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  • 1.
    Altamash, M.
    et al.
    Division of Periodontology, Department of Dental Medicine, Altamash Institute of Dental Medicine, Karachi, Pakistan; Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD). Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Engström, P. -E
    Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Periodontal treatment and HbA1c levels in subjects with diabetes mellitus2016Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, nr 1, s. 31-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It has earlier been reported that individuals with poorly controlled diabetes have severe periodontal disease (PD) compared to well-controlled diabetes. This longitudinal interventional study compared periodontal treatment outcomes with HbA1c level changes in four groups of diabetic and non-diabetic patients with or without PD, respectively. HbA1c, bleeding on probing (BOP), plaque index and periodontal pocket depth (PPD) 4 < 6 mm and >= 6 mm were recorded at baseline to 3 months after non-surgical treatment and 3-6 months for surgical treatment in subjects with or without T2D, and with or without PD. A total of 129 patients were followed from baseline to 6 months. Diabetics with PD and without PD showed reductions in HbA1c levels with a mean value of 0.3% after 3 months and mean values of 1% and 0.8%, respectively, after 6 months. Diabetics with PD showed higher levels of BOP versus non-diabetics without PD (P < 0.01) and versus diabetics without PD (P < 0.05) at baseline. After 6 months, diabetics with PD showed higher number of PPD 4 < 6 mm versus diabetics without PD (P < 0.01) and non-diabetics with PD (P < 0.01). Diabetics without PD showed higher levels of PPD 4 < 6 mm versus non-diabetics without PD (P < 0.01). Surgical and non-surgical periodontal treatment in all groups improved periodontal inflammatory conditions with a decrease in HbA1c levels in a period of three and 6 months. No change was seen in the number of pockets PPD 4 < 6 mm in diabetic subjects with PD after non-surgical and surgical treatment.

  • 2.
    Becker, Kathrin
    et al.
    Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany; Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany.
    Brunello, Giulia
    Department of Neurosciences, Dentistry Section, University of Padova, Padova, Italy.
    Gurzawska-Comis, Katarzyna
    Department of Oral Surgery, University of Birmingham, Birmingham, UK.
    Becker, Jürgen
    Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
    Sivolella, Stefano
    Department of Neurosciences, Dentistry Section, University of Padova, Padova, Italy.
    Schwarz, Frank
    Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Dental care during COVID-19 pandemic: survey of experts' opinion.2020Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 31, nr 12, s. 1253-1260Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The current COVID-19 outbreak in conjunction with the need to provide safe dental treatments, and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of front-line clinical experts on critical aspects of dental treatment provision during pandemic.

    MATERIAL & METHODS: , 2020.

    RESULTS: A total of 27 experts from different European countries completed the survey. The transmission risk of SARS-CoV-2 in dental settings for aerosol generating procedures was considered high by all experts except two. For aerosol-free and aerosol generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol-generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol-generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients.

    CONCLUSION: The limitation of aerosol-generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental health care providers and patients, thus reducing the transmission risk of COVID-19.

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  • 3.
    Becker, Kathrin
    et al.
    Universitätsklinikum Düsseldorf.
    Gurzawska-Comis, Katarzyna
    University of Birmingham, UK; Birmingham Dental Hospital, UK.
    Brunello, Giulia
    Universitätsklinikum Düsseldorf.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska Institutet.
    Summary of European guidelines on infection control and prevention during COVID-19 pandemic2021Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, nr S21, s. 353-381Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The current COVID-19 pandemic highlighted the need for a review of guidelines on infection control and prevention to ensure safe delivery of dental care. However, it is not clear to what extent the rapidly published European guidelines reflect the current evidence and thus provide homogeneous recommendations.

    MATERIAL & METHODS: Guidelines from all European Union countries, Scotland, Switzerland and United Kingdom were retrieved. Information on triage, mouth rinse, personal protective equipment (PPE) for aerosol free/ generating procedures (non-AGP/AGP) and treatment of potentially infectious patients were summarised, and compared with recommendations from international organizations (WHO, ECDC, CDC).

    RESULTS: All included countries (30/30) published COVID-19 guidelines in 2020. All countries recommended triage and to postpone non-urgent treatment of potentially infectious patients. Hydrogen peroxide (1-1.5%) was the most frequently recommended antiseptic mouth rinse to reduce viral load (24/30). PPE for non-AGP treatments included mainly surgical masks (21/30) or FFP2/FFP3/N95 masks (16/30), whereas FFP2/FFP3 masks (25/30) and face shields (24/30) were recommended for AGP by the vast majority of guidelines. For high-risk/COVID positive patients, most countries recommended maximum protection, and treatment in specialised dental clinics (22/30).

    CONCLUSION: There was general agreement among recommendations for triage, mouth rinse, and PPE during AGP and treatment of potentially infectious patients. In contrast, recommendations on PPE for non-AGP treatment varied considerably among the European countries possibly due to limited scientific evidence regarding transmission risk during non-AGP treatments.

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  • 4.
    Bertl, Kristina
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Bruckmann, Corinna
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Gotfredsen, Klaus
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Hyaluronan vid parodontal behandling2015Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 10, s. 58-65Artikel, forskningsöversikt (Övrigt vetenskapligt)
    Abstract [sv]

    Hyaluronan (HY) har på grund av sina egenskaper (bakteriostatiska, antiin ammatoriska et cetera) nyligen introducerats för användning i parodon- tal terapi. Denna litteraturgenomgång bygger del- vis på en nyligen publicerad systematisk översikt, och har kompletterats med gingivitstudier och de senast publicerade vetenskapliga arbetena med HY inom parodontitbehandling. Artikeln ger en sammanfattning av de terapeutiska möjligheterna med HY-applikation som monoterapi eller som ett tillägg till behandling av gingivit och parodontit. Vid sökning i tre litteraturdatabaser fann vi 18 kontrollerade studier. I majoriteten av dessa stu- dier beskrivs för HY-testgruppen jämfört med kontrollgruppen ● en statistiskt signi kant förbättring i gingivalin- dex för gingivitpatienter ● en statistiskt signi kant minskning i blödning vid sondering och fickdjup vid icke-kirurgisk parodontal behandling ( gur I), dock i måttligt kliniskt relevant utsträckning. Att erhålla någon ytterligare vinst i klinisk fästenivå av HY-applikation vid parodontal kirurgi verkar inte troligt. Till dags dato saknas rapporter av oönskade bi- verkningar av HY-applikation. På grund av den avsevärda heterogeniteten i studierna (avseende produkter, metoder för applicering, dos och applikationstid) går det inte att dra någon tydlig slutsats om administration och e ektstorlek av HY vid behandling av gingivit eller parodontit.

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  • 5.
    Bertl, Kristina
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Bruckmann, Corinna
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Gotfredsen, Klaus
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Hyaluronanprodukte in der Therapie von Gingivitis- und Parodontitispatienten: Eine Literaturübersicht2015Ingår i: Parodontologie, ISSN 0937-1532, Vol. 26, nr 4, s. 423-433Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Application of hyaluronan (HY) in periodontal treatment has recently increased due to its bacteriostatic and anti-in ammatory pro- perties. This review is based in part on a recent systematic review and also includes newly published studies such as those on gingivitis patients. It summarizes the thera- peutic possibilities of HY application as a monotherapy and as an adjunct in the treatment of gingivitis and periodontitis. Based on literature searches in 3 databases, 18 controlled trials were identi ed. When comparing the HY test group with the control group, the majority of the clinical trials reported (a) a signi cant improvement in gingival indices of gingivitis patients and (b) a signi cant but clinically moderate reduction in bleeding on probing and probing pocket depth after nonsurgical treatment of periodontitis patients. The effect of HY application on clinical attachment level gain after surgical regenerative treatment remains unclear. Because no unexpected side effects were reported after HY-application, its use can thus be considered safe. However, due to the considerable heterogeneity of the available studies, in terms of product diffe- rences and varying application modalities, no recommendation can be provided re- garding the appropriate HY administration or the effective amount for the treatment of gingivitis or periodontitis.

  • 6.
    Bertl, Kristina
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Burisch, Johan
    Gastrounit, Medical Division, Copenhagen University Hospital ‐ Amager and Hvidovre Hvidovre Denmark;Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital ‐ Amager and Hvidovre Hvidovre Denmark.
    Pandis, Nikolaos
    Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine University of Bern Switzerland.
    Bruckmann, Corinna
    Division of Conservative Dentistry and Periodontology University Clinic of Dentistry, Medical University of Vienna Vienna Austria.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Periodontitis prevalence in patients with ulcerative colitis and Crohn's disease - PPCC: a case–control study2022Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 49, nr 12, s. 1262-1274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this questionnaire-based, case-control study was to assess whether self-reported oral health and periodontitis in ulcerative colitis (UC) and Crohn's disease (CD) patients differ from that in matched controls without inflammatory bowel disease (IBD).

    Methods: A survey including questions on general anamnestic information, IBD diagnosis, and oral health was distributed online. Self-perceived overall health of teeth and gums, severe periodontitis, and tooth loss were defined as outcome parameters.

    Results: Analyses were based on answers from 1108 IBD patients and 3429 controls. IBD patients reported significantly worse oral health and more periodontal problems compared to controls. Regression analyses corrected for relevant confounders showed for UC and CD patients significantly increased odds for fair or poor self-perceived overall health of teeth and gums (OR 2.147 and 2.736, respectively) and for severe periodontitis (OR 1.739 and 2.574, respectively) compared to controls; CD patients presented additionally 91% higher odds for having <20 remaining teeth.

    Conclusions: UC and CD patients have significantly increased odds for worse self-perceived oral health and severe periodontitis compared to controls, with CD patients being more severely affected and losing more teeth. It is strongly recommended that IBD patients are kept under close surveillance to prevent periodontitis development and/or mitigate its progression.

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  • 7.
    Bertl, Kristina
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Sigmund Freud Univ Vienna, Fac Med, Dept Periodontol, Dent Clin, Vienna, Austria.
    Burisch, Johan
    Copenhagen Univ Hosp Amager & Hvidovre, Med Div, Gastrounit, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ado, Hvidovre, Denmark..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska Inst, Dept Dent Med, Div Oral Dis, Stockholm, Sweden..
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls: The Periodontitis Prevalence in ulcerative Colitis and Crohn disease (PPCC) case-control study2024Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 95, nr 2, s. 159-174Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To describe the frequency and impact of oral lesions and professional dental care costs in patients with inflammatory bowel disease (IBD) (i.e., Crohn disease [CD] or ulcerative colitis [UC]) compared to matched controls).

    Methods: IBD patients and matched controls were surveyed on general anamnestic information, eating and drinking habits, and oral health- and dental care-related questions; IBD patients were additionally surveyed on oral lesions. Problems related to oral lesions and the amount of money spent for professional dental care in the past 12 months were defined as primary outcome parameters.

    Results: Answers from 1108 IBD patients and 3429 controls were analyzed. About 30% of the patients indicated having had problems with oral lesions, with CD patients having 46% higher odds and having them more often in a generalized form compared to UC patients. Further, self-reported severe periodontitis increased the odds of having oral lesions by almost 2.3-times. However, only about 12.5% of IBD patients were informed by their physician about oral lesions and about 10% indicated receiving treatment for them. Compared to controls, IBD patients required more often dental treatment and spent more money; specifically, UC and CD patients had 27 and 89% higher odds, respectively, for having spent ≥3000 DKK (ca. 440 USD) at the dentist compared to controls.

    Conclusions: IBD patients have more often oral health problems and higher expenses for professional dental care compared to matched controls. This included problems with IBD-related oral lesions, but these are rarely addressed by the medical or dental team.Keywords: Crohn disease; case-control studies; colitis; dental care; inflammatory bowel diseases; surveys and questionnaires; ulcerative.

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  • 8.
    Bertl, Kristina
    et al.
    Malmö högskola, Odontologiska fakulteten (OD). Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Austria.
    Parllaku, Arlinda
    Private Practice, Tirana, Albania; Postgraduate Course Periodontology, Medical University of Vienna.
    Pandis, Nikolaos
    School of Dental Medicine, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.
    Buhlin, Kåre
    Department of Dental Medicine, Division of Periodontology, Karolinska Institute, Huddinge, Sweden.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    The effect of local and systemic statin use as an adjunct to non-surgical and surgical periodontal therapy. A systematic review and meta-analysis.2017Ingår i: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 67, s. 18-28Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objectives To evaluate the effect of local and/or systemic statin use as an adjunct to non-surgical and/or surgical periodontal therapy. Data Literature search according to PRISMA guidelines with the following eligibility criteria: (a) English or German language; (b) interventional studies; (c) statins as monotherapy or as an adjunct to non-surgical and/or surgical treatment of periodontitis; (d) clinical and/or radiographic treatment effect size of statin intake reported. Sources Medline (PubMed), Embase (Ovid), CENTRAL (Ovid). Study selection Thirteen clinical studies regarding local application and 2 with systemic administration of statins as an adjunct to non-surgical treatment (SRP) and 4 studies regarding intrasurgical statin application with a maximum follow-up of 9 months could be included; simvastatin, atorvastatin, and rosuvastatin were used. Local but not systemic statin application as an adjunct to SRP yielded significantly larger probing pocket depth (PD), radiographic defect depth (RDD), and bleeding index reduction, and larger clinical attachment level gain, and less residual PD and RDD (p≤0.016); rosuvastatin appeared as the most efficacious. Three of 4 studies reported a significant positive effect of intrasurgical statin application. No adverse events were reported after statin use. The vast majority of the included studies were from the same research group. Conclusions Significant additional clinical and radiographic improvements are obtained after local, but not systemic, statin use as an adjunct to SRP in deep pockets associated with intrabony defects and seemingly with furcation defects; intrasurgical statin application seems similarly beneficial. Confirmation of these results, and especially of the effect size, from other research groups is warranted.

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  • 9.
    Bertl, Kristina
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
    Steiner, Ilse
    Private Practice, Taiskirchen, Austria; Postgraduate Course Periodontology, Medical University of Vienna, Vienna, Austria.
    Pandis, Nikolaos
    Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
    Buhlin, Kåre
    Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Statins in nonsurgical and surgical periodontal therapy. A systematic review and meta-analysis of preclinical in vivo trials.2018Ingår i: Journal of Periodontal Research, ISSN 0022-3484, E-ISSN 1600-0765, Vol. 53, nr 3, s. 267-287Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The cholesterol-lowering drugs, statins, possess anti-inflammatory, antimicrobial and pro-osteogenic properties, and thus have been tested as an adjunct to periodontal treatment. The present systematic review aimed to answer the following focused research question: What is the effect of local and/or systemic statin use on periodontal tissues in preclinical in vivo studies of experimentally induced periodontitis (EIP) and/or acute/chronified periodontal defect (ACP) models? A literature search (of Medline/PubMed, Embase/Ovid, CENTRAL/Ovid) using the following main eligibility criteria was performed: (i) English or German language; (ii) controlled preclinical in vivo trials; (iii) local and/or systemic statin use in EIP and/or ACP models; and (iv) quantitative evaluation of periodontal tissues (i.e., alveolar bone level/amount, attachment level, cementum formation, periodontal ligament formation). Sixteen studies in EIP models and 7 studies in ACP models evaluated simvastatin, atorvastatin or rosuvastatin. Thirteen of the EIP (81%) and 2 of the ACP (29%) studies presented significantly better results in terms of alveolar bone level/amount in favor of statins. Meta-analysis based on 14 EIP trials confirmed a significant benefit of local and systemic statin use (P < .001) in terms of alveolar bone level/amount; meta-regression revealed that statin type exhibited a significant effect (P = .014) in favor of atorvastatin. Three studies reported a significantly higher periodontal attachment level in favor of statin use (P < .001). Complete periodontal regeneration was never observed; furthermore, statins did not exert any apparent effect on cementum formation. Neither local nor systemic use of statins resulted in severe adverse effects. Statin use in periodontal indications has a positive effect on periodontal tissue parameters, supporting the positive results already observed in clinical trials. Nevertheless, not all statins available have been tested so far, and further research is needed to identify the maximum effective concentration/dose and optimal carrier.

  • 10.
    Björnfot Holmström, Sofia
    et al.
    Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lira-Junior, Ronaldo
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
    Zwicker, Stephanie
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Majster, Mirjam
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Gustafsson, Anders
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Åkerman, Sigvard
    Malmö universitet, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Svensson, Mattias
    Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Boström, Elisabeth A
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    MMP-12 and S100s in saliva reflect different aspects of periodontal inflammation2019Ingår i: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 113, s. 155-161Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Matrix metalloproteinase (MMP)-12, S100A8/A9, and S100A12 are involved in innate immune responses. We addressed whether different aspects of oral health and non-disease-related covariates influence their levels in saliva. 436 participants were clinically examined, completed a health questionnaire, and provided stimulated saliva. Salivary levels of MMP-12, S100A8/A9, and S100A12 were determined by enzyme-linked immunosorbent assays. Lower MMP-12 levels were observed in individuals 40-64years old (yo) compared to < 40yo, and higher S100A8/A9 levels were found in individuals > 64yo compared to 40-64yo. Smokers exhibited lower MMP-12 and S100A12 levels compared to non-smokers. All three proteins were elevated in individuals with bleeding on probing (BOP)>20% compared to those with BOP</=20%, and the S100A8/A9 levels were higher in individuals having >/= 10% gingival pocket depths (PPD)>/=4mm compared to the ones with shallow pockets < 4mm. The extent of alveolar bone loss or presence of manifest caries did not alter any of the markers. MMP-12, S100A8/A9, and S100A12 levels were higher in participants with high periodontal inflammatory burden. All three proteins correlated positively to BOP, PPD, and to several inflammatory mediators. The explanatory variables for MMP-12 in saliva were age, smoking, presence of any tumor, and percentage of PPD>/=4mm. The determinant of salivary S100A8/A9 was percentage of BOP, while S100A12 levels were associated with percentage of BOP and presence of any tumor. Taken together, MMP-12 and the S100/calgranulin levels in saliva reflect different aspects of periodontal inflammation. Smoking and age should be taken into account in further investigation of these proteins as biomarker candidates of periodontal disease.

  • 11.
    Bladh, Magnus
    et al.
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Gustafsson, Nils
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Engström, Gunnar
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Kennbäck, Cecilia
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska Institutet, Solna, Sweden.
    Nilsson, Peter M
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
    Jönsson, Daniel
    Malmö universitet, Odontologiska fakulteten (OD). Department of Clinical Sciences, Lund University, Malmö, Sweden; Public Dental Service of Skåne, Lund, Sweden.
    Levring Jäghagen, Eva
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Defined shapes of carotid artery calcifications on panoramic radiographs correlate with specific signs of cardiovascular disease on ultrasound examination2024Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 137, nr 4, s. 408-420, artikel-id S2212-4403(23)01541-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim was to optimize diagnostics for carotid artery calcifications (CACs) on panoramic radiographs (PRs) to identify cardiovascular disease (CVD) by investigating how 4 defined CAC shapes are associated with ultrasound (US) findings indicating CVD.

    STUDY DESIGN: The study included 414 participants (802 neck sides) from the Malmö Offspring Dental Study, examined with PRs. The PRs were assessed for CAC shapes stratified into 4 categories: single, scattered, vessel-width defining, and vessel-outlining. The carotid arteries were examined with US for signs of CVD: the presence of plaques, largest individual area of a plaque, number of plaques, and percentage reduction of the lumen. Associations between the different CAC categories and US characteristics were analyzed.

    RESULTS: All categories of CAC were significantly associated with a higher degree of US findings indicating CVD compared with no CAC (P < .001). The most significant differences were found for vessel-outlining CAC, with the mean of the largest individual plaque area of 17.9 vs 2.3 mm2, mean number of plaques 1.6 vs 0.2, and mean percentage reduction of the lumen 24.1% vs 3.5% (all P < .001).

    CONCLUSIONS: Independent of shape, CACs detected on PRs were associated with a higher degree of US findings of CVD. This was most pronounced for vessel-outlining CAC. With refined differential diagnostics of CACs in PRs, dentists may contribute to improved identification of patients in need of cardiovascular prevention.

  • 12.
    Brunello, Giulia
    et al.
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany; University of Padova, Padova, Italy.
    Gurzawska-Comis, Katarzyna
    University of Birmingham, Birmingham, United Kingdom.
    Becker, Kathrin
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
    Becker, Jürgen
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
    Sivolella, Stefano
    University of Padova, Padova, Italy.
    Schwarz, Frank
    Goethe University, Frankfurt, Frankfurt am Main, Germany.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska Institutet.
    Dental care during COVID-19 pandemic: follow-up survey of experts' opinion2021Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, nr S21, s. 342-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The purpose of the present survey is to give an update of European experts' opinion on infection control and prevention in dentistry during second wave of pandemic. The secondary aim was to analyse how experts' opinion changed in the light of the new scientific evidence since the first wave.

    MATERIAL & METHODS: An anonymous online 14-item questionnaire was sent to a total of 27 leading academic experts in Oral (and Maxillofacial) Surgery from different European countries, who had completed a previous survey in April-May 2020. The questionnaire covered the topics of dental setting safety, personal protective equipment (PPE), and patient-related measures to minimise transmission risk. Data collection took place in November-February 2020/21.

    RESULTS: 26 experts participated in the follow-up survey. The overall transmission risk in dental settings was scored significantly lower compared to the initial survey (P<0.05), though the risk associated with aerosol generating procedures (AGP) was still considered to be high. Maximum PPE was less frequently recommended for non-AGP (P<0.05), whereas the majority of experts still recommended FFP2/FFP3 masks (80.8%), face shields or goggles (88.5%), gowns (61.5%), and caps (57.7%) for AGP. Most of the experts also found mouth rinse relevant (73.1%) and reported to be using it prior to treatment (76.9%). No uniform opinion was found regarding the relevance of COVID-19 testing of staff and patients.

    CONCLUSION: With the continuation of dental care provision, transmission risk has been scored lower compared to the first wave of pandemic. However, high risk is still assumed for AGP, and maximum PPE remained advised for the respective treatments.

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  • 13.
    Brunkwall, Louise
    et al.
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Jönsson, Daniel
    Malmö universitet, Odontologiska fakulteten (OD). Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Ericson, Ulrika
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Hellstrand, Sophie
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Kennbäck, Cecilia
    Department of Internal Medicine, Skane University Hospital, Jan Waldenströms gata 15, 5th floor, 20502, Malmö, Sweden.
    Östling, Gerd
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Jujic, Amra
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skane University Hospital, Malmö, Sweden.
    Melander, Olle
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skane University Hospital, Jan Waldenströms gata 15, 5th floor, 20502, Malmö, Sweden.
    Engström, Gunnar
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Nilsson, Jan
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skane University Hospital, Malmö, Sweden.
    Ohlsson, Bodil
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skane University Hospital, Jan Waldenströms gata 15, 5th floor, 20502, Malmö, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Orho-Melander, Marju
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Persson, Margaretha
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skane University Hospital, Jan Waldenströms gata 15, 5th floor, 20502, Malmö, Sweden.
    Nilsson, Peter M
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skane University Hospital, Jan Waldenströms gata 15, 5th floor, 20502, Malmö.
    The Malmö Offspring Study (MOS): design, methods and first results.2021Ingår i: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 36, s. 103-116Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As cardio metabolic disease manifestations tend to cluster in families there is a need to better understand the underlying mechanisms in order to further develop preventive strategies. In fact, genetic markers used in genetic risk scores, important as they are, will not be able alone to explain these family clusters. Therefore, the search goes on for the so called missing heritability to better explain these associations. Shared lifestyle and social conditions in families, but also early life influences may be of importance. Gene-environmental interactions should be explored. In recent years interest has grown for the role of diet-microbiota associations, as microbiota patterns may be shared by family members. In the Malmö Offspring Study that started in 2013, we have so far been able to examine about 4700 subjects (18-71 years) representing children and grandchildren of index subjects from the first generation, examined in the Malmö Diet Cancer Study during 1991 to 1996. This will provide rich data and opportunities to analyse family traits of chronic disease across three generations. We will provide extensive genotyping and phenotyping including cardiovascular and respiratory function, as well as markers of glucose metabolism. In addition, also cognitive function will be assessed. A 4-day online dietary recall will be conducted and gut as well as oral microbiota analysed. The ambition is to provide one of the first large-scale European family studies with individual data across three generations, which could deepen our knowledge about the role of family traits for chronic disease and its underlying mechanisms.

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  • 14. Buhlin, Kåre
    et al.
    Holmer, Jacob
    Gustafsson, Anders
    Hörkkö, Sohvi
    Pockley, Alan Graham
    Johansson, Anders
    Paju, Susanna
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Pussinen, Pirkko J.
    Association of periodontitis with persistent, pro-atherogenic antibody responses2015Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 42, nr 11, s. 1006-1014Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To study antibody responses associated with molecular mimicry in periodontitis. Material & Methods: Fifty-four periodontitis cases (mean age 54.0 years) and 44 controls (53.6 years) were examined, after which cases received periodontal treatment. Established immunoassays were used to analyse levels of antibodies against two pathogens, Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg), heat shock proteins (Hsp), Hsp60, Hsp65, and Hsp70, and epitopes of oxidized low-density lipoprotein (oxLDL) (CuOx-LDL and MDA-LDL) in plasma samples that were collected at baseline and after 3 (n = 48) and 6 (n = 30) months. Results: When age, sex, smoking habit, and the number of teeth were considered in multivariate logistic regressions, Aa and Pg IgG, Hsp65-IgA, CuOx-LDL-IgG and -IgM, and MDA-LDL-IgG antibody levels were associated with periodontitis, whereas Hsp60-IgG2 antibody levels were inversely associated. The Aa antibody levels significantly correlated with the levels of IgA antibodies to Hsp65 and Hsp70, and both OxLDL IgA antibody levels. The levels of antibodies to Pg correlated with IgG antibodies to Hsp60, Hsp70, and both oxLDL antibody epitopes. None of the antibody levels changed significantly after treatment. Conclusions: Periodontitis is associated with persistently high levels of circulating antibodies that are reactive with pathogen-and host-derived antigens.

  • 15. Buhlin, Kåre
    et al.
    Hultin, Margareta
    Norderyd, Ola
    Malmö högskola, Odontologiska fakulteten (OD).
    Persson, Lena
    Pockley, Alan Graham
    Pussinen, Pirkko J.
    Rabe, Per
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Gustafsson, Anders
    Periodontal treatment influences risk markers for atherosclerosis in patients with severe periodontitis2009Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 206, nr 2, s. 518-522Artikel i tidskrift (Refereegranskat)
    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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  • 16. Buhlin, Kåre
    et al.
    Hultin, Margareta
    Norderyd, Ola
    Malmö högskola, Odontologiska fakulteten (OD).
    Persson, Lena
    Pockley, Alan Graham
    Rabe, Per
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Gustafsson, Anders
    Risk factors for atherosclerosis in cases with severe periodontitis2009Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, nr 7, s. 541-549Artikel i tidskrift (Refereegranskat)
    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.

  • 17.
    de Vries, Charlotte
    et al.
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden.
    Ruacho, Guillermo
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden; Public Dental Services, Folktandvården Stockholms Län AB, 113 82 Stockholm, Sweden.
    Kindstedt, Elin
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden; Section for Molecular Periodontology, Department of Odontology, Umeå University, 901 85 Umeå, Sweden; Wallenberg Centre for Molecular Medicine, Umeå University, 901 87 Umeå, Sweden.
    Potempa, Barbara Aleksandra
    Department of Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland.
    Potempa, Jan
    Department of Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY 40202, USA; Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
    Lundberg, Pernilla
    Section for Molecular Periodontology, Department of Odontology, Umeå University, 901 85 Umeå, Sweden.
    Svenungsson, Elisabet
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden.
    Lundberg, Karin
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden.
    Are Increased in Patients with Severe Periodontitis, and Associate with Presence of Specific Autoantibodies and Myocardial Infarction2022Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, nr 4, artikel-id 1008Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is accumulating data suggesting that periodontitis is associated with increased risk of systemic and autoimmune diseases, including cardiovascular disease, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and there is an unmet need to identify these individuals early. With the periodontal bacteria Porphyromonas gingivalis (Pg) as one of the key drivers of periodontitis, we set out to investigate whether antibodies to Pg virulence factor arginine gingipain (Rgp) could serve as a biomarker for periodontitis patients at increased risk of autoimmunity and systemic disease. We measured serum anti-Rgp IgG in three study populations: PAROKRANK (779 individuals with myocardial infarction (MI); 719 controls), where 557 had periodontitis, and 312 were positive for autoantibodies associated with RA/SLE; the PerioGene North pilot (41 periodontitis; 39 controls); and an SLE case/control study (101 SLE; 100 controls). Anti-Rgp IgG levels were increased in severe periodontitis compared to controls (p < 0.0001), in individuals positive for anti-citrullinated protein antibodies (p = 0.04) and anti-dsDNA antibodies (p = 0.035), compared to autoantibody-negative individuals; and in MI patients versus matched controls (p = 0.035). Our data support longitudinal studies addressing the role of anti-Rgp antibodies as biomarkers for periodontitis patients at increased risk of developing autoimmunity linked to RA and SLE, and mechanisms underpinning these associations.

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  • 18. Derks, Jan
    et al.
    Håkansson, Jan
    Wennström, Jan L
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Berglundh, Tord
    Patient-reported outcomes of dental implant therapy in a large randomly selected sample2015Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, nr 5, s. 586-591Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundIn addition to traditional clinical parameters, the need to include patient-reported assessments into dental implant research has been emphasized. AimThe aim of this study was to evaluate patient-reported outcomes following implant-supported restorative therapy in a randomly selected patient sample. Material and MethodsFour thousand seven hundred and sixteen patients were randomly selected from the data register of the Swedish Social Insurance Agency. A questionnaire containing 10 questions related to implant-supported restorative therapy was mailed to each of the individuals about 6years after therapy. Associations between questionnaire data, and (i) patient-related, (ii) clinician-related and (iii) therapy-related variables were identified by multivariate analyses. ResultsThree thousand eight hundred and twenty-seven patients (81%) responded to the questionnaire. It was demonstrated that the overall satisfaction among patients was high. Older patients presented with an overall more positive perception of the results of the therapy than younger patients and males were more frequently satisfied in terms of esthetics than females. While clinical setting did not influence results, patients treated by specialist dentists as opposed to general practitioners reported a higher frequency of esthetic satisfaction and improved chewing ability. In addition, patients who had received extensive implant-supported reconstructions, in contrast to those with small reconstructive units, reported more frequently on improved chewing ability and self-confidence but also to a larger extent on implant-related complications. ConclusionIt is suggested that patient-perceived outcomes of implant-supported restorative therapy are related to (i) age and gender of the patient, (ii) the extent of restorative therapy and (iii) the clinician performing the treatment.

  • 19.
    Eriksson, Kaja
    et al.
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Fei, Guozhong
    Center for Rheumatology, Academic Specialist Center, Stockholm Health Services, 10235 Stockholm, Sweden.
    Lundmark, Anna
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Benchimol, Daniel
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Lee, Linkiat
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Hu, Yue O. O.
    Science for Life Laboratory School of Biotechnology, KTH Royal Institute of Technology, 17121 Stockholm, Sweden; Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, 17164 Stockholm, Sweden.
    Kats, Anna
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Saevarsdottir, Saedis
    Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden.
    Catrina, Anca Irinel
    Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Andersson, Anders F.
    Science for Life Laboratory School of Biotechnology, KTH Royal Institute of Technology, 17121 Stockholm, Sweden.
    Klareskog, Lars
    Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden.
    Lundberg, Karin
    Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, 17176 Stockholm, Sweden.
    Jansson, Leif
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden; Department of Periodontology at Eastmaninstitutet, Stockholm County Council, 11382 Stockholm, Sweden.
    Yucel-Lindberg, Tulay
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, 14104 Huddinge, Sweden.
    Periodontal Health and Oral Microbiota in Patients with Rheumatoid Arthritis2019Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 8, nr 5, artikel-id 630Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to investigate the periodontal health of patients with established rheumatoid arthritis (RA) in relation to oral microbiota, systemic and oral inflammatory mediators, and RA disease activity. Forty patients underwent full-mouth dental/periodontal and rheumatological examination, including collection of blood, saliva, gingival crevicular fluid (GCF) and subgingival plaque. Composition of plaque and saliva microbiota were analysed using 16S rRNA sequencing and levels of inflammatory mediators by multiplex-immunoassay. The majority of the patients (75%) had moderate or severe periodontitis and the rest had no/mild periodontitis. Anti-citrullinated protein antibody (ACPA) positivity was significantly more frequent in the moderate/severe periodontitis (86%) compared to the no/mild group (50%). No significance between groups was observed for RA disease duration or activity, or type of medication. Levels of sCD30/TNFRSF8, IFN-2, IL-19, IL-26, MMP-1, gp130/sIL-6R ss, and sTNF-R1 were significantly higher in serum or GCF, and April/TNFSF13 was significantly higher in serum and saliva samples in moderate/severe periodontitis. The microbial composition in plaque also differed significantly between the two groups. In conclusion, the majority of RA patients had moderate/severe periodontitis and that this severe form of the disease was significantly associated with ACPA positivity, an altered subgingival microbial profile, and increased levels of systemic and oral inflammatory mediators.

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  • 20. Ernberg, Malin
    et al.
    Bergenholtz, Gunnar
    Dahlén, Gunnar
    Ekman, Agneta
    Eriksson, Per-Olof
    Grøndahl, Kerstin
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Lerner, Ulf
    Magnusson, Tomas
    Matsson, Lars
    Malmö högskola, Odontologiska fakulteten (OD).
    Pälvärinne, Raimo
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Examina och utbildning inom svensk odontologisk forskning: lägesrapport2003Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 95, nr 9, s. 54-59Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    En internationell utvärdering visade för några år sedan att Sverige riskerar att förlora sin position som världsledande nation inom odontologisk forskning. För att få en uppfattning om förändringarna inom forskarutbildningen och den postdoktorala meriteringen samlades data för 1990–2001 in från fakulteterna, Statistiska Centralbyrån samt Högskoleverket. Avsikten var att undersöka antalet forskarutbildade tandläkare, mångfalden bland doktoranderna och de som disputerat samt deras nuvarande anställningsform. Materialet jämfördes sedan med tidigare data. I medeltal avlade 25 personer per år doktorsexamen åren 1990–2001. Antalet har minskat under senare år. En majoritet av dem som avlade doktorsexamen hade odontologisk bakgrund. Relativt få har meriterat sig för en fortsatt akademisk karriär. 32 studerande påbörjade forskarutbildning åren 1991–2001. Andelen doktorander med annan akademisk grundexamen än odontologisk ökar. Sedan 1999 har forskningsvolymen minskat med motsvarande en hel fakultets forskningsvolym. Vi drar därför slutsatsen att kunskapsutvecklingen inom svensk odontologi riskerar att stagnera samt att fakulteternas behov av lärare till högre akademiska tjänster liksom folktandvårdens behov av handledare inom specialistutbildningen inte kommer att kunna tillgodoses i framtiden.

  • 21.
    Ferrannini, Giulia
    et al.
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Almosawi, Mariam
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Buhlin, Kåre
    Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    De Faire, Ulf
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Section of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kjellström, Barbro
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences Lund, Clinical Physiology, and Skåne University Hospital, Lund University, Lund, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Section of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Nygren, Åke
    Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.
    Näsman, Per
    Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden.
    Svenungsson, Elisabet
    Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Rydén, Lars
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Norhammar, Anna
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Capio St Görans Hospital, Stockholm, Sweden.
    Long-term prognosis after a first myocardial infarction: eight years follow up of the case-control study PAROKRANK2022Ingår i: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 56, nr 1, s. 337-342Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. To explore long-term cardiovascular outcomes and mortality in patients after a first myocardial infarction (MI) compared with matched controls in a contemporary setting. Methods. During 2010–2014 the Swedish study PAROKRANK recruited 805 patients <75 years with a first MI and 805 age-, gender-, and area-matched controls. All study participants were followed until 31 December 2018, through linkage with the National Patient Registry and the Cause of Death Registry. The primary endpoint was the first of a composite of all-cause death, non-fatal MI, non-fatal stroke, and heart failure hospitalization. Event rates in cases and controls were calculated using a Cox regression model, subsequently adjusted for baseline smoking, education level, and marital status. Kaplan–Meier curves were computed and compared by log-rank test. Results. A total of 804 patients and 800 controls (mean age 62 years; women 19%) were followed for a mean of 6.2 (0.2–8.5) years. The total number of primary events was 211. Patients had a higher event rate than controls (log-rank test p < .0001). Adjusted hazard ratio (HR) for the primary outcome was 2.04 (95% CI 1.52–2.73). Mortality did not differ between patients (n = 38; 4.7%) and controls (n = 35; 4.4%). A total of 82.5% patients and 91.3% controls were event-free during the follow up. Conclusions. In this long-term follow up of a contemporary, case-control study, the risk for cardiovascular events was higher in patients with a previous first MI compared with their matched controls, while mortality did not differ. The access to high quality of care and cardiac rehabilitation might partly explain the low rates of adverse outcomes. 

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  • 22.
    Franzon, Bengt
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Axtelius, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Åkerman, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Dental politics and subsidy systems for adults in Sweden from 1974 until 20162017Ingår i: BDJ Open, E-ISSN 2056-807X, Vol. 3, nr 17007Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The dental health sector, as part of the Swedish welfare system, originated in 1974. Since then, the dental insurance has undergone three major changes. The aim of this archive study was to study where in the legislative process the dental politics concerning national dental insurance and subsidies were formed. Materials and Methods: The material, such as Commission of inquiry proposals and Government Bills from four major dental reforms, was collected from the library at the Sveriges Riksdag (Swedish Parliament) and was analysed and structured using a modified version of the Health Field Model. Results: The views on the fundamental ideas, such as the connection between general and dental health, preventive dentistry, rehabilitation of the mouth and promotion of dental health, were the same over the years. The views on dentistry as a market, when it comes to freedom of prices, have undergone a major change since 1974, but the view on the welfare state remains the same. Conclusions: The Swedish dental subsidy systems and how dentistry has been treated politically are the results of a chain of events ranging from care for the population's dental health, political doctrines, ‘zeitgeist‚, dental policy, to state finances.

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  • 23.
    Franzon, Bengt
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Englander, Magnus
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Axtelius, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Odontology, Division of Oral Diseases, Karolinkska Institutet.
    Dentistry as a free market in the context of leading policymaking2018Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, nr 1, artikel-id 1484218Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to disclose the psychological meaning structure of dentistry as a free market within the context of leading Swedish policymaking. Following the criteria for the descriptive phenomenological psychological method data was collected from leading policy makers about the experiential aspects of dentistry as a free market within the context of a welfare state. The analysis showed that dentistry as a free market was experienced as a complex business relationship between buyers and sellers that transcended the traditional dentist and patient roles. The lived experience of the proposed business transaction was based on two inherently conflicting views: the belief in the individual's ability to make a free choice versus the understanding that all individuals in a society do not have the ability or the means necessary to make a free choice. Dentistry as a free market within a welfare state, such as Sweden, can thus be seen as a persistent attempt to hold on to a compromise between two very distinctive political ideologies.

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  • 24.
    Franzon, Bengt
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Moutakis, Mikael
    Department of Economics, Gothenburg University, Gothenburg, Sweden; The Swedish Dental- and Pharmaceutical Benefits Agency, Stockholm, Sweden.
    Axtelius, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Åkerman, Sigvard
    Malmö universitet, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    The relationship between practice ownership and follow-up of comprehensive dental care. A Swedish register study.2024Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 83, s. 151-159Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: The aims of this register study were:

    1. To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership.
    2. To study the extent of follow-up of patients who have undergone two types of treatments. 

    MATERIAL & METHODS: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed.  Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently.

    CONCLUSION: Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

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  • 25.
    Grant, Melissa
    et al.
    School of Dentistry, Institute of Clinical Sciences, University of Birmingham and Birmingham Community Healthcare Foundation Trust, Birmingham, United Kingdom.
    Kilsgård, Ola
    Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
    Åkerman, Sigvard
    Malmö universitet, Odontologiska fakulteten (OD). Swedish Dental Service of Skåne, Lund, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden.
    Demmer, Ryan T
    Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
    Malmström, Johan
    Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
    Jönsson, Daniel
    Malmö universitet, Odontologiska fakulteten (OD). Swedish Dental Service of Skåne, Lund, Sweden.
    The Human Salivary Antimicrobial Peptide Profile according to the Oral Microbiota in Health, Periodontitis and Smoking.2019Ingår i: Journal of Innate Immunity, ISSN 1662-811X, E-ISSN 1662-8128, Vol. 11, nr 5, s. 432-443Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Antimicrobial peptides (AMPs) are a diverse family of peptides that defend the mucosal surfaces of the oral cavity and other locations. Many AMPs have multiple functions and properties that influence aspects of innate defense and colonization by microorganisms. The human oral cavity is home to the second-most diverse microbiome, and the health of the mouth is influenced by the presence of these bacteria as well as by extrinsic factors such as periodontitis and smoking. This study hypothesized that the AMP profile is different in the presence of extrinsic factors and that this would also be reflected in the bacteria present. The AMP profile was analyzed by quantitative selected-reaction-monitoring mass spectrometry analysis and 40 bacterial species were quantified by DNA-DNA hybridization in saliva donated by 41 individuals. Periodontal status was assessed through dental examination and smoking status through medical charting. Periodontal health (in nonsmokers) was associated with a higher abundance of ribonuclease 7, protachykinin 1, β-defensin 128, lipocalin 1, bactericidal permeability-increasing protein fold-containing family B member 3, and bone-marrow proteoglycan. Nonsmoking periodontal disease was associated with an abundance of neutrophil defensin 1 and cathelicidin. However, 7 AMPs were overabundant in periodontal disease in smokers: adrenomedullin, eosinophil peroxidase, 3 different histones, myeloperoxidase, and neutrophil defensin 1. There were no differentially abundant AMPs in smokers versus nonsmokers with periodontal health. Correlation network inference of healthy nonsmokers, healthy smokers, nonsmoking periodontitis, or smoking periodontitis donors demonstrated very different networks growing in complexity with increasing numbers of stressors. The study highlights the importance of the interaction between the oral cavity and its resident microbiota and how this may be influenced by periodontal disease and smoking.

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  • 26.
    Gurzawska-Comis, Katarzyna
    et al.
    University of Birmingham, UK.
    Becker, Kathrin
    Universitätsklinikum Düsseldorf, Germany.
    Brunello, Giulia
    University of Padova, Italy; Universitätsklinikum Düsseldorf, Germany.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska Institutet.
    COVID-19: Review of European recommendations and experts' opinion on dental care. Summary and consensus statements of group 5. The 6th EAO Consensus Conference 2021.2021Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, nr S21, s. 382-388Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The present work reports the EAO Workshop group 5 and consensus plenary discussions and statements based on two reviews summarising European guidelines and experts' opinion on infection control and prevention (ICP) in dentistry during the pandemic.

    MATERIAL: Two manuscripts were presented at the 6th EAO Consensus Conference. The first study compared the most recent national guidelines/recommendations of European countries. The second paper was an experts' opinion-based survey on application of ICP regulation during the second wave. The outcome of COVID-19 group discussion was presented to all participants of the consensus to come to an agreement about the consensus statements and clinical recommendation.

    RESULTS: The dynamic of the pandemic had an impact on rapidly published and frequently updated national guidelines in Europe. As guidelines were not based on solid evidence, they were supplemented by experts' opinion on ICP in dentistry. The dental care should be guaranteed during the pandemic, however in case of suspected or confirmed COVID-19 disease, the treatment should be postponed if possible. Remote triage and patient-related measures (i.e., social distancing, hand hygiene and mask wearing) were recommended to be the most efficient to reduce SARS-CoV-2 transmission. The type of personal protective equipment for dental staff should be adequate to the procedure and infection risk.

    CONCLUSIONS: Adequate infection control protocols have to be followed by healthcare professionals and patients to minimise the spreading of COVID-19. We foresee the importance of continuously updating the national dental guidelines, considering the evolution of the pandemic and new scientific evidence becoming available.

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  • 27.
    Gustafsson, Anders
    et al.
    Karolinska institutet, Stockholm.
    Norhammar, Anna
    Fysiologkliniken, Capio S:t Görans sjukhus; Karolinska institutet, Stockholm.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska institutet, Stockholm.
    Rydén, Lars
    Karolinska institutet, Stockholm.
    Parodontit – en ofta förbisedd riskfaktor för en rad sjukdomar: Om sambandet med hjärt–kärlsjukdom, cancer och covid-192024Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 121, artikel-id 23137Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Periodontitis - an often neglected risk factor for several other diseases

    Periodontitis is a chronic inflammatory disease that degrades dental supporting tissues, including the alveolar bone. The global prevalence is 19%, in Sweden it is 11%. Left untreated, periodontitis can cause loss of teeth. The initial clinical manifestations of periodontitis usually start between 35 and 45 years of age. The underlying pathological mechanism is an aberrant inflammatory response to the bacteria colonizing the gingival crevice. Periodontitis has been associated with several other diseases, most prominently diabetes. The relation between periodontitis and diabetes is bidirectional in the sense that diabetes increases the risk for periodontitis and vice versa. Periodontitis also increases the risk for cardiovascular disease and cancer.

  • 28.
    Gustafsson, N
    et al.
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Ahlqvist, J
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Näslund, U
    Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Buhlin, K
    Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Gustafsson, A
    Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kjellström, B
    Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ryden, L
    Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden.
    Levring Jäghagen, E
    Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Associations among periodontitis, calcified carotid artery atheromas, and risk of myocardial infarction2020Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 99, nr 1, s. 60-68Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cardiovascular disease is a common cause of morbidity and premature mortality. Cardiovascular disease can be prevented when risk factors are identified early. Calcified carotid artery atheromas (CCAAs), detected in panoramic radiographs, and periodontitis have both been associated with increased risk of cardiovascular disease. This case-control study aimed to 1) investigate associations between periodontitis and CCAA detected in panoramic radiographs and 2) determine the risk of future myocardial infarctions due to CCAA combined with periodontitis. We evaluated 1,482 participants (738 cases and 744 controls) with periodontitis and CCAAs recruited from the PAROKRANK study (Periodontitis and Its Relation to Coronary Artery Disease). Participants were examined with panoramic radiographs, including the carotid regions. Associations between myocardial infarction and periodontitis combined with CCAA were evaluated in 696 cases and 696 age-, sex-, and residential area-matched controls. Periodontitis was evaluated radiographically (as degree of bone loss) and with a clinical periodontal disease index score (from clinical and radiographic assessments). We found associations between CCAA and clinical periodontal disease index score among cases (odds ratio [OR], 1.51; 95% CI, 1.09 to 2.10; P = 0.02) and controls (OR, 1.70; 95% CI, 1.22 to 2.38; P < 0.01), although not between CCAA and the degree of bone loss. In a multivariable model, myocardial infarction was associated with CCAA combined with periodontitis, as assessed by degree of bone loss (OR, 1.75; 95% CI, 1.11 to 2.74; P = 0.01). When the cohort was stratified by sex, only men showed a significant association between myocardial infarction and CCAA combined with periodontitis. Participants with clinically diagnosed periodontitis exhibited CCAA in panoramic radiographs more often than those without periodontitis, irrespective of the presence of a recent myocardial infarction. Participants with combined periodontitis and CCAA had a higher risk of having had myocardial infarction as compared with participants with either condition alone. These findings implied that patients in dental care might benefit from dentists assessing panoramic radiographs for CCAA-particularly, patients with periodontitis who have not received any preventive measures for cardiovascular disease.

  • 29.
    Herrera, David
    et al.
    ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain.
    Molina, Ana
    ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain.
    Buhlin, Kåre
    Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Perio Section, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Periodontal diseases and association with atherosclerotic disease2020Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 83, nr 1, s. 66-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cardiovascular diseases still account for the majority of deaths worldwide, although significant improvements in survival, after being affected by cardiovascular disease, have been achieved in the last decades. Periodontal diseases are also a common global burden. Several studies have shown a link between cardiovascular disease and periodontitis, although evidence is still lacking regarding the direct cause-effect relation. During the 2012 "Periodontitis and systemic diseases" workshop, the available evidence on the association between cardiovascular and periodontal diseases was discussed, covering biologic plausibility and clinical studies. The objective of the present narrative review was to update the previous reviews presented at the 2012 workshop, following similar methodological approaches, aiming to critically assess the available evidence. With regard to biologic plausibility, two aspects were reviewed: (a) for microbiologic mechanisms, assessing periodontal bacteria as a contributing factor to atherosclerosis based on seven "proofs," substantial evidence was found for Proofs 1 through 6, but not for Proof 7 (periodontal bacteria obtained from human atheromas can cause atherosclerosis in animal models), concluding that periodontal pathogens can contribute to atherosclerosis; (b) mechanistic studies, addressing five different inflammatory pathways that could explain the links between periodontitis and cardiovascular disease with the addition of some extra pathways , suggest an association between both entities, based on the presence of higher levels of these inflammatory markers in patients with periodontitis and cardiovascular disease, vs healthy controls, as well as on the evidence that periodontal treatment reduces serum levels of these mediators. When evidence from clinical studies was analyzed, two aspects were covered: (a) epidemiologic studies support the estimation that the incidence of atherosclerotic disease is higher in individuals with periodontitis than in individuals with no reported periodontitis, irrespective of many common risk factors, but with a substantial variability in the definitions used in reporting of exposure to periodontal diseases in different studies; (b) intervention trials have shown that periodontal therapy can reduce serum inflammatory mediators, improve the lipids profile, and induce positive changes in other cardiovascular disease surrogate measures, but no evidence is available to support that adequate periodontal therapy is able to reduce the risk for cardiovascular diseases, or the incidence of cardiovascular disease events in periodontitis patients.

  • 30.
    Holmstrup, Palle
    et al.
    Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Damgaard, Christian
    Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
    Olsen, Ingar
    Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD). Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Flyvbjerg, Allan
    Steno Diabetes Center Copenhagen, Copenhagen, Denmark.
    Nielsen, Claus Henrik
    Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
    Hansen, Peter Riis
    Section for Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Cardiology Department, Herlev and Gentofte Hospital, Hellerup, Denmark.
    Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician2017Ingår i: Journal of Oral Microbiology, E-ISSN 2000-2297, Vol. 9, nr 1, artikel-id 1332710Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson's disease, Alzheimer's disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.

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  • 31.
    Hämmerle, Christoph H F
    et al.
    Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Schliephake, Henning
    Department of Oral and Maxillofacial Surgery, University Medical Centre Goettingen, Goettingen, Germany.
    The 5(th) EAO Consensus Conference 7-10 February 2018, Pfaffikon, Schwyz, Switzerland2018Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, nr Suppl 18, s. 3-5Artikel i tidskrift (Övrigt vetenskapligt)
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  • 32.
    Jönsson, Daniel
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Swedish Dental Service of Skåne, Lund, Sweden.
    Orho-Melander, M
    Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
    Demmer, R T
    School of Public Health, University of Minnesota, Minneapolis, MN, United States; Mailman School of Public Health, Columbia University, New York, NY, United States.
    Engström, G
    Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
    Melander, O
    Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden.
    Nilsson, P M
    Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
    Periodontal disease is associated with carotid plaque area: the Malmö Offspring Dental Study (MODS)2020Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 287, nr 3, s. 301-309Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Periodontal disease is associated with cardiovascular disease (CVD) but it is unknown if periodontal disease severity is associated with asymptomatic carotid plaque. The aim of the current population‐based, observational study was to investigate if signs of periodontal disease are associated with the occurrence of carotid plaque and total plaque area (TPA). Methods: The Malmö Offspring Study (MOS) is a population‐based study. MOS participants underwent a thorough cardiovascular phenotyping, including carotid ultrasonography. The Malmö Offspring Dental Study (MODS) invited participants of MOS for dental examination, including periodontal charting. Multivariable regression models were used to analyse the presence of carotid plaque and TPA in relation to periodontal parameters. Results: In all, 831 MODS participants were recruited, out of which 495 belonged to the children generation with mean age of 53 years, 63% had carotid plaque and 38% had moderate or severe periodontal disease. In models adjusted for CVD risk factors, the OR for having carotid plaque in subjects with vs without periodontal disease was 1.75 (95% CI: 1.11–2.78). In a linear model with TPA as dependent and number of periodontal pockets ≥ 4 mm as independent variable, the adjusted beta‐coefficient was 0.34 mm2 (95% CI 0.16–0.52). Conclusion: Individuals within the highest quartile of periodontal pockets are expected to have 9 mm2 larger TPA compared to those without pockets. Our results suggest that intervention studies addressing periodontal disease could be useful for prevention of CVD.

  • 33.
    Kjellström, Barbro
    et al.
    Department of Medicine , Karolinska Institutet , Stockholm , Sweden.
    Rydén, Lars
    Department of Medicine , Karolinska Institutet , Stockholm , Sweden.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD). Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden.
    Norhammar, Anna
    Department of Medicine , Karolinska Institutet , Stockholm , Sweden; Department of Clinical Physiology , Capio St Görans Hospital , Stockholm , Sweden.
    Periodontal disease: important to consider in cardiovascular disease prevention2016Ingår i: Expert Review of Cardiovascular Therapy, ISSN 1477-9072, E-ISSN 1744-8344, Vol. 14, nr 9, s. 987-989Artikel i tidskrift (Övrigt vetenskapligt)
  • 34.
    Klinge, Anna
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Khalil, Dalia
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
    Lund, Bodil
    Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
    Naimi-Akbar, Aron
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Tranæus, Sofia
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Cariology, Karolinska Institutet, Stockholm, Sweden.
    Hultin, Margareta
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
    Prophylactic antibiotics for staged bone augmentation in implant dentistry2020Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, nr 1, s. 64-73Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: The objective of the study was to assess the effect of prophylactic antibiotics on the outcome of bone augmentation and subsequent dental implant placement by combining the recommended quality assessment methods for systematic reviews and primary studies.

    Materials and methods: This is a complex systematic review in which systematic reviews as well as primary studies are scrutinised. A search of Medline (OVID), The Cochrane Library (Wiley) and EMBASE, PubMed and Health technology assessment (HTA) organisations as-well as a complementary hand-search was carried out. Selected primary studies were assessed using GRADE. Each study was reviewed by three authors independently.

    Results: Abstract screening yielded six potential systematic reviews allocated for full-text inspection. A total of ten primary studies were read in full-text. No relevant systematic reviews regarding the topic of this article were found. The quality assessment resulted in two primary studies with a moderate risk of bias. Of the two studies with a moderate risk of bias, one compared a single dose of clindamycin 600 mg preoperatively with the same preoperative dose followed by four doses of 300 mg every 6 h. The second study compared a single dose prophylaxis of two different types of antibiotic compounds.

    Conclusion: In conclusion, the scientific evidence regarding the use of antibiotic prophylaxis for reducing the risk of infection in conjunction with bone augmentation procedures during dental implant placement is very limited. The infection rate as compared to nonusage of prophylactic antibiotics, selection of the most suitable compound, and the optimal duration of prophylactic treatment is still unknown.

  • 35.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Peri-implant marginal bone loss: an academic controversy or a clinical challenge?2012Ingår i: European Journal of Oral Implantology, ISSN 1756-2406, E-ISSN 1756-2414, Vol. 5, s. S13-S19Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this narrative review was to explore and discuss marginal bone loss around transmucosal oral implants and the related incidence of this biologic complication. Results: Treatment with osseointegrated implants is most often successful and improves the quality of life for the patient. At present only limited data are available to evaluate long-term technical and biological complications. When pen-implant tissue destruction occurs, little is known about the initiating process. Possible factors of relevance for the initiation and progression of peri-implantitis are discussed. Periodontitis, smoking and a variety of local factors are among the most plausible putative reported risk factors. Also, oral hygiene and the inability to clean the reconstruction were reported. The unit for reporting incidence of pen-implant bone loss varies in different studies between implants and patients. Since there seems to be a clustering effect, and implants in the same mouth cannot be considered independent from each other, it is recommended to use the patient as a unit. The different cut-off values for clinical parameters reported in different studies will exert a significant influence on the magnitude of the reported incidence of peri-implantitis. It is suggested that the composite variables including bone loss >= 2 mm, compared to initial radiographs at delivery of the prosthetic device, in combination with bleeding on probing should be interpreted as a 'red flag' for the clinician to critically evaluate if any intervention is indicated in the individual case. Conclusion: Until more solid scientific evidence has been made available, it is likely that the academic controversy in relation to pen-implant bone loss and peri-implantitis will continue.

  • 36.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Swedish Dentistry: Public and Private Dental Care & Education2017Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, nr S3, s. 21-21Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Data will be presented on the structure of public and private Swedish Dental Care regarding children, adolescents and adults. Also data on services provided and on the epidemiology of current oral/dental health will be shared. An overview on dental education from the different programs will be presented, including outcome of assessment of dental education. Trends in the range of international dental post-graduate education offered by Swedish universities will also be disclosed.

  • 37.
    Klinge, Björn
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Flemming, Thomas
    Cosyn, Jan
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Eisner, Barbara M.
    Hultin, Margareta
    Isidor, Flemming
    Lang, Niklaus P.
    Lund, Bodil
    Meyle, Juerg
    Mombelli, Andrea
    Manuel Navarro, Jose
    Pjetursson, Bjarni
    Renvert, Stefan
    Schliephake, Henning
    The patient undergoing implant therapy: Summary and consensus statements: The 4th EAO Consensus Conference 20152015Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, nr S11, s. 64-67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The assignment for this working group was to update the existing knowledge regarding factors considered being of special relevance for the patient undergoing implant therapy. This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis. Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review. Materials and methods: The literature in the respective areas of interest (antibiotic prophylaxis, peri-implantitis, patient-reported outcome measurements and health-economic aspects) was searched using different strategies for the different papers. Search strategies ranged from a complex systematic review to systematic-and narrative reviews, depending on subject and available literature. All collected material was critically reviewed. Four manuscripts were subsequently presented for group analysis and discussion and plenum discussions and concensus approval. The selected areas were considered to be of key importance and relevance for the patient undergoing implant therapy. Results: The results and conclusions of the review process are presented in the respective papers. The group's conclusions, identified knowledge gaps, directions for future research and concensus statements are presented in this article. The following reviews were available for group discussions and the foundation for subsequent plenary sessions: Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. (2015) Perioperative antibiotics in conjunction with dental implant placement. A complex systematic review. Renvert S & Quirynen M. (2015) Risk indicators for peri-implantitis. A narrative review. De Bruyn H, Raes S, Matthys C, Cosyn J. (2015) The current use of patient centered/reported outcomes in implant dentistry. A systematic review. Beikler T & Flemmig T. F. (2015) Economic evaluation of implant-supported prostheses. A narrative review.

  • 38.
    Klinge, Björn
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Oral Diseases, Karolinska Institutet, Stockholm, Sweden.
    Klinge, Anna
    Malmö universitet, Odontologiska fakulteten (OD).
    Bertl, Kristina
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Peri-implant diseases2018Ingår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 126, nr Suppl 1: S1, s. 88-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When celebrating 100 yr of dental research in the Nordic dental research commu- nity (i.e. Nordisk Odontologisk Fo€rening (NOF)), it is relevant to include dental implant treatment. In essence, the successful progress of implant treatment has added both to the quality of life for patients and also to many aspects of profes- sional development and job satisfaction for dentists. When appreciating the success story it also seems relevant to highlight some of the problems related to this treat- ment. Both technical and biological complications have often been ignored when reporting long-term results following implant treatment. Different opinions have been expressed in relation to the etiology of peri-implant diseases. Some even choose to ignore this condition as a clinical problem. This article presents a short overview of peri-implant diseases (i.e. peri-implant mucositis and peri-implantitis). The lack of internationally agreed disease definitions for peri-implant diseases, as with periodontitis, results in wide variation of estimates for the occurrence of peri- implant diseases when epidemiological data are reported. The profession still strives to find and define the best way to deal with peri-implant diseases once they are accurately diagnosed. Awareness of the tissue conditions in the peri-implant area, and relevant action when indicated, seems to be critical for the continued long-term successful outcome of dental implant treatment.

  • 39.
    Klinge, Björn
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lundström, Mats
    Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
    Rosén, Måns
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bertl, Kristina
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
    Klinge, Anna
    Malmö universitet, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Dental Implant Quality Register: A possible tool to further improve implant treatment and outcome2018Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, nr Suppl 18, s. 145-151Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Board of EAO (European Association for Osseointegration) has discussed an initiative to explore the conditions to establish a Dental Implant Register. It was suggested to bring this issue to the EAO Consensus Conference 2018 for a discussion and to possibly propose relevant and manageable parameters. This article presents some select examples from quality registers in the medical field. Based on the experience of established registers, essentially in the medical field, factors considered to be of importance, if and when establishing a Dental Implant Register are introduced and discussed.

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  • 40.
    Klinge, Björn
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Meyle, J.
    Working group 2,
    Peri-implant tissue destruction: the Third EAO Consensus Conference 20122012Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, nr s6, s. 108-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective The task of this working group was to update the existing knowledge base regarding the prevalence of peri-implant tissue destruction, the role of occlusal overload, and the outcome of non-surgical and surgical treatment. Materials and methods The literature was systematically searched and critically reviewed. Four manuscripts were presented in key areas deemed to be essential for the current understanding of the magnitude of the clinical entity peri-implantitis. The role of overload as an etiological component was reviewed. Also available data on the results from non-surgical and surgical interventions for the control of tissue destruction were presented. Results The consensus statements following plenary session approval, clinical implications, and directions for future research based on the group discussions are presented in this article. The results and conclusions of the systematic review process are presented by the respective authors in the subsequent papers.

  • 41.
    Klinge, Björn
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sanz, Mariano
    ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinical Specialties, University Complutense, Madrid, Spain.
    Alcoforado, Gil
    Clinica Alcoforado, Lisboa, Portugal.
    Bienz, Stefan P
    Center of Dental Medicine, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
    Cosyn, Jan
    Department of Periodontology and Oral Implantology, Educational Committee Dental School, Ghent University, Ghent, Belgium.
    De Bruyn, Hugo
    Research Cluster Periodontology, Oral Implantology, Removable & Implant Prosthodontics, Ghent University, Ghent, Belgium.
    Derks, Jan
    Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Figuero, Elena
    ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinical Specialties, University Complutense, Madrid, Spain.
    Gurzawska, Katarzyna
    University of Birmingham - Birmingham Dental School & Hospital - Oral Surgery Department, Birmingham, United Kingdom.
    Heitz-Mayfield, Lisa
    International Research Collaborative, The University of Western Australia, Perth, WA, Australia.
    Jung, Ronald E
    Center of Dental Medicine, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
    Ornekul, Turker
    Cosmodent Center for Dentistry and Dental Implants, Istanbul, Turkey.
    Sagado, Alberto
    Clinica Salgado, Alicante, Spain; Group Aula Dental Avanzada, Departamento de Anatomía e Histología, Universidad Miguel Hernández, Alicante, Spain.
    Dental implant register: Summary and consensus statements of group 2. The 5(th) EAO Consensus Conference 20182018Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, nr Suppl 18, s. 157-159Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    OBJECTIVES: This publication reports the EAO Workshop group-2 and consensus plenary discussions and statements on a narrative review providing the background and possible facilities and importance of a dental implant register, to allow for a systematic follow-up of the clinical outcome of dental implant treatment in various clinical settings. It should be observed that the format of the review and the subsequent consensus report consciously departs from conventional consensus publications and reports. MATERIAL AND METHODS: The publication was a narrative review on the presence and significance of quality registers regarding select medical conditions and procedures. The group discussed and evaluated the publication and made corrections and recommendations to the authors and agreed on the statements and recommendations described in this consensus report. RESULTS: Possible registrations to be included in an implant register were discussed and agreed as a preliminary basis for further development, meaning that additional parameters be included or some be deleted. CONCLUSIONS: It was agreed to bring the idea of an implant quality register, including the presented results of discussions and proposals by the group- and plenary sessions, to the EAO Board for further discussion and decision.

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  • 42. Koole, Sebastiaan
    et al.
    Thevissen, Eric
    Linden, Ulf
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Using clinical cases to stimulate active learning in a short periodontal continuing professional development course2015Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, nr 1, s. 1-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A case-based approach was used in a two-day periodontal continuing professional development course as a strategy to stimulate active learning. The present study investigates the outcome of this course format in terms of feasibility, perceived efficiency as a learning approach and reported individual learning goals. The study was performed in five identical courses entitled 'risk analysis and treatment in periodontal patients' at Malmo University between 2011-2014. Before the course, clinical cases were used to activate participants' prior knowledge and to attune their focus on the course content. During the course, cases were discussed to synchronise theory with practical application. A pre- and end-course questionnaire were developed to evaluate participants' characteristics (age, clinical expertise, experience and expectations), perceptions on feasibility and instructiveness and emerged individual learning goals. The participants (39 dentists and 78 dental hygienists) reported an average preparation time of 62 minutes (range 2-190) and had positive perceptions on the accessibility, instructiveness and difficulty of cases. Expectations ranged between refreshing, acquiring new knowledge and mastering the course subject. Most reported learning goals were related to daily clinical practice including the development of a treatment plan, when to continue non-surgical treatment or to extract teeth/perform surgery, the approach to periodontitis, how to motivate non-compliant patients and when to refer. Conclusion:The use of clinical cases to stimulate active learning in a short-term continuing professional development periodontal course was positively perceived by the dentists and dental hygienists in terms of feasibility and learning potential.

  • 43.
    Lira-Junior, Ronaldo
    et al.
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Holmström, Sofia Björnfot
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Clark, Reuben
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Zwicker, Stephanie
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Majster, Mirjam
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Johannsen, Gunnar
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Axtelius, Björn
    Malmö universitet, Odontologiska fakulteten (OD).
    Åkerman, Sigvard
    Malmö universitet, Odontologiska fakulteten (OD).
    Svensson, Mattias
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Huddinge, Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Boström, Elisabeth A.
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    S100A12 Expression Is Modulated During Monocyte Differentiation and Reflects Periodontitis Severity2020Ingår i: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 11, artikel-id 86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    S100A12 is a calcium-binding protein of the S100 subfamily of myeloid-related proteins that acts as an alarmin to induce a pro-inflammatory innate immune response. It has been linked to several chronic inflammatory diseases, however its role in the common oral immunopathology periodontitis is largely unknown. Previous in vitro monoculture experiments indicate that S100A12 production decreases during monocyte differentiation stages, while the regulation within tissue is poorly defined. This study evaluated S100A12 expression in monocyte subsets, during monocyte-to-macrophage differentiation and following polarization, both in monoculture and in a tissue context, utilizing a three-dimensional co-culture oral tissue model. Further, we explored the involvement of S100A12 in periodontitis by analyzing its expression in peripheral circulation and gingival tissue, as well as in saliva. We found that S100A12 expression was higher in classical than in non-classical monocytes. S100A12 expression and protein secretion declined significantly during monocyte-to-macrophage differentiation, while polarization of monocyte-derived macrophages had no effect on either. Peripheral monocytes from periodontitis patients had higher S100A12 expression than monocytes from controls, a difference particularly observed in the intermediate and non-classical monocyte subsets. Further, monocytes from periodontitis patients displayed an increased secretion of S100A12 compared with monocytes from controls. In oral tissue cultures, monocyte differentiation resulted in increased S100A12 secretion over time, which further increased after inflammatory stimuli. Likewise, S100A12 expression was higher in gingival tissue from periodontitis patients where monocyte-derived cells exhibited higher expression of S100A12 in comparison to non-periodontitis tissue. In line with our findings, patients with severe periodontitis had significantly higher levels of S100A12 in saliva compared to non-periodontitis patients, and the levels correlated to clinical periodontal parameters. Taken together, S100A12 is predominantly secreted by monocytes rather than by monocyte-derived cells. Moreover, S100A12 is increased in inflamed tissue cultures, potentially as a result of enhanced production by monocyte-derived cells. This study implicates the involvement of S100A12 in periodontitis pathogenesis, as evidenced by increased S100A12 expression in inflamed gingival tissue, which may be due to altered circulatory monocytes in periodontitis.

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  • 44.
    Lira-Junior, Ronaldo
    et al.
    Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden; Rio de Janeiro State University, Faculty of Odontology, Department of Periodontology, Rio de Janeiro, Brazil.
    Åkerman, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Gustafsson, Anders
    Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD). Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden.
    Boström, Elisabeth A.
    Karolinska Institutet, Department of Dental Medicine, Division of Periodontology, Stockholm, Sweden.
    Colony stimulating factor-1 in saliva in relation to age, smoking, and oral and systemic diseases2017Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Colony stimulating factor (CSF)-1 is a growth factor that stimulates the survival, proliferation and differentiation of mononuclear phagocytes, which has been implicated in several inflammatory diseases. This study evaluated the possible influence of age, sex, smoking, periodontitis, caries, and several systemic conditions on salivary levels of CSF-1. Four-hundred and forty-one individuals were enrolled in this study. All participants answered a health questionnaire and underwent a comprehensive oral examination. Stimulated saliva was collected and CSF-1 levels were analysed by enzyme-linked immunosorbent assay. Salivary levels of CSF-1 were significantly increased in participants over 64 years old and in non-smoking individuals, whereas no difference was observed between men and women. Individuals having periodontitis and manifest caries had significantly higher levels of CSF-1. Participants with muscle and joint disease exhibited increased CSF-1 levels as compared to those without. Age, smoking, percentage of pockets >= 4 mm, number of manifest caries lesions, and presence of tumor were associated with CSF-1 levels. Salivary levels of CSF-1 are associated with age, smoking, periodontitis, manifest caries, and the presence of muscle and joint diseases and tumors. CSF-1 might be a promising biomarker candidate in saliva of both local and systemic conditions that needs further investigation.

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  • 45.
    Lira-Junior, Ronaldo
    et al.
    Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Stockholm, Sweden; Rio de Janeiro State University, Faculty of Odontology, Department of Periodontology, Rio de Janeiro, Brazil.
    Åkerman, Sigvard
    Malmö universitet, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Stockholm, Sweden.
    Boström, Elisabeth A.
    Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Stockholm, Sweden.
    Gustafsson, Anders
    Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Stockholm, Sweden.
    Salivary microbial profiles in relation to age, periodontal, and systemic diseases2018Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 13, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Analysis of saliva is emerging as a promising tool to diagnose and monitor diseases which makes determination of the salivary microbial profile in different scenarios essential. Objective To evaluate the effects of age, periodontal disease, sex, smoking, and medical conditions on the salivary microbial profile. Design A randomly selected sample of 441 individuals was enrolled (51% women; mean age 48.5 +/- 16.8). Participants answered a health questionnaire and underwent an oral examination. Stimulated saliva was collected and the counts of 41 bacteria were determined by checkerboard DNA-DNA hybridization. Results Elderly participants (>64 years old) presented a significant increase in 24 out of 41 bacterial species compared to adults (<= 64 years old). Eubacterium nodatum, Porphyromonas gingivalis, and Tannerella forsythia were significantly higher in participants with generalized bone loss compared to without. Males and non-smokers had higher bacteria counts in saliva. Individuals having mental disorders or muscle and joint diseases showed significantly altered microbial profiles whereas small or no differences were found for subjects with high blood pressure, heart disease, previous heart surgery, bowel disease, tumors, or diabetes. Conclusion Age, periodontal status, sex, smoking, and certain medical conditions namely, mental disorders and muscle and joint diseases, might affect the microbial profile in saliva.

  • 46. Lund, Bodil
    et al.
    Hultin, Margareta
    Tranæus, Sofia
    Malmö högskola, Odontologiska fakulteten (OD).
    Naimi-Akbar, Aran
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Complex systematic review: Perioperative antibiotics in conjunction with dental implant placement2015Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, nr Suppl 11, s. 1-14Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim of this study was to revisit the available scientific literature regarding perioperative antibiotics in conjunction with implant placement by combining the recommended methods for systematic reviews and complex systematic reviews. MATERIAL AND METHODS: A search of Medline (OVID), The Cochrane Library (Wiley), EMBASE, PubMed and Health technology assessment (HTA) organizations was performed, in addition to a complementary hand-search. Selected systematic reviews and primary studies were assessed using GRADE and AMSTAR, respectively. A meta-analysis was performed. RESULTS: The literature search identified 846 papers of which 10 primary studies and seven systematic reviews were included. Quality assessment of the systematic reviews revealed two studies of moderate risk of bias and five with high risk of bias. The two systematic reviews of moderate risk of bias stated divergent numbers needed to treat (NNT) to prevent one patient from implant failure. Four of the primary studies comparing antibiotic prophylaxis with placebo were estimated to be of low, or moderate, risk of bias and subjected to meta-analysis. The NNT was 50 (pooled RR 0.39, 95% CI 0.18, 0.84; P = 0.02). None of these four studies individually show a statistical significant benefit of antibiotic prophylaxis. Furthermore, narrative analysis of the studies eligible for meta-analysis reveals clinical heterogeneity regarding intervention and smoking. CONCLUSION: Antibiotic prophylaxis in conjunction with implant placement reduced the risk for implant loss by 2%. However, the sub-analysis of the primary studies suggests that there is no benefit of antibiotic prophylaxis in uncomplicated implant surgery in healthy patient.

  • 47.
    Lundmark, Anna
    et al.
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Johannsen, Gunnar
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Eriksson, Kaja
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Kats, Anna
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Jansson, Leif
    Department of Periodontology, Folktandvården Eastmaninstitutet, Stockholm, Sweden.
    Tervahartiala, Taina
    Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Rathnayake, Nilminie
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Åkerman, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Sorsa, Timo
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Yucel-Lindberg, Tulay
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
    Mucin 4 and matrix metalloproteinase 7 as novel salivary biomarkers for periodontitis2017Ingår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, nr 3, s. 247-254Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Periodontitis is a chronic inflammatory disease, characterized by irreversible destruction of tooth-supporting tissue including alveolar bone. We recently reported mucin 4 ( MUC4) and matrix metalloproteinase 7 (MMP7) as highly associated with periodontitis in gingival tissue biopsies. The aim of this study was to further investigate the levels of MUC4 and MMP7 in saliva and gingival crevicular fluid (GCF) samples of patients with periodontitis. Materials and Methods: Saliva and GCF samples were collected from periodontitis patients and healthy controls. The levels of MUC4, MMP7, and total protein concentrations were analysed using ELISA or Bradford assay. Results: MUC4 levels were significantly lower in saliva and GCF from periodontitis patients relative to healthy controls. MMP7 levels were significantly higher in saliva and GCF from periodontitis patients. Multivariate analysis revealed that MUC4 was significantly associated with periodontitis after adjusting for age and smoking habits and, moreover, that the combination of MUC4 and MMP7 accurately discriminated periodontitis from healthy controls. Conclusions: MUC4 and MMP7 may be utilized as possible novel biomarkers for periodontitis.

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  • 48. Mattheos, N.
    et al.
    de Bruyn, H.
    Hultin, M.
    Jepsen, S.
    Klinge, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Koole, S.
    Sanz, M.
    Ucer, C.
    Lang, N. P.
    Developing implant dentistry education in Europe: the continuum from undergraduate to postgraduate education and continuing professional development2014Ingår i: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 18, nr S1, s. 4-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Implant dentistry is a treatment modality which has mainstream clinical practice of comprehensive care, which however is not adequately represented in the undergraduate dental curricula. A consensus workshop organised by ADEE in 2008, set the benchmarks for the knowledge and competences a modern dental practitioner must possess with regard to implant dentistry, as well as defined undergraduate and postgraduate pathways for the acquisition of these competences. Today, 5 years later, there exist several challenges for the implementation of these benchmarks in both undergraduate curricula but also post-graduation educational pathways. Methods: A consensus workshop was organised by ADEE, bringing together 48 opinion leaders, including academic teachers of all disciplines related to implant dentistry, specialists, representatives of relevant scientific and professional associations, as well as industry delegates. The objectives of the workshop were to evaluate the existing scientific literature, reported experience and best practices in order to identify potential and limitations for the implementation of implant dentistry in the undergraduate curriculum, as well produce recommendations for the optimal educational structures for postgraduate programmes and continuing professional development. Results: The scientific committee conducted two European-wide questionnaire surveys to better document the current state of education in implant dentistry. Upon completion of the surveys, reviewers were appointed to produce three scientific review papers, identifying current achievements and future challenges. Finally, during the 3 days of the workshop, all the evidence was reviewed and the main conclusions and recommendations that were adopted by all participants are reported in the present Consensus Paper. Conclusions: Implementation of implant dentistry in the undergraduate curriculum has improved significantly, but still lags behind the benchmarks set in 2008 and the diversity between institutions remains big. At the post-graduation level, there is currently a wide diversity of courses and pathways towards competences related to implant dentistry and there is at present a great need for quality assurance, as well as standardisation and transparency of the learning outcomes.

  • 49.
    Naimi-Akbar, Aron
    et al.
    Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden; Department of Dental Medicine, Division of Cariology, Karolinska Institutet, Stockholm, Sweden.
    Hultin, Margareta
    Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
    Klinge, Anna
    Malmö universitet, Odontologiska fakulteten (OD).
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Stockholm, Sweden.
    Tranæus, Sofia
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Division of Cariology, Karolinska Institutet, Stockholm, Sweden.
    Lund, Bodil
    Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden; Department of Dental Medicine, Division of Oral Maxillofacial Diagnostics and Surgery, Section of Oral Maxillofacial Surgery, Karolinska Institutet, Stockholm, Sweden.
    Antibiotic prophylaxis in orthognathic surgery: A complex systematic review2018Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 13, nr 1Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective In orthognathic surgery, antibiotics are prescribed to reduce the risk of postoperative infection. However, there is lack of consensus over the appropriate drug, the dose and duration of administration. The aim of this complex systematic review was to assess the effect of antibiotics on postoperative infections in orthognathic surgery. Methods Both systematic reviews and primary studies were assessed. Medline (OVID), The Cochrane Library (Wiley) and EMBASE (embase.com), PubMed (non-indexed articles) and Health Technology Assessment (HTA) publications were searched. The primary studies were assessed using GRADE and the systematic reviews by AMSTAR. Results Screening of abstracts yielded 6 systematic reviews and 36 primary studies warranting full text scrutiny. In total, 14 primary studies were assessed for risk of bias. Assessment of the included systematic reviews identified two studies with a moderate risk of bias, due to inclusion in the meta-analyses of primary studies with a high risk of bias. Quality assessment of the primary studies disclosed one with a moderate risk of bias and one with a low risk. The former compared a single dose of antibiotic with 24 hour prophylaxis using the same antibiotic; the latter compared oral and intravenous administration of antibiotics. Given the limited number of acceptable studies, no statistical analysis was undertaken, as it was unlikely to contribute any relevant information. Conclusion With respect to antibiotic prophylaxis in orthognathic surgery, most of the studies to date have been poorly conducted and reported. Thus scientific uncertainty remains as to the preferred antibiotic and the optimal duration of administration.

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  • 50.
    Naimi-Akbar, Aron
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Division of Cariology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden; Department of Oral and Maxillofacial Surgery , Karolinska University Hospital , Stockholm , Sweden.
    Kjellström, Barbro
    Department of Medicine K2 , Karolinska Institutet , Stockholm , Sweden.
    Rydén, Lars
    Department of Medicine K2 , Karolinska Institutet , Stockholm , Sweden.
    Rathnayake, Nilminie
    Division of Periodontology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden.
    Klinge, Björn
    Malmö universitet, Odontologiska fakulteten (OD). Division of Periodontology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden.
    Gustafsson, Anders
    Division of Periodontology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden.
    Buhlin, Kåre
    Division of Periodontology, Department of Dental Medicine , Karolinska Institutet , Huddinge , Sweden.
    Attitudes and lifestyle factors in relation to oral health and dental care in Sweden: a cross-sectional study2019Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, nr 4, s. 282-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of the present study was to investigate attitudes to and perceptions of dental treatment and costs, self-assessed personal oral health status and dental self-care in an adult Swedish population, with special reference to potential associations between these factors and periodontal status. Material and methods: The study population comprised 1577 subjects who had undergone radiographic dental examination. The subjects were grouped by severity of periodontitis, based on extent of bone loss, as none, mild/moderate or severe. Subjects answered a questionnaire about socioeconomic factors, oral care habits and attitudes to dental treatment. Other questions covered medical history, smoking and other life style factors. Associations were tested using the Chi-squared test and a logistic regression model. Results: Compared to subjects with no periodontitis, those with mild/moderate or severe periodontitis were less likely to afford (p < .001), more often refrained from treatment due to costs (p < .001) and in the past year had experienced dental problems for which they had not sought treatment (p < .001). They also reported more anxiety in relation to dental appointments (p = .001). Regarding caries prevention, the severe periodontitis group used least fluoride products (p = .002). Conclusions: Swedish adults regard their oral health as important, those with periodontitis have a more negative perception of their oral health and are less prone to seek help. These discouraging findings suggest the need for targeted measures, which focus on improving the care of this group of patients.

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