Prevention of Initial Periodontitis Is an Investment in the Future.

Background: Periodontal tissue damage is mainly caused by the active form of collagenolytic matrix metalloproteinase-8, aMMP-8, the concentration of which in the mouth rinse can be measured with a mouth rinse chairside-test. The mouth rinse chair side test can be used to identify adolescents with a risk of periodontitis.

Methods: The data were collected at the Kotka Health Centre (2004-2005, N = 501 and 2014-2015, N = 47) and at the Hämeenlinna Health Centre (2017-2018, N = 125) consisting of adolescents aged 14-17.

aMMP-8 Point-of-Care Test (POCT) Identifies Reliably Periodontitis in Patients with Type 2 Diabetes as well as Monitors Treatment Response.

Background: The link between diabetes and periodontitis is bi-directional: high glucose levels increase the risk of periodontitis and elevated oral fluid aMMP-8 as well as diabetic development while untreated periodontitis worsens glycaemic control.

Methods: Type-2 patients (N = 161) underwent an aMMP-8 Point-of-Care Test (POCT) at diabetes clinics. If the test was positive, the patient was sent to an oral health care clinic and oral health examination, health-promoting as well as necessary treatment procedures were carried out.

Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)-Three-Month Interim Results.

A single-site, randomized clinical trial was designed to determine the efficacy of regular home use of Lumoral dual-light antibacterial aPDT in periodontitis patients. For the study, 200 patients were randomized to receive non-surgical periodontal treatment (NSPT), including standardized hygiene instructions and electric toothbrush, scaling and root planing, or NSPT with adjunctive Lumoral treatment. A complete clinical intraoral examination was conducted in the beginning, at three months, and at six months.

Adherence to individualized recall intervals for oral health examinations.

Objectives: The aim of this follow-up study was to investigate whether adults attend an oral health examination (OHE) based on their individual recall interval (IRI) without a reminder recall system.

Methods: The study population included adults who were attending an OHE recommended by their dentists based on their IRI in public oral healthcare clinics of Helsinki City January 1, 2009-December 31, 2009. The inclusion criteria were as follows: alive until the end of IRI, length of the IRI of 12-60 months, and study participants had not been treated successfully by a dental specialist during the IRI period (n = 41,255).

Comparing the effectiveness of competition as a method of reminding primary oral health care dentists to record diagnoses with two alternative methods used to enhance the recording of diagnoses in primary health care.

The purpose of this study was to investigate whether competition is an effective method to remind primary oral health care dentists to record diagnoses (RRD). The effectiveness of competition was examined in comparison with financial group bonuses (FGBs) and electronic reminders (ERs) of the electronic health record, together with superior-subordinate or development discussions. Putative differences in the diagnosis recording cultures of Finnish public health care physicians and dentists were studied.

Development of the use of primary health care emergency departments after interventions aimed at decreasing overcrowding: a longitudinal follow-up study.

Background: This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups.

Methods: This was an observational retrospective study carried out by gradually decreasing ED services in primary care. The interventions aimed at decreasing use of EDs were a) application of ABCDE-triage combined with public guidance on the proper use of EDs, b) closure of a minor supplementary ED, and finally, c) application of "reverse triage" with enhanced direction of the public to office-hours services and away from the remaining ED The annual number of visits to office-hours primary care GPs in different gender, age and diagnosis groups (International Classification of Diseases (ICD - 10) were recorded during a 13-year follow-up period.

Implementing of aMMP-8 point-of-care test with a modified new disease classification in Finnish adolescent cohorts.

Objectives: Periodontitis is a multifactorial biofilm-induced inflammatory disease; however, clinical and radiographic information reflects events that have already occurred. aMMP-8 lateral-flow chairside or point-of-care-test (POC-test) results have also come to complement the overall status of the patient's current situation. The current study aimed to clarify the usefulness of aMMP-8 chairside-test (aMMP-8 POCT) results to alert the initial or early periodontitis in adolescents, a potential periodontitis risk group with cut off 20 ng/ml in Stage I periodontitis, according to the current periodontitis classification system.

Development of office-hours use of primary health centers in the early years of the 21 century: a 13-year longitudinal follow-up study.

This study, conducted in a Finnish city, examined whether a long-lasting observed trend in Finnish primary health care, namely, a decreasing rate of office-hour visits to general practitioners (GPs), would lead to reduced services for specific gender, diagnosis or age groups. This was an observational retrospective follow-up study. The annual number of visits to office-hour primary care GPs in different gender, diagnosis and age groups was recorded during a 13-year follow-up period.

Low association between bleeding on probing propensity and the salivary aMMP-8 levels in adolescents with gingivitis and stage I periodontitis.

Background And Objective: Bleeding on probing (BOP) is a widely accepted measure used in periodontal diagnostics. Previous studies suggest that several factors can affect BOP propensity. The aim of this study was to investigate the relative impact of different local and modifying factors on BOP levels.

Tobacco Products, Periodontal Health and Education Level: Cohort Study from Sweden.

Background: The aim of this study is to investigate if using tobacco products (including snuff, smoking tobacco and dual-using) associates with periodontal health, education level and mortality in a Swedish cohort, hypothesizing that tobacco products affect periodontal health, associate with lower education and increase the risk of death.

Method: Study cohort of 1080 subjects aged 31-40 years (528 men, 552 women) was clinically examined and interviewed in 1985 and followed for mortality until 2015. Subjects were classified into two groups: "tobacco users" and "non-users".

Oral health indices predict individualised recall interval.

Objectives: The individualised recall interval (IRI) is part of the oral health examination. This observational, register-based study aimed to explore how oral health indices DMFT (decayed, missing, filled teeth), DT (decayed teeth), CPI (Community Periodontal Index, maximum value of individual was used) and number of teeth are associated with IRI for adults.

Methods: Oral health examination includes an assessment of all oral tissues, diagnosis, a treatment plan and assessment and a determination of the interval before the next assessment.

aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting.

This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and easy way to screen and detect diseased patients.

The effect of electronic reminders on the recording of diagnoses in primary care: A quasi-experimental before and after study.

This study examined whether using electronic reminders leads to an increase in the rate of diagnosis recordings in the electronic health record system following visits to a general practitioner. The impact of electronic reminders was studied in the primary health care of a Finnish city. This observational quasi-experimental study based on a before-and-after design was carried out by installing an electronic reminder to improve the recording of diagnoses in the computerized electronic health record system.

Recording of diagnoses in public primary oral health care in a retrospective longitudinal observational study in a Finnish town: Underrepresentation of periodontitis diagnoses.

Objectives: This study investigates which oral diagnoses public primary dental care dentists record.

Methods: An observational register-based retrospective follow-up study was performed in the public primary oral health care of a Finnish town after the dentists were advised to mark the diagnoses in their practices. The rate of recorded diagnoses resulting from visits to the public primary care dentists was studied.

Oral Health in Women with a History of High Gestational Diabetes Risk.

We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded.

On the diagnostic discrimination ability of mouthrinse and salivary aMMP-8 point-of-care testing regarding periodontal health and disease.

This study investigated the diagnostic utility of mouthrinse and saliva in aMMP-8 measurements to analyze patients' risk for active periodontal tissue destruction and progression of periodontal disease among 47 adolescents. Results show that measurements from mouthrinse produce better discrimination and should be used instead of saliva measurements.

A point-of-care test of active matrix metalloproteinase-8 predicts triggering receptor expressed on myeloid cells-1 (TREM-1) levels in saliva.

Background: This cross-sectional study aims to investigate if a point-of-care (PoC) test of active matrix metalloproteinase-8 (aMMP-8) predicts levels of inflammation amplifier triggering receptor expressed on myeloid cells-1 (TREM-1) and its putative ligand the neutrophil peptidoglycan recognition protein 1 (PGLYRP1) in saliva.

Methods: Forty-seven adolescents, aged 15 to 17 years, were tested with aMMP-8 PoC test, which was followed by a full-mouth clinical examination of the assessment of periodontal, mucosal, and oral health. TREM-1 and PGLYRP1 levels were analyzed by ELISA.

Active Matrix Metalloproteinase-8 Point-of-Care (PoC)/Chairside Mouthrinse Test vs. Bleeding on Probing in Diagnosing Subclinical Periodontitis in Adolescents.

This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. A total of 47 adolescents (30 boys/17 girls) aged 15⁻17 were first tested with the aMMP-8 PoC test, followed by a full-mouth evaluation of clinical parameters of oral health including periodontal, oral mucosal, and caries assessment.

Cross-sectional analysis of risk factors for subclinical periodontitis; active matrix metalloproteinase-8 as a potential indicator in initial periodontitis in adolescents.

Background: The aim of this study was to investigate how different patient-related risk indicators might be associated with the odds of developing subclinical periodontitis in adolescents.

Methods: This cross-sectional study included 252 Finnish individuals aged 15 to 16 years, of whom 141 were boys and 111 girls. A specially trained dentist performed clinical examinations: measurements included periodontal indexes (bleeding on probing, visible plaque index, root calculus, and probing depth, smoking by pack-years, periodontal bacteria (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola) and the potential salivary periodontal biomarkers (active matrix metalloproteinase-8 [aMMP-8], polymorphonuclear leukocyte elastase [PMN elastase], and total protein, albumin, immunoglobulin A, immunoglobulin G, and immunoglobulin M).

Point-of-Care/Chairside aMMP-8 Analytics of Periodontal Diseases' Activity and Episodic Progression.

Traditional periodontal disease diagnostics are based mainly on clinical examination and radiographs. They assess only past tissue destruction and provide no information on the current disease status or its future progression. The objective is to find out if an active matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test could provide a cost-effective way to get around this limitation.

Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation.

Objective: This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.

Material And Methods: Fifty-three CKD patients were followed up for a mean of 10.

Activity of rheumatoid arthritis correlates with oral inflammatory burden.

To study oral health in patients with rheumatoid arthritis (RA) with emphasis on disease activity and treatment of RA. In this prospective cohort study 81 RA patients [53 early untreated RA (EURA) and 28 chronic RA (CRA) patients with inadequate response to synthetic disease modifying antirheumatic drugs (DMARDs)], underwent rheumatological [Disease Activity Score (28-joint) DAS28] and dental examinations [Total Dental Index (TDI), Decayed Missing Filled Teeth (DMFT) and Decayed Missing Filled Surfaces (DMFS)]. For controls, 43 volunteers were examined.

Anti-rheumatic medication and salivary MMP-8, a biomarker for periodontal disease.

Objective: To investigate the impact of anti-rheumatic medications on salivary matrix metalloproteinase (MMP)-8 levels and MMP-8/TIMP (tissue inhibitor of MMPs)-1 ratio in patients with rheumatoid arthritis (RA) and periodontal findings during a 1-year follow-up.

Materials And Methods: Salivary MMP-8 was measured by an immunofluorometric assay and TIMP-1 by an enzyme-linked immunosorbent assay of 53 patients with early untreated RA (ERA), naïve to synthetic disease modifying anti-rheumatic drugs (DMARDs), of 28 patients with chronic RA (CRA), candidates for biologic DMARDs and of 43 age- and sex-matched controls. Periodontal health was evaluated by bleeding on probing (BOP), pocket depth (PD), and periodontal inflammatory burden index (PIBI).

Inflammatory biomarkers in saliva and serum of patients with rheumatoid arthritis with respect to periodontal status.

Objective: To study prospectively the association of salivary and serum matrix metalloproteinase (MMP)-8, tissue inhibitor of MMPs (TIMP)-1 and interleukin (IL)-6 with periodontal and systemic inflammation in rheumatoid arthritis (RA). We hypothesized that biomarker concentrations reflect inflammation.

Methods: Fifty three early untreated RA (ERA) and 28 chronic RA (CRA) patients, underwent rheumatological and dental examinations at baseline and one year later after starting first conventional or biological disease modifying antirheumatic drug.