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PubMed1998

Variation in the apparent density of human mandibular bone with age and dental status.

This study examines the variability in the anatomy of mandibles of differing ages and different stages of tooth loss. Mandibles from individuals between 19 and 96 y were sectioned into 2 mm thick vertical plane-parallel slices and cleaned of marrow and periosteum. The apparent density (mass per unit volume in g/ml) from midline (MID) and mental foramen region (MF) sites was determined by weighing the slices and dividing by a volume calculated as the product of section thickness and the mean area of the 2 sides of the section. The cortical thickness of the inferior border and the basal and alveolar bone heights were measured in radiographs of the slices. Mandibular apparent density was negatively correlated with the cross sectional area (midline r=-0.48, mental foramen r=-0.45), and at the midline was significantly greater in edentulous than in dentate individuals (means (+/-S.E.M.) edentulous n=13: 1.43 (+/-0.07) g/ml; dentate n=17: 1.27 (+/-0.04) g/ml, P < 0.05). Where a large enough age range was available, mandibular apparent bone density showed a significant increase with age (midline males: r=0.53, n=18) especially for dentate individuals (r=0.91, n=8). There was a correlation between the apparent densities at the two sites in the same mandible (r=0.64), with the values obtained for the midline being significantly greater than for the mental foramen region (midline 1.34 (+/-0.04) g/ml; mental foramen 1.19 (+/-0.04) g/ml, P < 0.001, paired t test). The mandible shows great interindividual variability, but there may be a considerable reduction in cross sectional girth of the mandible following tooth loss, and, unlike postcranial sites, an increase in apparent density with age.

Adult↗
PubMed2005

The relationship between dietary intake and the number of teeth in elderly Japanese subjects.

OBJECTIVE: This study used a precise weighing method to assess whether tooth loss was related to nutrient intake in elderly Japanese subjects. MATERIAL AND METHODS: Fifty-seven subjects aged 74 years were randomly selected from a longitudinal interdisciplinary study of ageing. Complete 3-day food intake data were obtained by a precise weighing method. The dietary intakes of energy and nutrients were calculated based on the Standard Tables of Food Composition in Japan (5th ed.). A clinical evaluation of the number of teeth present was carried out. Multiple regression standardised coefficients for each nutrient was estimated based on a continuous scale adjusted for gender, smoking habits, and educational level. After dividing the subjects into two groups according to the number of teeth present (0-19, 20+), the difference in the intake of nutrients and the amount of food consumed per day was evaluated. RESULTS: The number of teeth present had a significant relationship with the intake of several nutrients. In particular, total protein, animal protein, sodium, vitamin D, vitamin B1, vitamin B6, niacin, and pantothenic acid were significantly associated with the number of teeth present and with the two groups (0-19, 20+). The intake of vegetables and fish, shellfish, and their products was significantly lower among subjects with fewer teeth. CONCLUSION: This study suggests that there was a significant relationship between nutrient intake, such as minerals and vitamins from food, and tooth loss.

Aged↗
PubMed2007

A prospective study of periodontal disease and pancreatic cancer in US male health professionals.

Two previous cohort studies reported positive associations between tooth loss or periodontitis and pancreatic cancer risk. Data on periodontal disease were obtained at baseline and every other year thereafter in a cohort of 51,529 male health professionals aged 40-75 years. A total of 216 patients were diagnosed with incident pancreatic cancer during 16 years of follow-up. Multivariable relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models controlling for potential confounders, including detailed smoking history. All statistical tests were two-sided. Compared with no periodontal disease, history of periodontal disease was associated with increased pancreatic cancer risk (overall, multivariable RR = 1.64, 95% CI = 1.19 to 2.26; P = .002; crude incidence rates: 61 versus 25 per 100,000 person-years; among never smokers, multivariable RR = 2.09, 95% CI = 1.18 to 3.71; P = .01; crude incidence rates: 61 versus 19 per 100,000 person-years). In contrast, baseline number of natural teeth and cumulative tooth loss during follow-up were not strongly associated with pancreatic cancer. The association between periodontal disease and increased risk of pancreatic cancer may occur through plausible biologic mechanisms, but confirmation of this association is necessary.

Adult↗
PubMed2006

Gender differences in the relation between number of teeth and systolic blood pressure.

BACKGROUND: Tooth loss predicts total and circulatory mortality. The reasons for the increased mortality in subjects with a low number of teeth may be related to enhanced atherosclerosis, elevated arterial pressure and more frequent hypertension. The present study was designed to investigate whether there is an association between the number of teeth and arterial pressure or hypertension. METHODS: We used data of 4185 adult subjects (2150 women) collected for the population-based Study of Health in Pomerania. The number of teeth was counted by trained and certified dentists. Hypertension was defined as systolic blood pressure >or= 140 mmHg or diastolic blood pressure >or= 90 mmHg or use of antihypertensive medication. Multivariable analyses were adjusted for relevant confounders. RESULTS: The adjusted mean (standard error) systolic blood pressure in men having 0-6 teeth was 149.6 mmHg (1.3 mmHg) compared to 142.6 mmHg (1.2 mmHg) in men having 27-28 teeth (P < 0.05). The adjusted odds for hypertension in men with 0-6 teeth compared to men with 27-28 teeth were 1.91 (95% confidence interval 1.21; 3.02, P < 0.05). In women no such relations were found. CONCLUSION: There is an inverse association between the number of teeth and systolic blood pressure and hypertension in men but not in women. The present findings partly explain the relation between tooth loss and mortality.

Adult↗
PubMedDate not supplied

Interaction of obesity and skeletal bone mineral density in tooth retention in Japanese postmenopausal women.

OBJECTIVE: To investigate whether being overweight is associated with increased or decreased risk of tooth loss in Japanese postmenopausal women. DESIGN: The number of remaining teeth (total, anterior, and posterior teeth), mandibular bone height, and mandibular cortical mass were evaluated on the dental panoramic radiographs of 450 Japanese postmenopausal women. The bone mineral densities (BMDs) at the lumbar spine and femoral neck were measured by dual-energy x-ray absorptiometry. These measurements were compared among participants in three body mass index (BMI) categories (underweight, normal BMI, and overweight). RESULTS: Analysis of covariance adjusted for confounding variables revealed that participants who were overweight had a significantly lower number of total (P = 0.019) and anterior (P = 0.012) remaining teeth than did those with normal BMI, although the former had significantly higher skeletal BMD values than the latter. No significant difference was observed in mandibular bone height between the overweight participants and those with normal BMI. There were no significant differences in the number of remaining teeth between the under- and overweight participants. Overweight participants had significantly higher skeletal BMDs (P < 0.001) and tended to have larger mandibular cortical masses than those who were underweight. CONCLUSIONS: Despite their higher skeletal BMD, postmenopausal women who are overweight may have an increased risk of tooth loss, especially of the anterior teeth, compared with women who have normal BMI. This risk appears to be similar to that for underweight women.

Absorptiometry, Photon↗
PubMed2001

Ten-year survival rates of teeth adjacent to treated and untreated posterior bounded edentulous spaces.

STATEMENT OF PROBLEM: Failure to replace a single missing posterior tooth may lead to a variety of dental problems, which may ultimately result in tooth loss. However, little is known about the fate of the adjacent teeth if a missing posterior tooth is not replaced. PURPOSE: This retrospective study evaluated the survival of teeth adjacent to treated and untreated posterior bounded edentulous spaces. MATERIAL AND METHODS: Data were obtained from electronic treatment records from the Kaiser Permanente Dental Care Program, Portland, Ore. A final sample of 317 patients who met the study inclusion criteria was identified. Each bounded edentulous space was placed in 1 of 3 treatment categories: untreated, restored with a fixed partial denture, or restored with a removable partial denture. Subsequent treatment and the status of the teeth adjacent to the bounded edentulous space were followed through December 1999. Ten-year Kaplan-Meier survival estimates were generated for each treatment group, and differences in survival were evaluated with the log-rank chi-square test (alpha=.05). RESULTS: There was a significant difference in survival among the 3 treatment categories (P=.005). Spaces restored with a fixed partial denture had longer 10-year survival estimates (92%) than those that remained untreated (81%). Spaces restored with a removable partial denture had the poorest 10-year survival rate (56%). CONCLUSION: Under the conditions and selection bias associated with this retrospective study, the survival of teeth adjacent to a single posterior edentulous space was negatively associated with removable partial denture placement compared with no treatment or the use of a fixed partial denture.

Adolescent↗
PubMed2004

The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance.

BACKGROUND: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. OBJECTIVE: To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old. MATERIAL AND METHODS: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. RESULTS: Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. CONCLUSION: The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.

Adult↗
PubMed1993

Various reasons for permanent tooth extractions in a Caribbean population--Antigua.

A study was undertaken in September 1990 to investigate the reasons for permanent tooth extractions in Antigua. Eight out of 10 dentists on the island were requested to record permanent tooth extractions, including tooth type and reasons for extraction, during a 6 week study period. All 8 dentists provided data which indicated that 471 teeth were Extractions for orthodontic and impaction reasons comprised 4.3 per cent of tooth extrac-irregularly attending dental services. The principle reason for extractions was caries (61.6 per cent). Periodontitis (29.9 per cent) was the next most frequent reason for extractions and it became the predominant indication for tooth loss after 40 years of age. Extractions for orthodontic and impaction reasons comprised 4.3 per cent of tooth extraction, but these causes disappeared after 30 years of age. Restorable teeth were not commonly removed. The tooth types most frequently extracted due to caries were lower first molars and upper molars. Most commonly extracted, periodontally involved teeth were lower central incisors and upper third molars.

Adolescent↗
PubMed1983

Rapidly progressive periodontitis. A distinct clinical condition.

We report radiographic, clinical, historical, and laboratory observations on seven patients selected to illustrate the features and characteristics of rapidly progressive periodontitis, with the aim of establishing this disease as a distinct clinical entity. This form of periodontitis is seen most commonly in young adults in their twenties, but it can occur in postpubertal individuals up to approximately 35 years of age. During the active phase, the gingival tissues are extremely inflamed and there is hemorrhage, proliferation of the marginal gingiva, and exudation. Destruction is very rapid, with loss of much of the alveolar bone occurring within a few weeks or months. This phase may be accompanied by general malaise, weight loss, and depression, although these symptoms are not seen in all patients. The disease may progress, without remission, to tooth loss, or alternatively, it may subside and become quiescent with or without therapy. The quiescent phase is characterized by the presence of clinically normal gingiva that may be tightly adapted to the roots of teeth with very advanced bone loss and deep periodontal pockets. The quiescent phase may be permanent, it may persist for an indefinite period, or the disease activity may return. Most patients with rapidly progressive periodontitis have serum antibodies specific for various species of Bacteroides, Actinobacillus, or both, and manifest defects in either neutrophil or monocyte chemotaxis. Affected patients generally respond favorably to treatment by scaling and open or closed curettage, especially when accompanied by standard doses of antibiotics for conventional time periods. A small minority of patients do not respond to any treatment, including antibiotics, and the disease progresses inexorably to tooth loss even in the presence of aggressive periodontal therapy and maintenance. At the present time it is not possible to distinguish prior to treatment which individuals will respond to therapy and which will not.

Adult↗
PubMed1999

Epidemiology of periodontal diseases: an update.

This article provides a brief review of findings from epidemiological studies of periodontal disease that have been generated over the past five years. In line with the conclusions of the 1996 World Workshop in Periodontics, the recent data support the concept that early onset periodontitis appears to be rather infrequent, while advanced adult periodontitis, leading to severe loss of supporting periodontal tissues and tooth loss, does not exceed a prevalence of 10-15% in most populations. However, a number of important issues remain unresolved. It is still not clear whether the prevalence of these diseases has shown an overall decline in recent years. In fact, retention of teeth in older age may contribute to an increase. Analytical epidemiological studies have been increasingly successful in identifying a handful of risk factors for disease onset and progression. These include colonisation at high levels by certain subgingival bacteria, environmental exposures such as cigarette smoking, and systemic conditions such as diabetes mellitus. Importantly, the molecular basis of host susceptibility has recently begun to be unraveled. Research efforts are now focused on creating multi-factorial models to assess the risk for disease, prior to the development of irreversible damage. Importantly, the role of periodontal infections as a modifier of systemic health is being increasingly explored.

Adult↗
PubMed1992

[Statistical survey of prosthetic restorations--fixed and removable prosthesis].

This is a continued report on the statistical classification of the prosthetic restorations placed in the outpatients in the Tokyo Medical and Dental University Hospital. The data were collected from the laboratory records during the period of January to June of 1986. The results are summarized as follows: 1. Total of 419 bridges, consisting of nearly the same number in the maxillary and mandibular units, were fabricated. A wide variety of designs was observed for those not covered by the health insurance. 2. Approximately 83% of the 265 complete dentures were covered by the health insurance. The number of the maxillary units was slightly more than that of the mandibular units, which was similar to the data collected about 20 years ago. 3. Seven hundred and fifty-four partial dentures were placed and approximately 45% of these were covered by the health insurance. 4. Various designs were observed in the 'Konus-Kronen' type of prosthesis. They were assumed to be applied not only for the restoration of the edentulous areas, but also for the splinting of the remaining teeth. 5. Fixed bridges were placed in more than 90% of the cases with single tooth loss. However, partial dentures were more frequently used than the fixed bridges for the restoration of the two-tooth loss.

Denture Design↗
PubMed2006

The relationship of periodontal disease to cardiovascular diseases--review of literature.

Association of Oral and Systemic diseases has gained importance because the high occurrence of oral diseases is an extremely common source of infection. Epidemiological Studies have presented periodontal diseases as a risk factor for development of cardiovascular diseases. A chronic oral infection such as periodontitis is a constant potential source of infection and has now been considered as a separate risk factor for cardiovascular diseases, cerebrovascular diseases, peripheral arterial disease and respiratory diseases as well as delivery of low-birth-weight infants. The possible pathways linking oral infections to systemic diseases are metastatic infections, bacterial endotoxins, and systemic vascular injury. People with a history of periodontal disease and/or tooth loss were found at higher risk for Peripheral arterial disease (PAD) as compared to those without periodontal disease and/or tooth loss. All studies on the relationship of periodontal diseases to cardiovascular diseases are inconclusive and most of the data is based on epidemiological studies.

Cardiovascular Diseases↗
PubMed1986

Endodontics.

It is known that pets with broken teeth or teeth with other diseases of the pulp suffer considerable pain and frequent infection. To ignore these problem teeth would not only be inhumane, it would risk chronic infection, abscessation, and tooth loss. Although extraction of these teeth is sometimes necessary, the procedure is often difficult to perform and painful for the animal. The resultant tooth loss is cosmetically displeasing and, frequently, there is compromise in function. The endodontic treatment of these teeth, on the other hand, is relatively easy to perform. It almost always results in immediate cessation of pain and will usually allow the tooth to remain functional for the lifetime of the pet.

Animals↗
PubMed1982

Differing profiles of periodontal disease in two similar South Pacific island populations.

The periodontal condition of a cross-section of individuals aged between 15-59 years was characterised from clinical and radiographic observations of dental calculus, gingival inflammation, the level of the gingival attachment , alveolar bone loss, teeth missing or requiring extraction for periodontal reasons. The common characteristics of the profile in Tonga and W. Samoa were a high prevalence of the factors common to periodontal disease: calculus and gingival inflammation; a progressive apical movement of the gingival attachment; and alveolar bone loss. All these criteria showed a positive age dependency with calculus (particularly subgingival calculus) and gingival inflammation being very commonly associated with all tooth types at an early age, less than 30 years. Tooth loss observed was presumed to be previously associated with periodontal disease because the prevalence of dental caries was very low in both populations. Substantial differences were observed in the number of missing teeth between Tongan and Samoan populations, the Tongan subjects having a high rate of tooth loss. From radiographic interpretations of the periodontal conditions fewer subjects in Tonga were assessed as having no disease, and there was a higher prevalence of progressive destructive disease in Tonga than in W. Samoa. The proportion of subjects in both countries with no disease decreased rapidly with age. There was no evident explanation of the greater severity of disease in Tonga than in W. Samoa. The prevalence of microbial plaque, calculus and gingival inflammation was very high in all subjects at all ages particularly over 30 years in both populations.

Adolescent↗