To describe the rationale, design and methodology of a geographically-representative and population-based study investigating the epidemiology, impact, personal and economic burden of age-related eye diseases, declining visual and other sensory systems in Asians aged >60 years in Singapore.PIONEER (The PopulatION HEalth and Eye Disease PRofilE in Elderly Singaporeans Study) is currently a cross-sectional study targeting 3152 Chinese, Malay and Indian adults who are Singapore citizens or permanent residents aged 60 years and older living across Singapore. The study is intended to be longitudinal, with several waves of data planned to be collected in the future. The sampling frame consisted of 7000 names derived from age, gender and ethnicity-stratified random sampling of individuals >60 years. Selected individuals were invited via letters, home visits, and telephone calls for a clinical assessment at the Singapore Eye Research Institute. Individuals with limited mobility were examined in a custom-designed mobile eye clinic. Questionnaires were subsequently administered at participants' homes by trained interviewers in their preferred language. A total of 3,299 participants (from East, West, North and South Singapore) were approached from December 2017 to November 2019. Of these, 953 (28.5%) were deemed ineligible. Out of 2,346 eligible participants, 904 (38.5%) refused, and 1,442 (61.5%) attended our clinical testing protocol, giving an initial response rate of 61.5%. Of these, 1,170 (81%) were cognitively able to complete the questionnaire assessment. The mean age±SD of our participants was 73.8±8.6 years; n=798 (55.3%) were female; and 828 (57.4%) were of Chinese ethnicity. The findings from this study will allow a deeper understanding of the risk factors and impact of aging in Asian populations, particularly in relation to the visual function and other functional system.
Aim
The aim of this study was to investigate patient‐ and tooth‐level factors that may predict tooth loss and periodontitis progression in patients who have undergone at least 5 years of periodontal maintenance.
Materials and Methods
In this retrospective cohort study, 135 patients were examined after active periodontal therapy (APT) and periodontal maintenance for 5.09–8.65 years (mean 6.16 ± 0.74 years). Regression models were applied to identify risk factors associated with tooth loss and disease progression.
Results
Stage IV periodontitis (incidence rate ratio [IRR] = 4.61; 95% confidence interval, CI [2.97–7.18], p < .001), the presence of ≥5 sites with probing pocket depth (PPD) ≥5 mm at the end of APT (IRR = 2.04; 95% CI [1.32–3.20], p < .01), and residual PPD ≥7 mm at the end of APT (odds ratio [OR] = 3.01; 95% CI [1.14–7.94], p < .05) were risk factors for tooth loss. Residual PPDs of 5 mm (OR = 2.02; 95% CI [1.20–3.40], p < .01) and 6 mm (OR = 2.41; 95% CI [1.22–4.76], p < .05) at the end of APT were risk factors for disease progression. Above 3 mm, each 1 mm increase in maximum PPD/clinical attachment loss was associated with an increased risk of tooth loss and disease progression.
Conclusions
Stage IV periodontitis is associated with an increased risk of tooth loss. Teeth with PPD ≥5 mm at the end of APT are at risk of periodontitis progression or tooth loss.
With increasing knowledge of wound biology and material sciences, the provision of dental implants as a treatment modality has become increasingly predictable and more commonly used to replace missing teeth. However, without appropriate follow up, peri-implant diseases could develop and affect the long-term success of implants. Currently, there is not enough focus on the prevention of peri-implant diseases, as compared to the definition of the disease, its prevalence, and treatment. In the present study, we aim to summarize various factors influencing the successful maintenance of dental implants and highlight current gaps in knowledge. Factors influencing the successful maintenance of dental implants can be divided into three categories: implant-, dentist-, and patient-related factors. Patients with dental implants are often more dentally aware, and this offers an advantage. Compared to gingiva, peri-implant mucosa responds at a different pace to the bacterial challenge. Dental practitioners should be aware of how treatment protocols affect long-term success, and be vigilant in detecting peri-implant diseases at an early stage. Compared to periodontal maintenance, less longitudinal studies on implant maintenance are available, and therefore, there is a tendency to rely heavily on information extrapolated from the periodontal literature. More studies on the significance of implant maintenance care are required.
The aim of the present narrative review was to highlight considerations when treating Chinese patients with periodontal diseases. These considerations can be broadly categorized into anatomical, microbiological, and genetic considerations. Anatomical considerations are tooth‐related factors causing site‐specific issues, and these include incisal palatal groove, root concavities, three‐rooted permanent mandibular first molar, furcation entrance dimensions, cervical enamel projections, root trunk length, and molar root fusion. Aggregatibacter actinomycetemcomitans was found to be commensal in the oral flora of Chinese. The association between a single gene polymorphism and periodontal disease has not been unequivocally proven in Chinese populations. Despite these subtle differences compared to other ethnic populations, studies of Chinese participants from various geographic regions have demonstrated that periodontal disease in this particular ethnic group can be successfully treated.
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