BRITISH DENTAL JOURNAL VOLUME 198 NO. 6 MARCH 26 2005 345

ABSTRACTS

Loss of teeth and coronary heart diseaseRagnarsson E, Eliasson ST et al. Int J Prosthodont 2004; 1177: 441446

Tooth loss and heart disease were linked only by their commoncausal factor of tobacco smoking.

There is current interest in whether periodontal disease may causeother illnesses, such as heart disease. Early studies suggested sucha link, but evidence has been accumulating to suggest that smok-ing is a major confounding factor. The present study involved twosamples of Icelandic subjects: 1,023 from an Icelandic Heart Soci-ety study, and 1,590 from a WHO cardiovascular disease project.

During the studies, which lasted respectively from 1966 to1998, and 1987 to 1998, 353 subjects died, 82 of them from heartdisease. From all CHD mortality data, adjusted odds ratios werecalculated, allowing for known risk factors in the order: age andgender, cholesterol, blood pressure, educational level and smok-ing. When edentulousness was considered, significant but verysmall hazard ratios were obtained (means 1.88 to 1.46) until smok-ing was added (1.46; CIs 0.882.43); number of yrs of edentulismand number of remaining teeth gave totally insignificant hazardratios throughout.

doi:10.1038/sj.bdj.4812177

Periodontal pathogens in atheromatousplaques. A controlled clinical andlaboratory trialCairo F, Gaeta C et al. J Periodont Res 2004; 3399: 442446

No periodontal pathogens were found in atheromatous plaques.

Some studies have suggested an association where periodontitisis a possible cause of cardiovascular disease, but others have indi-cated that smoking is a common risk factor for both, and haveeven questioned whether there is any association when all factorsare considered. In this study, a test group of 26 dentate patientswho received carotid endarterectomy was examined periodontal-ly, including dental plaque sampling, and their carotid atheroma-tous plaques were compared with those removed from a controlgroup of 26 edentulous patients undergoing the same procedure.

In the test group, 7 patients were excluded as negative toDNA amplification, and in the control group, 5. Using a PCRmethod with tested specific primers, T. forthsythensis was foundin dental plaque from 79% of test group patients, F. nucleatumin 63%, P. intermedia in 53%, P. gingivalis in 37%, and A.actinomycetemcomitans in 5%. Carotid specimens of all 40patients showed severe atherosclerosis, but none of the peri-odontal bacteria were detected. Tests showed the experimentalmethod to be extremely sensitive, with a detection limit of 100genome equivalents.

doi:10.1038/sj.bdj.4812180

P E R I O D O N TO L O G Y; C A R D I O L O G Y

D E N TA L P U B L I C H E A L T H ; C A R D I O L O G Y

Comparison of implant survival followingsinus floor augmentation procedures withimplants placed in pristine posteriormaxillary bone: a systematic reviewGraziani F, Donos N et al. Clin Oral Impl Res 2004; 1155: 677682

Implant survival in different studies showed greater variability ingrafted areas than those without augmentation.

Implant survival in the posterior maxilla is less than in otherparts of the jaws. This study sought to compare implant survivalafter sinus grafting with survival after normal placing ofimplants in this region. After initial identification of 579 studiespossibly relevant to this comparison, 486 were rejected as clearlyirrelevant, and a further 87 were excluded because of lack of con-trol or comparison groups.

In the remaining 6 studies, individual implant survival rangedfrom 75% to 100% in both the augmented and non-augmentedposterior maxilla, with follow-up from 8 months to 6 yrs. Patient-based implant survival could only be estimated from 2 studies, at36% after 3 yrs with iliac block bone graft, and 100% after 5 yrswith bone from intra-oral sources. Respective controls gave sur-vival of 73% and 100%. The authors were unable to perform ameta-analysis because of the heterogeneity of studies.

doi:10.1038/sj.bdj.481279

The dentist's communicative role inprosthodontic treatmentSondell K, Palmqvist S et al. Int J Prosthodont 2004; 1177: 666671

Dentist communication influenced the patient's opinion at thetime, but had no apparent effect on the patient's view of thecompleted treatment.

There is evidence that dentists need to communicate well toachieve predictable treatment outcomes. However, patients havebeen studied more than dentists, and this study aimed at identify-ing the dentist's communicative role in patient satisfaction withprosthodontic treatment. In 3 Swedish specialist prosthodonticclinics, 61 patients treated by 15 dentists were followed throughtreatment with conversation recorded, and completed appropriatequestionnaires.

Following statistical multilevel modelling, patient satisfac-tion during an appointment was found to be largely related topatient factors, with only 2% of variance dependent on the den-tist in a communication model. Three months after completionof treatment, patient satisfaction did not appear to relate to thedentist. The authors comment that dentist communicationaffected patient satisfaction during an appointment, but had no impact on patient satisfaction with outcome shortly aftertreatment.

doi:10.1038/sj.bdj.4812178

I M P L A N T D E N T I S T R Y

Abstracts on this page have been chosen andedited by Dr Trevor Watts

P R O S T H O D O N T I C S ; B E H AV I O U R A L S C I E N C E

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