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  • 1. Ahonen, Hanna
    et al.
    Kvarnvik, Christine
    Norderyd, Ola
    Malmö University, Faculty of Odontology (OD).
    Broström, Anders
    Fransson, Eleonor I
    Lindmark, Ulrika
    Clinical and self-reported measurements to be included in the core elements of the World Dental Federation's theoretical framework of oral health2021In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 71, no 1, p. 53-62Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Oral health is part of general health, and oral diseases share risk factors with several non-communicable diseases. The World Dental Federation (FDI) has published a theoretical framework illustrating the complex interactions between the core elements of oral health (CEOHs): driving determinants, moderating factors, and general health and well-being. However, the framework does not specify which self-reported or clinical measurements to be included in the CEOHs.

    OBJECTIVES: To explore oral health measurements relevant for a general adult population to be included in the CEOHs in the FDI's theoretical framework of oral health.

    MATERIALS AND METHODS: A psychometric study was performed, using cross-sectional data from Sweden (N = 630, 54% women, mean age 49.7 years). The data set initially consisted of 186 self-reported and clinical measurements. To identify suitable measurements, the selection was discussed in different settings, including both experts and patients. Principal component analyses (PCAs) were performed to explore, reduce and evaluate measurements to be included in the three CEOHs. Internal consistency was estimated by Cronbach's Alpha.

    RESULTS: The validation process yielded 13 measurements (four clinical, nine self-reported) in concordance with the CEOHs. PCAs confirmed robust validity regarding the construction, predicting 60.85% of variance, representing psychosocial function (number of measurements = 5), disease and condition status (number of measurements = 4), and physiological function (number of measurements = 4). Cronbach's Alpha indicated good to sufficient internal consistency for each component in the constructs (α = 0.88, 0.68, 0.61, respectively).

    CONCLUSION: In a Swedish general adult population, 13 self-reported and clinical measurements can be relevant to include to operationalise CEOHs in the FDI's theoretical framework.

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  • 2. Buhlin, Kåre
    et al.
    Hultin, Margareta
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Persson, Lena
    Pockley, Alan Graham
    Pussinen, Pirkko J.
    Rabe, Per
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Gustafsson, Anders
    Periodontal treatment influences risk markers for atherosclerosis in patients with severe periodontitis2009In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 206, no 2, p. 518-522Article in journal (Refereed)
    Abstract [en]

    This study investigated the effect of mechanical infection control for periodontitis and periodontal surgery on the prevalence of well-established risk factors for atherosclerosis, and plasma levels of cytokines, antibodies against heat shock proteins and markers of systemic inflammation. Sixty-eight patients between 39 and 73 years of age with severe periodontitis who had been referred to four specialist periodontology clinics in Sweden were investigated. A fasting venous blood sample was taken at baseline and additional samples were collected after 3 and 12 months. A total of 54 patients underwent periodontal treatment. The periodontal treatment was successful, as pathogenic gingival pockets decreased significantly. Plasma glucose, lipids and markers of systemic inflammation were not significantly altered after 3 months. One year after the initial treatment, HDL-C concentrations were significantly increased (Delta0.08mmol/L) whereas LDL-C concentrations decreased (Delta0.23mmol/L). Haptoglobin concentrations were also lower. Interleukin-18 and interferon-gamma levels were also lower after 12 months (60ng/L (-23%) and 11ng/L (-97%) respectively). Treatment had no effect on plasma levels of IgA, IgG1, IgG2 antibodies against heat shock proteins. In conclusion, this study indicates that standard treatment for periodontal disease induces systemic changes in several biochemical markers that reflect the risk for atherosclerosis.

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  • 3. Buhlin, Kåre
    et al.
    Hultin, Margareta
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Persson, Lena
    Pockley, Alan Graham
    Rabe, Per
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Gustafsson, Anders
    Risk factors for atherosclerosis in cases with severe periodontitis2009In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, no 7, p. 541-549Article in journal (Refereed)
    Abstract [en]

    AIM: Studies have reported on an association between cardiovascular disease (CVD) and periodontitis. The purpose of this case-control study was to provide an insight into this association by determining the plasma levels of some risk markers for CVD in cases with periodontitis. MATERIALS AND METHODS: Sixty-eight cases with periodontitis, mean age 53.9 (SD 7.9) years, and 48 randomly selected healthy controls, mean age 53.1 (SD 7.9) years, were investigated. Fasting blood plasma was analysed for glucose, lipids, markers systemic inflammation, cytokines and antibodies against heat shock proteins (Hsp). The associations between periodontitis and the various substances analysed in plasma were calculated using a multivariate logistic regression model, which compensated for age, gender, smoking and body mass index. RESULTS: The regression analyses revealed a significant association between periodontitis and high levels of C-reactive protein (CRP) [odds ratio (OR) 4.0, confidence interval (CI) 1.4-11.4] and fibrinogen (OR 8.7, CI 2.6-28.4), IL-18 (OR 6.5, CI 2.2-19.5), and decreased levels of IL-4 (OR 0.12, CI 0.0-0.5). The study showed increased levels of antibodies against Hsp65 (OR 2.8, CI 1-7.6) and 70 (OR 2.9, CI 1.1-7.8) and decreased levels of antibodies against Hsp60 (OR 0.3, CI 0.1-0.8). CONCLUSIONS: Periodontitis was associated with increased levels of CRP, glucose, fibrinogen and IL-18, and with decreased levels of IL-4.

  • 4.
    Edman, Kristina
    et al.
    Uppsala University; Center for Public Dental Services, Region Dalarna County.
    Holmlund, Anders
    Public Dental Services, Region Gävleborg County; Uppsala University.
    Norderyd, Ola
    Malmö University, Faculty of Odontology (OD). Institute for Postgraduate Dental Education, Region Jönköping County; Jönköping University.
    'Caries disease among an elderly population-A 10-year longitudinal study'2021In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 19, no 2, p. 166-175Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the prevalence of dental caries and to identify risk factors for dental caries in an elderly population between 2008 and 2018.

    METHODS: This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions 10 years apart to 273 individuals who were 65 and 75 years of age in 2008. The variables included were prevalence of dental caries as well as socioeconomic and socio-behavioural factors.

    RESULTS: The number of teeth decreased in both age groups by a mean of 2 over the 10-year study period, but the prevalence of dental caries remained stable. Approximately, a quarter of the participants had caries lesions. Toothbrushing once a day or less was the factor most strongly correlated with dental caries lesions (OR: 3.82, 95% CI: 1.68-8.66, p = 0.001), followed by need for homecare (OR: 3.50, 95% CI: 1.55-7.93, p = 0.003) and interproximal cleaning less than once a day (OR: 2.65, 95% CI: 1.36-5.19, p = 0.004).

    CONCLUSIONS: This longitudinal study revealed no increase in the prevalence of dental caries lesions, indicating that good oral health can be preserved among elderly people. The highest risk for dental caries lesions was among participants with inadequate oral hygiene routines (toothbrushing once a day or less and seldom using interproximal devices) and in need of help in daily living, emphasizing the importance of oral hygiene and collaboration between dental services and community-based health care.

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  • 5.
    Edman, Kristina
    et al.
    Uppsala University.
    Norderyd, Ola
    Malmö University, Faculty of Odontology (OD). Jönköping University.
    Holmlund, Anders
    Uppsala University.
    'Periodontal health and disease in an older population: A 10-year longitudinal study'2022In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 50, no 4, p. 225-232Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018. Methods This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65 years and 75 years in 2008. Results The mean number of teeth decreased significantly over the ten-year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period. Conclusions Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.

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  • 6.
    Jansson, Henrik
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Evaluation of a periodontal risk assessment model in subjects with severe periodontitis. A 5-year retrospective study2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate a well-established periodontal risk assessment tool in patients with severe periodontitis included in a supportive periodontal treatment (SPT) program. In total 20 individuals were included in the analysis. All subjects were randomly selected after successful periodontal treatment and at least 5 years SPT. Clinical and radiographic measurements were collected from patient records and analyzed according to the periodontal risk assessment model. Using the periodontal risk assessment model all subjects were classified as low, moderate, or high-risk patients. According to the model 7 patients were classified as moderate risk patients and 13 as high-risk patients. When comparing all the patients using only bleeding on probing (BoP) mean prevalence of 20% as a cut-off point, 15 patients were categorised as having low-moderate risk for periodontitis progression and 5 subjects as having high-risk for disease progression. The periodontal risk assessment model seems to overestimate the risk for disease progression. However the model is a suitable tool to visualize for both the clinician and the patient different variables of importance for periodontal health. The model is also beneficial to show how periodontal treatment can reduce further risk for periodontal disease.

  • 7.
    Jansson, Henrik
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Wahlin, Åsa
    Malmö högskola, Faculty of Odontology (OD).
    Johansson, Veronica
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Isberg, Per-Erik
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Impact of Periodontal Disease Experience on Oral Health-related Quality of Life2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 3, p. 438-445Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Periodontal research has traditionally focused on the site level, regarding etiology, pathogenesis, and treatment outcome. Recently, some studies have indicated that the presence of periodontal disease is associated with reduced quality of life. The aim of this study is to investigate the impact of periodontal disease experience on the quality of life. METHODS: This cross-sectional study includes 443 individuals. Clinical and radiographic examinations were performed; in conjunction, the oral health-related quality of life of all participants was assessed using the Swedish short-form version of the Oral Health Impact Profile (OHIP-14). Based on marginal bone loss, measured on radiographs, three different groups were identified: participants with loss of supporting bone tissue of less than one third of the root length (BL-), loss of supporting bone tissue of one third or more of the root length in <30% of teeth (BL), or loss of supporting bone tissue of one third or more of the root length in ≥ 30% of teeth (BL+). RESULTS: The effect of periodontal disease experience on quality of life was considerable. For the BL- group, the mean OHIP-14 score was 3.91 (SD: 5.39). The corresponding mean values were 3.81 (SD: 5.29) for the BL group and 8.47 (SD: 10.38) for the BL+ group. The difference among all groups was statistically significant (P ≤ 0.001). A comparison among the mean OHIP-14 scores in the different groups (BL-, BL, and BL+) revealed significant differences in six of seven conceptual domains. CONCLUSIONS: The BL+ individuals experienced reduced quality of life, expressed as the OHIP-14 score, compared with the BL and BL- participants.

  • 8. Malmström, Johan
    et al.
    Slotte, Christer
    Adolfsson, Erik
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Thomsen, Peter
    Bone response to free form-fabricated hydroxyapatite and zirconia scaffolds: a histological study in the human maxilla2009In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 20, no 4, p. 379-385Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Synthetic and biological materials are increasingly used to provide temporary or permanent scaffolds for bone regeneration. This study evaluated the effect of material chemistry and microporosity on bone ingrowth and osseointegration of zirconia (ZrO(2)) and hydroxyapatite (HA) scaffolds in the human maxilla. MATERIAL AND METHODS: Twelve patients subjected to dental implant placement were enrolled in the study. Scaffolds of ZrO(2) and HA were placed in the maxilla of each subject, using a randomization protocol. After 3 months of healing, biopsies were harvested comprising the scaffolds and surrounding bone tissue. The biopsies were processed for histological evaluation and morphometric analysis (bone ingrowth and bone-to-scaffold contact). RESULTS: Healing was uneventful in all cases. All scaffolds demonstrated a measurable bone response using light microscopy and scanning electron microscopy. Microporous HA scaffolds revealed four times larger bone ingrowth and seven times larger bone contact as compared with ZrO(2) scaffolds. CONCLUSION: The results show that chemistry and microporosity of HA promote bone ingrowth and bone contact of ceramic scaffolds in human maxilla.

  • 9. Najim, Uday
    et al.
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Prevalence of intrabony defects in a Swedish adult population: A radiographic epidemiological study2017In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 75, no 2, p. 123-129Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of this radiographic study was to evaluate the prevalence of intrabony defects and to study the correlation between these defects and clinical variables in a Swedish adult population. Another aim was to study the combined relationship of intrabony defects and furcation involvement with clinical variable. Materials and methods: The present study was performed using bitewing and apical radiographs from 329 subjects. The clinical and radiographic data were collected from the study that was carried out in Jonkoping 2003. Intrabony defects were measured from the bottom of the pocket to the highest point of alveolar bone crest. Furcations were considered healthy if the furcation was filled with bone up to the fornix. SPSS was used to analyze the results. Results: 2014 molars and 5898 non-molars were included in the study. The prevalence of intrabony defects was 2.2% in the whole population. Multivariate analysis showed that periodontal pockets (p <0.0001), plaque (p <0.001), age (p <0.02) and gender (p <0.03) had a significant relationship with the occurrence of intrabony defects. On the other hand, gingivitis, smoking habits and education level were not associated with intrabony defects. Multivariate analysis showed that the only variable associated with presence of intrabony defects and furcation involvement was presence of periodontal pockets (p <0.0001). Whilst, gingivitis, education level, plaque, gender, age and smoking habits were not associated with the outcome. Conclusions: Mandibular second molars were most likely to display intrabony defects, whilst mandibular incisors were the least likely to do so.

  • 10. Najim, Uday
    et al.
    Slotte, Christer
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Prevalence of furcation-involved molars in a Swedish adult population. A radiographic epidemiological study2016In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 2, no 2, p. 104-111Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to identify the prevalence of molars with furcation involvements grades II and III in adults participating in the Jonkoping Oral Health Study 2003. The second aim was to study correlations between different variables and the presence of furcation involvement in these individuals. The present study was performed using bitewing and apical radiographs from 329 subjects. Furcations were considered healthy if the furcation was filled with bone up to the fornix. Two thousand fourteen molars fulfilled the inclusion criteria. The prevalence of molars with furcation involvements was 8.3%. Univariate analysis showed that plaque, age, and presence of periodontal pockets were significantly correlated with furcation-involved molar/s (P 0.0001). Gingivitis and education were also significantly correlated to the presence of furcation involvement (P 0.006) and (P <= 0.01), respectively. Gender had no association with presence of involvements. Multivariate analysis showed that age and presence of periodontal pockets were significantly correlated with furcation involvement (P 0.0001). Smoking was also found to be associated with furcation involvement (P 0.04). The tooth most frequently and least likely displaying furcation involvement was the maxillary first molar and the mandibular second molar, respectively. Periodontal pockets, age, and smoking were risk indicators for furcation involvement.

  • 11.
    Nebel, Daniel
    et al.
    Malmö högskola, Faculty of Odontology (OD). Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Bratthall, G
    Malmö högskola, Faculty of Odontology (OD).
    Ekblad, E
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD). Department of Periodontology, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Nilsson, B-O
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Estrogen regulates DNA synthesis in human gingival epithelial cells displaying strong estrogen receptor β immunoreactivity.2011In: Journal of Periodontal Research, ISSN 0022-3484, E-ISSN 1600-0765, Vol. 46, no 5, p. 622-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE: Estrogen acts via estrogen receptor (ER) α and β. The expression pattern of ERs and their importance in gingival tissues are not fully understood. In this study, we investigate gingival ER expression and effects of estrogen on gingival epithelial cell proliferation.

    MATERIAL AND METHODS: Gingival biopsies were obtained from both healthy and diseased sites in three male and three female subjects. Expression of ERα and β was determined by immunohistochemistry. Effects of 17β-estradiol (E(2) ) on cell proliferation, monitored by measuring DNA synthesis, were studied in cultured human gingival epithelial HGEPp.05 cells.

    RESULTS: Estrogen receptor β, but not ERα, immunoreactivity was demonstrated in nuclei of epithelial cells in all layers of the gingival epithelium, but also in cells of the lamina propria. No differences were observed between male and female subjects. The same pattern, i.e. high ERβ expression but no ERα expression, was observed in both healthy and diseased sites within each individual. No differences in the intensity of the ERβ immunoreactive signal and the number of ERβ-positive nuclei were observed between healthy and diseased gingiva. Treatment with a physiological concentration of E(2) (10 nm) had no effect on DNA synthesis in ERβ- and ERα-expressing HGEPp.05 cells. In contrast, E(2) at high concentrations (500 nm and 10 μm) reduced DNA synthesis by 60-70%.

    CONCLUSION: Human gingival epithelial cells display strong ERβ but low ERα immunoreactivity both in vivo and in culture. Estrogen attenuates gingival epithelial cell DNA synthesis at high but not low concentrations, suggesting a concentration-dependent mechanism.

  • 12.
    Nebel, Daniel
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jönsson, Daniel
    Malmö högskola, Faculty of Odontology (OD).
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Bratthall, Gunilla
    Nilsson, Bengt-Olof
    Differential regulation of chemokine expression by estrogen in human periodontal ligament cells2010In: Journal of Periodontal Research, ISSN 0022-3484, E-ISSN 1600-0765, Vol. 45, no 6, p. 796-802Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE: Estrogen modulates inflammatory responses, but the mechanisms involved have not yet been identified. Periodontal ligament (PDL) cells produce chemokines (a group of chemoattractant molecules that recruit leukocytes) and it has been suggested that estrogen modulates periodontal inflammation by regulating the expression of chemokines by PDL cells. Therefore, the objectives of this study were to investigate the regulation of chemokine ligand 2 [CCL2/monocyte chemoattractant protein 1 (MCP-1)], chemokine ligand 3 [CCL3/macrophage inflammatory protein-1α (MIP-1α)] and chemokine ligand 5 (CCL5/RANTES) by estrogen in human PDL cells. MATERIAL AND METHODS: PDL cells were obtained from the PDL of premolars, extracted for orthodontic reasons, from two boys and two girls (16 and 17 years of age). PDL cell CCL2, CCL3 and CCL5 mRNA transcripts were determined by quantitative real-time PCR. The concentrations of CCL2, CCL3 and CCL5 proteins were determined by ELISAs. RESULTS: Treatment with 0.5 μg/mL of lipopolysaccharide (LPS, from Escherichia coli) + 100 nm 17β-estradiol (E(2) ) for 24 h reduced the expression of CCL3 mRNA by about 40% compared to PDL cells treated with LPS alone. Attenuation of CCL3 mRNA was not associated with a decrease in CCL3 protein within 48 h, suggesting a slow turnover of the CCL3 protein. Interindividual differences in the effects of E(2) on CCL5 mRNA expression were observed. E(2) (100 nm) increased the expression of CCL5 by 40-60% in PDL cells derived from two subjects but reduced the expression of CCL5 by about 30% in cells from another subject. CCL2 mRNA and CCL2 protein were highly expressed, but not regulated by E(2) . Similar data were observed in cells obtained from both boys and girls. CONCLUSION: Regulation, by estrogen, of chemokine expression in PDL cells shows a complex pattern involving the down-regulation as well as the up-regulation of chemokines, suggesting that estrogen exerts both anti-inflammatory and proinflammatory effects through these mechanisms.

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  • 13.
    Norderyd, Ola
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Koch, Goran
    Papias, Apostolos
    Kohler, Alkisti Anastassaki
    Helkimo, Anna Nydell
    Brahm, Carl-Otto
    Lindmark, Ulrika
    Lindfors, Ninita
    Mattsson, Anna
    Rolander, Bo
    Ullbro, Christer
    Gerdin, Elisabeth Warnberg
    Frisk, Fredrik
    Oral health of individuals aged 3-80 years in Jonkoping, Sweden, during 40 years (1973-2013)2015In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, p. 57-68Article in journal (Refereed)
    Abstract [en]

    The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city ofionkoping, Sweden, in 1973,1983,1993, 2003, and 2o13.The 1973 study constituted a random sample of L000 individuals evenly distributed in the age groups 3, 5,10,15, 20, 30,40, 50, 6o, and 7o yea rs.The same age groups with addition of a group of 8o-year-olds were included in the 1983,1993, 2003, and 2013 studies, which comprised 1,104;1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-6o years were treated by the Public Dental Service amounting to about 5o%. Almost 7o% of the 70- and 80-year-olds were treated by private practitioners. In 2013,10-20% of the individuals in the age groups 30-40 years did not regularly visit neither Public Dental Service nor a private practitioner.The corresponding figures for the individuals 50-80 years old were 4-7%. Similar number of avoidance was reported in the previous studies. In the survey 2013, about 20-30% of the individuals in the age groups 20-50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist.These findings were in agreement with the results from the surveys 1973-2003. Among the younger age groups, 10-15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series. In 2013, the knowledge of the etiology of caries was known by about 6o% of the individuals which was similar to that reported 1973 zoo3.Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries.This percentage was equivalent during the period 1973-2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day.These frequencies have gradually increased during the 40-year period. Around 40% in the age groups 50-8o years used toothpicks regularly in 2013.This is a about 1/3-1/2 less compared to 2003. In the age groups 20-40 years 3-14% used toothpicks for proximal cleaning in 2013. In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3-20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013

  • 14.
    Norderyd, Ola
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Koch, Goran
    Papias, Apostolos
    Kohler, Alkisti Anastassaki
    Helkimo, Anna Nydell
    Brahm, Carl-Otto
    Lindmark, Ulrika
    Lindfors, Ninita
    Mattsson, Anna
    Rolander, Bo
    Ullbro, Christer
    Gerdin, Elisabeth Warnberg
    Frisk, Fredrik
    Oral health of individuals aged 3-80 years in Jonkoping, Sweden during 40 years (1973-2013)2015In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, p. 69-86Article in journal (Refereed)
    Abstract [en]

    The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973,1983,1993,2003, and 2013 random samples of 1,000;1,104;1,078; 987; and 1,010 individuals, respectively, were studied.The individuals were evenly distributed in the age groups 3,5,10,15, 20,30,40,50, 60,70, and 8o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jonkoping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment. The frequency of edentulous individuals aged 40-70 years was 16,12, 8,1, and 0.3% in 1973,1983,1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age.The total number of individuals with implants was 36 in 2013.This was higher than earlier surveys,4 in 1993, and 18 in 2003. The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013,43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations.There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years.The most obvious change was the decrease in number of FS over the 40 year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 4o and 50-year-olds.The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups. In age groups-Jo-30-year-olds a major reduction from about 3o% to 15% in mean plaque score was seen between 1973-2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003-2o13.The percentage of tooth sites with gingivitis was for zo years and older about 4o% in 1973. In 2013, the percentage was about15%.The frequency of sites with gingivitis was generally lower in 2013 compared with the other years:1973-1993. The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003-2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen. The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.

  • 15.
    Norderyd, Ola
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Moesgaard Henriksen, Birgitte
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Periodontal disease in Norwegian old-age pensioners2012In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 29, no 1, p. 4-8Article in journal (Refereed)
    Abstract [en]

    PURPOSE:  To identify factors of importance for periodontal health and disease on an old-age Norwegian population. MATERIALS AND METHODS: From a random sample of 1152 urban and rural elderly Norwegians, aged 67 years or older, 582 individuals were agreed to participate in the study. After exclusion of edentulous individuals, 394 individuals were remained. A standardised clinical examination was performed by the same examiner. In conjunction with the clinical examination, a questionnaire was filled out regarding demographic and social status, educational level, tobacco habits and general condition. RESULTS: In the examined population, 33% of the subjects had periodontal disease. Out of those, 12% had severe periodontitis, that is, ≥3 periodontal pockets ≥6 mm. All variables were tested separately in a logistic regression model with periodontal pockets 6 mm and above, as the outcome variable. After univariate testing the following variables were included in a multivariate logistic regression model: daily smoking, higher plaque score, rural living and lower education. Only daily smoking remained significantly correlated to periodontal disease in the multivariate model. CONCLUSIONS:  This study has shown a prevalence of periodontal disease in 33% of the study population. Out of those approximately 12% had more severe periodontitis. Daily tobacco use was the only factor significantly correlated to presence of periodontal disease.

  • 16.
    Norderyd, Ola
    et al.
    Malmö University, Faculty of Odontology (OD). The Institute for Postgraduate Dental Education, Jönköping, Sweden; Department of Biomedicine and Natural Sciences, Centre for Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Wahlin, Åsa
    The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    The Secrets of Jönköping: Why Do Most 80-Year-Olds Have More Than 20 Remaining Teeth, and Why Are There Very Few Edentulous?2018In: Translational Oral Health Research / [ed] Jukka H. Meurman, Springer, 2018, p. 143-149Chapter in book (Refereed)
    Abstract [en]

    Repeated epidemiological studies have been performed in the city of Jönköping, Sweden, every 10 years since 1973. The studies were initiated in order to describe the changes in oral health in the population. Basic preventive dental care and supplementary programs were extensively performed in the population, especially among children and adolescents. In this population, the percentage of individuals with sound teeth (no caries or restorations) continuously increased each decade. The main finding regarding periodontitis is the significant increase in individuals having no or minimal periodontitis experience. In 2013, 20–60-year-olds had nearly complete dentitions (28 teeth), and the individuals in age groups 70 and 80 years had a mean number of teeth of 23 and 21, respectively. Edentulous individuals having complete dentures in the age groups 40–70 years decreased from approximately every sixth individual in 1973 to none in 2013. The continuous improvement in oral health and the reduced need for restorative treatment will have an impact on dental health-care and dental delivery systems in the near future.

  • 17. Riben-Grundstrom, Caroline
    et al.
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Andre, Ulrika
    Renvert, Stefan
    Treatment of peri-implant mucositis using a glycine powder air-polishing or ultrasonic device: a randomized clinical trial2015In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, no 5, p. 462-469Article in journal (Refereed)
    Abstract [en]

    AimTo evaluate the clinical treatment effects of a glycine powder air-polishing or ultrasonic device on peri-implant mucositis. Materials and methodsThirty-seven patients with one implant diagnosed with peri-implant mucositis (probing depth 4mm (0.2N) and bleeding on probing (BOP) (primary outcome)) were randomly assigned to treatment with either glycine powder air-polishing (GPAP) or ultrasonic (US) debridement. Treatment was performed at baseline and at 3 and 6months. Professional supra gingival cleaning was performed at 9 and 12months. Oral hygiene instructions were reinforced at each visit. ResultsAt 12months there was a statistically significant reduction in mean plaque score, bleeding on probing and number of periodontal pockets 4mm within the treatment groups compared to baseline. The percentages of diseased sites were significantly reduced for both groups. ConclusionsTreatment with a glycine powder air-polishing or an ultrasonic device is effective in non-surgical treatment of peri-implant mucositis.

  • 18. Slotte, Christer
    et al.
    Asklöw, Barbro
    Sultan, Jeff
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    A Randomized Study of Open-Flap Surgery of 32 Intrabony Defects With and Without Adjunct Bovine Bone Mineral Treatment2012In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 83, no 8, p. 999-1007Article in journal (Refereed)
    Abstract [en]

    Background: Bovine bone mineral (BBM) is extensively used as a filler material in periodontal reconstructive surgery of intrabony defects. Data are mostly available on the combined use of BBM with other biomaterials. The aim of this study is to evaluate healing after open-flap debridement (OF) of intrabony periodontal defects alone or with adjunct treatment with BBM. Methods: After initial treatment, 32 patients with 32 intrabony periodontal defects participated in the study. Full-thickness flaps were raised and root surfaces and defects were debrided. Patients were then randomly assigned to treatment groups, either OF alone or combined with defect fill with BBM, and followed in a strict postoperative maintenance care program for 12 months. Results: At 12 months, a mean ± SE gingival recession of 1.1 ± 0.3 mm in OF and 0.9 ± 0.4 mm in BBM occurred. Probing depth reduction was 4.0 ± 0.5 mm in OF and 3.2 ± 0.7 mm in BBM. Gain in clinical attachment level was 2.8 ± 0.6 mm in OF and 2.3 ± 0.8 mm in BBM. Probing bone level was reduced by 2.7 ± 0.7 mm in OF and 1.8 ± 1.1 mm in BBM. None of the above parameters showed significant intergroup differences. In contrast, radiographic defect depth change was significantly greater in BBM (3.4 ± 2.3 mm) than in OF (1.9 ± 1.7 mm). Conclusions: Both treatments resulted in improved periodontal conditions. The adjunctive use of BBM in this study did not enhance the clinical result compared to OF alone.

  • 19.
    Wahlin, Åsa
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Marginal bone loss in the adult population in the county of Skane, Sweden2013In: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, no 1, p. 39-47Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the prevalence and extent of periodontal disease registered as marginal bone loss and subject characteristics in the adult population in the county of Skåne in Sweden. One thousand individuals, 20-89 years old, were randomly selected and 451 subjects agreed to participate in the study. They answered a questionnaire and in conjunction with the clinical and radiological examination the subjects answered questions about their medical history. The examiners were co-ordinated regarding the diagnostic criteria through comprehensive written instructions, practice and discussions of clinical cases. One observer estimated marginal bone loss around the teeth on digital panoramic radiographs and bitewings. The individuals were classified regarding periodontal disease experience according to the following criteria: PD- = loss of supporting bone tissue < 1/3 of the root length, PD = loss of supporting bone tissue > or = 1/3 of the root length in < 30% of the teeth and PD+ = loss of supporting bone tissue > or = 1/3 the root length in > or = 30% of the teeth. Subjects with no or minor bone loss, i.e. PD- constituted 69% of the population. Twenty percent of the study population had marginal bone loss corresponding to localised periodontal disease (PD) and 11% exhibited generalised periodontal bone loss (PD+). The periodontal treatment need, defined as probing pocket depth > or = 6 mm and bleeding on probing > or = 20%, was 53% in the PD+ group. An interesting result was that there were no differences in periodontal disease experience between the genders. Conclusions: The prevalence and extent of periodontal disease in this study correlates well with recent other studies. Eleven percent of the population has experienced generalised periodontal disease, and 53% of them have a periodontal treatment need defined as 1 or more site with PPD > or = 6 mm and BoP > or = 20%.

  • 20.
    Wahlin, Åsa
    et al.
    Malmö University, Faculty of Odontology (OD).
    Papias, Apostolos
    Jansson, Henrik
    Malmö University, Faculty of Odontology (OD).
    Norderyd, Ola
    Malmö University, Faculty of Odontology (OD).
    Secular trends over 40 years of periodontal health and disease in individuals aged 20-80 years in Jonkoping, Sweden: Repeated cross-sectional studies2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 9, p. 1016-1024Article in journal (Refereed)
    Abstract [en]

    AimTo assess trends over 40years regarding prevalence and severity of periodontitis in a Swedish adult population. Materials and methodsCross-sectional examinations using the same clinical protocol have been repeated every 10years (1973-2013) in a Swedish city with focus on periodontal disease in adults. Periodontal recordings included all teeth, excluding 3rd molars. Periodontal disease experience was classified (no/minor, moderate and severe). ResultsThe no/minor group increased from 43% in 1983 to 60% in 2013. There was a non-significant trend for a decrease of the severe group. Over the 40-year period, the number of teeth increased significantly and at the examination 2013, the severe group accounted for this increase. More than 60% of the study population in 2013 had no periodontal pockets (PD) 6mm. The number of PD 4mm and 6mm were unaltered between 2003 and 2013 in all age groups, except for the 20-year old individuals. This group showed a statistically significant increase of 4mm PD. ConclusionsThe periodontal health has improved in the population over the 40 years. The number of teeth increased significantly in the population, and in 2013, this increase occurred entirely in the severe group. Finally, there was a trend toward diminished prevalence of severe periodontitis.

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