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      Periodontitis and edentulism as risk indicators for mortality: Results from a prospective cohort study with 20 years of follow‐up

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          Abstract

          Aim

          To investigate the association between periodontitis and edentulism with cardiovascular disease (CVD) and all‐cause mortality.

          Methods

          Baseline data of 506 subjects including 256 angiographically verified coronary artery disease patients and 250 matched participants in cardiovascular health from the Kuopio Oral Health and Heart study were collected from 1995–1996. Mortality data were accrued until May 31, 2015, and related to baseline periodontal health and edentulism, assessed as exposure and collected by means of clinical and radiographic examination by a single examiner. Cox proportional hazards regression models were fit using covariates such as age, gender, smoking, BMI, and education.

          The final sample size for the periodontitis models ranged from 358 to 376, while the edentate models included 413 to 503 subjects for CVD and all‐cause mortality, respectively with no missing values in the predictor, confounders, and outcome.

          Results

          The strongest association was found between edentulism and CVD and all‐cause mortality (HR: 1.9 CVD, HR: 1.6 all‐cause; p < .01).

          Conclusions

          Edentulism considered as a poor oral health marker was associated strongly with CVD mortality while periodontitis was not.

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          Most cited references48

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          Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: Classification and case definitions for periodontitis

          A new periodontitis classification scheme has been adopted, in which forms of the disease previously recognized as "chronic" or "aggressive" are now grouped under a single category ("periodontitis") and are further characterized based on a multi-dimensional staging and grading system. Staging is largely dependent upon the severity of disease at presentation as well as on the complexity of disease management, while grading provides supplemental information about biological features of the disease including a history-based analysis of the rate of periodontitis progression; assessment of the risk for further progression; analysis of possible poor outcomes of treatment; and assessment of the risk that the disease or its treatment may negatively affect the general health of the patient. Necrotizing periodontal diseases, whose characteristic clinical phenotype includes typical features (papilla necrosis, bleeding, and pain) and are associated with host immune response impairments, remain a distinct periodontitis category. Endodontic-periodontal lesions, defined by a pathological communication between the pulpal and periodontal tissues at a given tooth, occur in either an acute or a chronic form, and are classified according to signs and symptoms that have direct impact on their prognosis and treatment. Periodontal abscesses are defined as acute lesions characterized by localized accumulation of pus within the gingival wall of the periodontal pocket/sulcus, rapid tissue destruction and are associated with risk for systemic dissemination.
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            Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study

            Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank’s classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.
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              Global epidemiology of dental caries and severe periodontitis - a comprehensive review.

              Dental caries and periodontitis are the most common oral diseases and major causes of tooth loss.
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                Author and article information

                Contributors
                mario.romandini@gmail.com
                Journal
                J Periodontal Res
                J Periodontal Res
                10.1111/(ISSN)1600-0765
                JRE
                Journal of Periodontal Research
                John Wiley and Sons Inc. (Hoboken )
                0022-3484
                1600-0765
                25 October 2022
                February 2023
                : 58
                : 1 ( doiID: 10.1111/jre.v58.1 )
                : 12-21
                Affiliations
                [ 1 ] ETEP Research Group (Etiology and Therapy of Periodontal and Peri‐implant Diseases) Faculty of Odontology, University Complutense of Madrid Madrid Spain
                [ 2 ] Periodontology Unit, Centre for Host Microbiome Interactions Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London London UK
                [ 3 ] Department of Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
                [ 4 ] Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
                [ 5 ] Center for Clinical and Translational Research The Forsyth Institute Massachusetts Cambridge USA
                Author notes
                [*] [* ] Correspondence

                Mario Romandini, Universidad Complutense de Madrid, Facultad de Odontología, Plaza Ramón y Cajal, 3, 28040 Madrid, Spain.

                Email: mario.romandini@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-8254-5471
                https://orcid.org/0000-0001-5646-083X
                https://orcid.org/0000-0001-6702-6836
                https://orcid.org/0000-0003-3231-8868
                https://orcid.org/0000-0003-0078-3992
                https://orcid.org/0000-0002-6293-5755
                Article
                JRE13061 JRE-12-21-6725.R2
                10.1111/jre.13061
                10092146
                36282792
                7dc3af03-3704-4d39-9ad6-74b755f7ca2c
                © 2022 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 September 2022
                : 12 December 2021
                : 19 September 2022
                Page count
                Figures: 4, Tables: 4, Pages: 10, Words: 4668
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                February 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:12.04.2023

                all‐cause mortality,cvd mortality,edentulism,longitudinal study,periodontitis,pocket depth

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