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PubMed1993

Long-term periodontal care: a comparative retrospective survey.

The maintenance of 172 patients who were treated and then attended a periodontal practice in Sydney, Australia for periods of at least 10 years has been surveyed. The results, expressed as loss of teeth over the maintenance period, have been compared with a 1978 study. Results of the two surveys have been compared for total tooth loss over the maintenance period, loss of individual tooth types, loss of teeth with furca lesions, and tooth loss relative to surgical experience. The comparative analysis is limited by the difference in total number of patients and by the duration of the studies. The proportionate division of patients into three groups according to tooth retention (well maintained, downhill, and extreme downhill) was statistically similar in both surveys. There were very few statistically valid differences in numbers of individual teeth lost between the two studies. Despite these comparable end results of long-term maintenance, the surgical experience was quite different, with the patients in our practice undergoing much more surgical treatment than those in the earlier report. The results appear to support the hypothesis that long-term maintenance is attainable for most periodontal patients, and is consistent with a variety of treatment approaches.

Adult↗
PubMed1993

Dental health patterns in an urban Midsouth population: race, sex and age changes.

Little is known about the oral health of American blacks. In particular, have they experienced the same reductions in dental caries and improvements in oral health as has the majority culture during the past several decades? A contemporary series of patient records (n = 300) was examined to test for age, sex, and race (American black and white) differences in an urban Midsouth population. Tooth loss was strongly age progressive in blacks and whites, but the rate was much greater in blacks. Periodontal probing depths also tended to be greater in blacks, particularly for the maxillary anterior teeth. The pattern of tooth loss with age in blacks is similar to rates recorded for the whole United States in the early 1960s. Subsequently, whites have tended to experience substantial improvements in oral health (ie, fewer decayed, missing, and filled teeth and less tooth loss); blacks in this sample have not exhibited this improvement.

Adolescent↗
PubMed1988

A study of the height of intact alveolar bone on panoramic radiographs of adult patients.

This study describes a method of estimating alveolar bone height on panoramic radiographs by using constant anatomic landmarks as reference points and calculating ratios of given distances between certain of these landmarks in dentate patients with no radiographic evidence of horizontal bone loss. Measurements were performed on four different types of panoramic radiographs. Results determined for the maxillae and mandible were constant between the different types of panoramic films. Because of differences in the measurements obtained on the right and left sides on Panorex films that have been trimmed and spliced to remove anatomic overlap in the midline areas, this type of projection may not be suitable for analysis of the maxillary alveolar bone as described in this study. The use of the mental foramen as a constant anatomic landmark for analysis of mandibular alveolar bone on panoramic radiographs may not be feasible since it appears that it may not be possible to consistently determine the exact location of the foramen. The results of the present study suggest a difference of as much as 25% among patients in the same ratio in the maxillae and as much as 12% in the same ratio in the mandible. Therefore, the results may not be of significant value as "baseline" data to estimate alveolar bone loss at a given time after tooth loss. However, this method could prove valuable in serial studies where alveolar bone height for a single patient is compared at different times before and after tooth loss.

Adolescent↗
PubMed1993

Six-year progression of destructive periodontal disease in 2 subgroups of elderly Chinese.

Two groups of elderly chinese were selected from a large epidemiological sample on the basis of a low ("best" group) or a high ("worst" group) number of sites with attachment loss levels > or = 6 mm and/or pocket depth > or = 4 mm and at least 16 teeth present. Six years later the patients were clinically reexamined and the subgingival microflora was assessed. This paper presents the clinical characteristics of destructive periodontal disease progression among the two subgroups. The "best" group lost an average of 1.8 teeth, contrasting the average loss of 5.3 teeth among the "worst" group. Virtually all teeth lost among the "worst" group had a baseline attachment loss level > or = 4 mm, in contrast to 48% among the "best" group. While dental caries could be identified as a cause of tooth loss in both groups, the excess tooth loss among the "worst" group seems attributable to periodontal destruction. The average of 1.21 mm attachment/site lost among the "best" group was not statistically significantly different from the 1.36 mm/site lost among the "worst" group during the 6 years. Individual mean losses of attachment ranged from a gain of 0.03 mm to a loss of 3.19 mm. An attachment loss > or = 2 mm at a site was highly positively associated with a high initial attachment loss level (> or = 4 mm) at that site among the "best" group, whereas a highly negative association was seen among the "worst" group.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1988

Tooth mortality in an adult rural population in Kenya.

This paper reports on the pattern of tooth loss in a random sample of 1131 adults aged from 15 to 65 years in a rural area of Kenya in which access to formal dental care is minimal. We found that the majority of the population retained most of their dentition in a functional state even up to the age of 65 years: In all age groups, more than 50% had at least 26 teeth present, and more than 90% had at least 16 teeth present. The prevalence of edentulousness was less than 0.3%. The principal cause of tooth loss in all age groups was caries, and this was true for all tooth-types except incisors, for which periodontal disease was the main cause of tooth loss. The cultural practice of removing lower central incisors was observed only in those over 40 years of age. More teeth were lost due to caries among women than among men, while the reverse was true for teeth lost due to periodontal diseases. In view of the fact that most people retain most of their teeth throughout life, it is suggested that the most appropriate strategies for dental health care in this population should be those promoting self care, rather than the introduction of a formal treatment-oriented approach provided by dentists.

Adolescent↗
PubMed2000

Oral symptoms and signs in elderly patients with type 2 diabetes mellitus. A focus on diabetic neuropathy.

OBJECTIVE: We investigated oral disorders and compared the findings with the occurrence of neuropathy in type 2 diabetes mellitus. STUDY DESIGN: Mucosal diseases, tooth loss, and temporomandibular joint dysfunction were examined in 45 patients with long-term type 2 diabetes mellitus and in 77 control subjects. The occurrence of neuropathy was evaluated by neurophysiologic tests. RESULTS: Of patients with diabetes, 56% suffered from dry mouth and 18% from glossodynia; of controls, correspondingly, 36% and 7% (P <.05); 2 or more mucosal lesions were detected in 42% and 20%, respectively (P =. 008). Temporomandibular joint dysfunction was found in 27% of subjects with diabetes and in 16% of control subjects. Peripheral neuropathy was present in 42% of patients with diabetes and in none of the controls (P <.01), and autonomic parasympathetic neuropathy in 54% and 31%, respectively (P =.02). Peripheral and autonomic parasympathetic neuropathies were independent risk factors for tooth loss and temporomandibular dysfunction. CONCLUSIONS: Diabetic neuropathy was found to be associated with tooth loss and temporomandibular joint dysfunction.

Age Factors↗
PubMed1996

Missing front teeth in exile Tamils--an unresolved phenomenon.

In the period from 1986 to 1995, the Department of Public Health in Wuppertal conducted an examination of 263 patients who had come from Sri Lanka as refugees and applied for political asylum in the Federal Republic of Germany. Isolated front tooth gaps were observed in more than 60% of the patients, an incidence significantly higher than in a control group of asylum seekers from countries other than Sri Lanka, and much higher than the incidence of traumatic tooth loss reported in the literature. The aetiology of this tooth loss remains largely unresolved. The bulk of the medical histories given by the patients did not correspond with the clinical and X-ray evidence gathered. Since medical and dental causes for the loss of the teeth can be excluded, one must ask whether social, cultural or religious causes are responsible.

Adolescent↗
PubMed2005

Dental death rate prevalence in smokers and non smokers adults with periodontal disease.

The current study target was to evaluate the dental loss pattern in an adult population with periodontal disease who was treated at the Periodontal Chair, Dentistry Faculty, National University of Rosario, Argentina. The sample was of 203 patients, 130 women and 73 men; 75 of them were blond cigarette smokers and 128 of them were not in that habit. Inclusion criteria as follows: good systemic condition given by the absence of illnesses that may be risky for the development of a periodontal disease, and the presence of at least one teeth with insertion loss of 2 mm. minimum in its proximal faces. The age average of the group was 37,83 years (IC 95% 34,46-41,19) for smokers, and 40,98 (IC 95% 38,27- 43,69) years for non smokers. Regarding females, 85 of them were non smokers and 45 had that habit; concerning men 43 were non smokers and 30 were indeed. The independence test made under smoking and sex variables showed no significant relation between them. Regarding smoker group the smoked cigarette average per day (daily doses) was 13,27 cigarettes (IC 95% 10,96-15,57) and the time since habit started in measure of months was 193,57 (IC 95% 160,43-226,81). The death rate for tooth loss in each group was 4,71 teeth (CI 95 % 3,43-5,98) for smokers and 5,05 teeth (CI 95% 4,07-6,03) for non-smokers. Setting the probability of error of type I equal to 0.05, this study demonstrated that in this group of patients with periodontal disease, the tooth loss in smoker individuals was similar to the tooth loss in non-smoker individuals.

Adolescent↗
PubMed2004

Self-reported number of remaining teeth is associated with bone mineral density of the femoral neck, but not of the spine, in Japanese men and women.

Recent studies suggest that a small number of remaining teeth may be associated with low skeletal bone mineral density (BMD) in postmenopausal women. Estrogen deficiency after menopause is considered potential cause relating to tooth loss accompanied by low skeletal BMD in women. Since estrogen plays a dominant role in regulating the male skeleton, it is likely that a small number of remaining teeth also may be associated with low skeletal BMD in men. However, it remains uncertain whether tooth loss is associated with low skeletal BMD in both men and women. We investigated the association between self-reported number of remaining teeth and BMD of the spine and the femoral neck in a cohort of 1914 Japanese subjects aged 48-95 years who were recruited from the Adult Health Study conducted by the Radiation Effects Research Foundation (RERF). BMD of the spine and the femoral neck was measured by dual energy X-ray absorptiometry (DXA). Tooth count was self-reported in response to a simple question to subjects about the number of remaining teeth they had at the time of the survey. Multiple regression analysis adjusted for age, weight, height, smoking, estrogen use, and years since menopause revealed a significant association between number of remaining teeth and BMD of the femoral neck in both men and women; however, no association was found between number of remaining teeth and BMD of the spine in both sexes. Retention of four teeth was significantly associated with a 0.004 g/cm2 increase in femoral neck BMD in men (P<0.05), which was similar to that observed in women (P<0.01). Our results suggest the presence of common causes, except age and body weight, relating to tooth loss accompanied by low BMD of the femoral neck in both men and women.

Age Factors↗
PubMed1986

Dental pathology of prehistoric residents of Oregon.

Dentitions of 208 prehistoric skeletal specimens from five geographic regions of Oregon were studied to describe their dental status. Comparisons were made of the incidence of specific pathologies among regions and between jaws. Maxillary premortem tooth losses were significantly higher than mandibular tooth loss. A relatively high caries incidence occurs in samples from the Willamette Valley and Klamath Basin, where plant foods were used aboriginally to a significant extent. A high frequency of abscesses was recorded in the Klamath Basin and the Lower Columbia River sample, which also showed the highest levels of attrition. Each of the five subsamples shows patterns of dental pathology consistent with former use of natural resources.

Dentition↗
PubMed2005

["Oral healthiness score for 8020" predicts loss of teeth in village residents].

OBJECTIVE: It is important for people to maintain an appropriate lifestyle through out life to enjoy a healthy life. We have already developed a health check questionnaire, "8020 Oral Healthiness Score", in an endeavor to help people aged 80 keep more than 20 teeth. The health check consists of ten questions chosen from our previous residents' study. Named the "Sawayaka Score" it has been in use since 1999. In the present study, we focused on the results of a three-year follow-up to determine whether the Score may predict tooth loss for screening purposes. METHODS: A total of 716 village residents who participated in medical and dental checkups in 1999 as the baseline year were followed in T village of Aichi-Prefecture. The total numbers of teeth lost were examined after 1-, 2- and 3-years and odds ratios with 95% confidence intervals (CI) were generated for analysis of screening. RESULTS: At the 1999 baseline, the average number of retained teeth was 23.7 +/- 6.2 (mean +/- standard error) (23.0 +/- 6.8 in males, and 24.4 +/- 5.5 in females), and the average oral health score (mean +/- standard error) was 13.1 +/- 3.9 points (12.8 +/- 4.0 in males, 13.4 +/- 3.9 in females). A low score of 4-8 at the baseline predicted major tooth loss, while an average score was associated with loss of only one or 2 teeth loss in the residents. The present study confirms that persons with a favorable lifestyle tend to retain more teeth. CONCLUSION: It can be concluded that the 8020 Oral Healthiness Score is a useful tool to support residents' oral health promotion and predict tooth loss.

Aged↗
PubMed2004

Influence of compliance and smoking habits on the outcomes of supportive periodontal therapy (SPT) in a private practice.

PURPOSE: The purpose of this retrospective cohort study was to evaluate the effect of smoking habits and patient compliance on the outcomes of supportive periodontal therapy (SPT) (tooth loss and residual pockets defined by probing depth of > or = 5 mm) in a private practice situation. MATERIALS AND METHODS: Eighty-seven patients, who completed active periodontal treatment and then followed an SPT program for at least 5 years, were recruited from the patient pool of a private dental practice. After active periodontal therapy and at the follow-up examination 5-11 years later, pocket probing depths (PPD) and tooth loss were assessed, and the patients were divided into 4 subgroups based on their smoking history: non-smokers (NS); occasional smokers (OS); moderate smokers (S); and heavy smokers (HS). The patient cohort was also divided into 4 subgroups based on patient compliance (mean delay from the scheduled recall sessions): fully compliant (< 1 week); compliant within 1-3 weeks; compliant within 3-6 weeks; and not compliant (> 6 weeks). RESULTS: The mean tooth loss per patient and year ranged from 0.11 - 0.18 in the various subgroups with no significant differences between them. After a mean observation period of 7.3+/-1.5 years, the incidence of new sites with residual probing depth of > or =5 mm varied between 1.2% for the NS and 13.8% for the HS (p < 0.05,), and between 3.2% for the compliant and 5.8% for the non-compliant patients. CONCLUSION: Smoking habits significantly influenced the treatment outcomes of SPT, while compliance was less influential regarding the incidence of new residual pockets during 7.3 years of SPT.

Adult↗
PubMed1986

Does osteomalacia contribute to development of oral complications of oxalosis?

Two renal dialysis patients with oral manifestations of oxalosis had undecalcified sections of iliac and alveolar bone and teeth examined histologically in an attempt to explain the development of tooth mobility and tooth loss. Osteomalacia was detected in all bone specimens and attributed to aluminum toxicity after the histochemical localization of aluminum at the calcification front between osteoid and calcified matrix. Aluminum was also detected histochemically in the cementum of teeth. Calcium oxalate crystals were present in bone marrow, teeth, and gingiva. It is proposed that tooth mobility and tooth loss in oxalosis result from the combined effects of osteomalacia and oxalate crystal deposition within the periodontium. To prevent avoidable tooth loss it is suggested that patients with oxalosis who develop tooth mobility should have aluminum toxicity and osteomalacia excluded as causal factors.

Adolescent↗
PubMed2001

Retrospective evaluation of the influence of the interleukin-1 genotype on radiographic bone levels in treated periodontal patients over 10 years.

BACKGROUND: A difference in genetic susceptibility to plaque accumulation has been advocated to explain different responses to periodontal therapy. The purpose of this study is to assess the role of the interleukin-1 (IL-1) polymorphism on the rate of bone and tooth loss in non-smoking periodontally treated patients during maintenance. METHODS: Sixty consecutive non-smoking patients (mean age 46.8 +/- 5.0) with moderate to severe periodontitis, treated and maintained for over 10 years were selected. At baseline (T0), radiographic evaluation (cemento-enamel junction [CEJ]-root apex, CEJ-bottom of defect mesial and distal, CEJ-bone crest mesial and distal, crown-root ratio) was performed. All patients received scaling and root planing; 36 patients then underwent surgical therapy. Subsequently, all patients were enrolled in a periodontal maintenance program with recall visits every 3.4 +/- 1.0 months for at least 10 years. At the latest recall visit (T2) the same radiographic measurements evaluated at baseline were taken and a DNA sample for IL-1 genetic susceptibility testing was collected and sent for analysis. RESULTS: Twenty-three of the 60 patients (38.3%) were IL-1 genotype positive. A total of 52 teeth (3.3%) out of 1,566 were lost due to periodontitis between T0 and T2; 28 of 957 (2.9%) in the IL-1 genotype negative group and 24 of 609 (3.9%) in IL-1 genotype positive group. The mean variation in bone defect level (DeltaBD) averaged -0.04 mm in IL-1 genotype negative patients and 0.01 mm in IL-1 genotype positive patients. The mean variation in bone crest level (DeltaBC) averaged -0.24 mm in IL-1 genotype negative patients and -0.28 mm in IL-1 genotype positive patients. However, a few patients showed significant differences in response to therapy based on initial bone levels and genotype. IL-1 negative patients who showed minimal initial bone loss responded to the therapy better than the IL-1 positive patients. IL-1 positive patients with severe initial bone loss showed a better response to the therapy than IL-1 negative patients. CONCLUSIONS: On average, there were no significant differences related to IL-1 genotype in tooth loss after 10 years in a non-smoking, well-maintained periodontal population. On an individual patient basis, the IL-1 genotype, in combination with the initial bone level, seems useful at the beginning of therapy for predicting bone level variation.

Adult↗
PubMed2001

Epidemiological study on improving the QOL and oral conditions of the aged--Part 1: The relationship between the status of tooth preservation and QOL.

In part 1 of this epidemiological study, a survey was conducted for all senior citizens aged 70 and over who resided in a mountainous village in the mid-section of Hyogo Prefecture. It focused on the relationship among the number of existing teeth, life environment, health status, and activities of daily living; and the correlation between oral status and QOL was analyzed. The daily activities of individuals were compared between those having one or more teeth and others who were totally edentulous. Subsequently, it was found that for both males and females, the odds ratio was significantly high for the dentulous individuals, in comparison with edentulous individuals, to exhibit a behavior indicative of a better QOL (such as "opportunity for conversation with family members or others)", "regular physical activities", and "attend meetings or group outings"). The result of this survey indicates that the presence of teeth is very closely related to one's daily activities. It was concluded that preventing tooth loss is vital for maintaining the masticatory function; so to prevent tooth loss, periodontal disease must be averted.

Aged↗
PubMed2005

Predictive accuracy of sexing the mandible by ramus flexure.

Loth & Henneberg (Am J Phys Anthrop 99 (1996) 473) described a single morphological indicator of sexual dimorphism, namely the presence or absence of flexure on the posterior border of the mandible, with a predictive accuracy of 90.6-99.0%. In the other studies, which have criticized mandibular ramus flexure as sex indicator in adult and fossils specimens by the same method, the accuracy of sexing was found between 59.0% and 80.4% which is well below the reported 90.6-99.0% (Am J Phys Anthrop 107 (1998) 363; Am J Phys Anthrop 111 (2000) 573; Am J Phys Anthrop 111 (2000) 429; Homo 53 (2002) 97). It was indicated that the method sexed males more reliably than females and consistency was low. In the current blind test, 120 mandibles from forensic cases were examined for the presence or absence of mandibular ramus flexure. Virtually identical results were obtained when a second observer examined the same sample of mandibles. The results were then compared to records of the same cases resulting in 85.8% accuracy for the total sample. A marked difference was observed between sexes where the ramus shape was diagnostic for 92.6% of the males but for only 60.0% of the females (p < 0.001). When mandibles with excessive tooth loss (more than two molars missing) (n = 35) were removed from the sample (in normative sample), the overall predictive value increased to 90.6% (95.6% accuracy in males and 70.6% in females). Our results confirm that there are marked differences between the sexes in the predictive accuracy and this indicator is better in mandibles without molar tooth loss as mentioned by Loth & Henneberg. They also pointed out that the tooth loss is a potential source of error. On the other hand, in this study, there were no sexing errors when mandibles which ramus shape scores -1, 0 and +1 were extracted from the normative sample as the "sex indeterminate group". This study suggests that further assessment should be made only when both rami are available for observation, and the mandible shows either bilateral flexure (+2) or bilateral non-flexure (-2). The consideration of this new categorization can also be useful when using Loth & Henneberg's method.

Adult↗
PubMed2002

Maximum clenching force of patients with moderate loss of posterior tooth support: a pilot study.

STATEMENT OF PROBLEM: Patients who have lost moderate posterior tooth support may also lose clenching force as a result of sensitivity to increased loading to the remaining teeth and possibly a loss of muscle strength, because clenching forces are limited to avoid stress to the remaining teeth. Few studies have correlated moderate posterior tooth loss with maximum clenching force. PURPOSE: The purpose of this pilot study was to test the hypothesis that moderate loss of posterior tooth support will have a significant effect on maximum clenching force. MATERIAL AND METHODS: The maximum clenching force of 44 adults, ages 28 to 76 (mean 46), with posterior tooth loss was compared with the maximum clenching force of a control group of 20 healthy full dentition adults, ages 18 to 55 (mean 30), by use of a bilateral strain-gauged transducer. The transducer consisted of 2 stainless steel plates separated by a steel sphere that balanced occlusal forces between right and left sides. Acrylic resin pads were fabricated for each patient to protect the cusps of the teeth. The overall accuracy was found to be within 2.3% of full scale over a range of 0 to 4000 N (0 to 900 lbs). The calibration reliability of the system was checked frequently by use of a dead weight of 222 N (50 lbs). Clenching forces were supported by first and second molars and second premolars when possible. The instrumentation, methods, and operator were the same for both groups. A 2-tailed Student t test (alpha=0.01) and a pooled estimate of the mean were used to determine possible statistical significance. To test for possible correlations between clenching force and lost tooth support and between clenching force and age, a linear regression correlation coefficient R was calculated. RESULTS: For the 44 subjects with posterior tooth loss, the mean clenching force was 462 N (104 lbs), with a range of 98 to 1031 N (22 to 232 lbs). This compares with a mean of 720 N (162 lbs) with a range of 244 to 1243 N (55 to 280 lbs) for the full-dentition subjects. A 2-tailed t test showed that the average difference of 258 N (58 lbs) between the 2 groups was significant (P< or =.01). There was only a moderate negative association between clenching strength and loss of mandibular tooth support (R = -0.35). Clenching force was not well correlated with age as indicated by low R values (R = 0.21, missing tooth group and R = -0.03, full dentition group). CONCLUSION: Within the limitations of this study the maximum clenching force was less (P< or =.01), by 258 N (58 lbs) on average, in subjects with moderate loss of posterior tooth support. Loss of maximum clenching force was associated with a modest negative correlation to the number of missing teeth in the mandibular arch (R = -0.35). The range of clenching force was surprisingly large for both the missing tooth (98 to 1031 N) and full dentition (244 to 1243 N) groups.

Adolescent↗
PubMed2003

Dento-alveolar lesions and nutritional habits of a Roman Imperial age population (1st-4th c. AD): Quadrella (Molise, Italy).

The study of teeth is very important in archaeoanthropology for reconstruction of the nutritional habits and living conditions of past populations. We have analysed dental lesions of pathological (caries, abscesses and ante mortem tooth loss) and non-pathological origin (calculus), linear enamel hypoplasia and tooth wear in 67 adults from the Roman Imperial age necropolis (1st-4th c. AD) of Quadrella (Molise, Italy). The high frequency of caries (likely giving rise to the abscesses and ante mortem tooth loss), the abundant calculus and the low frequency of heavy wear are probably due to a limited use of hard fibrous foods and a high consumption of carbohydrates. The high frequency of linear enamel hypoplasia suggests metabolic problems during growth. Comparison of these data with those for two coeval Italian necropoleis near Rome (Latium), Isola Sacra and Lucus Feroniae, indicates poorer living conditions in the Quadrella population.

Adult↗