed an increment in the number of caries-free children reaching the 57.9% in the age group of 7 years. But this excitement over the increase in the number of caries-free children must be tempered by the recognition that 35% of these individuals had 70% of the caries. We still need educational, preventive and restorative programs, and focus our efforts in detecting and treating the highly susceptible children.

Adolescent

[Validity of partial systems of periodontal examination in epidemiological studies].

The purpose of the present study was to determine the representativeness of partial examination in the assessment of the average severity and the prevalence of periodontal disease. 343 subjects aged 7, 12 and 15-19 years were examined for the presence or absence of gingival bleeding after gentle probing, supra or subgingival calculus and pocket depths of 4-5 mm., or 6 mm. and over, of each tooth. Three sets of average severity and prevalence scores were prepared: based on the full mouth examination, on observations made from the index teeth of the P.D.I., and on the six teeth utilized for the C.P.I.T.N. in this age group. Partial indices tended to underestimate the real prevalence of the different signs, and slightly overestimate severity, being these observations statistically significant. Average severity scores were obtained more accurately with the six Ramfjord teeth, while real prevalence rates were better determined with the C.P.I.T.N. teeth. From an epidemiological point of view, the real significance of the differences observed should be further determined.

Adolescent

[Caries prevalence and periodontal treatment needs in the same individuals].

The aim of this study was to determine whether dental caries and periodontal disease occur frequently in the same subjects 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated. Dental caries and periodontal treatment needs were registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria of WHO. We have found a highly significant relation between both variables, average D.M.F.T. scores increased as periodontal treatment needs were more advanced. Those subjects with lower codes of C.P.I.T.N. presented also lower D.M.F.T. scores, while these individuals with higher D.M.F.T. scores, based on a great number of open carious lesions, were more affected for periodontal disease. It does not support either a directly synergistic or antagonistic correlation in the prevalence of these two diseases in the same subjects. Dental health status is at a certain time an end result of years of varying dental health behaviour. In industrialized countries a variety of factors seems to determine the prevalence of dental caries and/or periodontal disease: dietary habits, access to fluorides, efficacy of oral hygiene measures, utilization of dental health care services. These data and ideas supported the strategy of preventing the dental caries and periodontal disease simultaneously.

Adolescent

[Relationship of dental treatment and oral hygiene to caries prevalence and need for periodontal treatment].

The aim of this study was to examine the relationship between differences in dental attendance and oral hygiene patterns and dental caries and periodontal treatment needs. 1469 young people, aged 7, 12 and 15-19 years, and representing the urban (60%) and rural (40%) population from Spain were evaluated. Dental caries and periodontal treatment needs were registered according to the index D.M.F.T. and C.P.I.T.N., following the criteria of W.H.O. Regular dental attendance was observed in 16.6% of subjects examined, and only 9.4 saw a dentist regularly for dental prophylaxis. Statistical analyses showed that while the more frequent the dental visits, the lower the rate of caries, and periodontal treatment needs, the higher, however, the average number of fillings and the D.M.F.T. scores. These individuals had the higher number of functioning teeth, restored or sound, but they also had the disadvantage of having higher levels of disease experience. By the other way the individuals who saw the dentist regularly for dental prophylaxis presented the lower caries rate and periodontal treatment needs, the fewer tooth loss, and also an important reduction in the D.M.F.T. scores. Similar observations had been made in the individuals who brush their teeth frequently or with a correct technique. The results suggested that while frequent dental visits do not apparently help to prevent the onset of further dental disease, we can achieve this goal with regular preventive oriented dental therapy.

Adolescent

Self-assessment of gingival bleeding.

The benefit obtained from the use of a manual for self-assessment of gingival bleeding was evaluated among a group of Finnish army conscripts. After the baseline examination, performed by a dentist, three test groups self-assessed bleeding from their gums during toothbrushing and when cleaning between their teeth with a toothpick. The dentist re-examined the first test group 1 month, the second group 3 months and the third group 6 months after the self-assessment. Gingival bleeding among the test group subjects was compared with that of control group subjects who had been matched for number of bleeding sites at baseline. The self-assessed gingival bleeding was found to correlate with the clinical findings of bleeding. One and 3 months after the self-assessment the test groups had better gingival health than their respective control groups. Six months after the self-assessment, no difference in gingival health was found between the test and control groups. Observed gingival bleeding during the original self-assessment was found to be a positive predictive factor for the subsequent improvement in gingival health.

Dental Devices, Home Care