Monisha Billings1, Birte Holtfreter2, Panos N Papapanou3, Gabriela Lopez Mitnik1, Thomas Kocher2, Bruce A Dye1. 1. National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA. 2. Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Unit of Periodontology, University Medicine Greifswald, Greifswald, Germany. 3. Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY, USA.
Abstract
OBJECTIVE: We used epidemiologic data of clinical periodontal status from two population-based samples in two countries, United States and Germany, to examine 1) the impact of age on the relative contribution of recession and pocketing on the distribution of clinical attachment loss, and 2) whether it is feasible to define age-dependent thresholds for severe periodontitis. METHODS: The analytical sample was based on persons aged ≥30 and included 10,713 individuals in the United States, participants in NHANES 2009 to 2014, and 3,071 individuals in Pomerania, Germany, participants in the SHIP-Trend 2008 to 2012. NHANES used a full-mouth examination protocol to collect data on recession (R), pocket depth (PD) and clinical attachment loss (CAL) for six sites/tooth on a maximum of 28 teeth; SHIP-Trend used a half-mouth examination at four sites/tooth. In both samples, percentile distributions of mean CAL/person were generated for each 5-year age interval. Age-dependent thresholds defining the upper quintile of mean CAL were calculated for both samples. The topographic intraoral distribution of CAL and the relative contribution of R and PD on CAL was assessed. RESULTS: Mean CAL increased linearly with age in both samples and was higher in SHIP-Trend than NHANES across the age spectrum. In contrast, mean PD was constant across age groups in both populations. R contributed increasingly to CAL with age, especially after 45 to 49 years. Upper quintile mean CAL thresholds in NHANES were < 3 mm for ages up to 39 years, and under 3.58 mm in all other age groups. Corresponding values in SHIP-Trend were also < 3 mm in ages up to 39 years but increased linearly with age up to 7.21 mm for ages ≥75 years. CONCLUSIONS: Despite substantial differences in the overall severity of attachment loss between the two samples, common patterns of CAL and of the relative contribution of R and PD to CAL with increasing age were identified. Although periodontitis severity may vary in different populations, empirical evidence-driven definitions of CAL thresholds signifying disproportionate severity of periodontitis by age are feasible.
OBJECTIVE: We used epidemiologic data of clinical periodontal status from two population-based samples in two countries, United States and Germany, to examine 1) the impact of age on the relative contribution of recession and pocketing on the distribution of clinical attachment loss, and 2) whether it is feasible to define age-dependent thresholds for severe periodontitis. METHODS: The analytical sample was based on persons aged ≥30 and included 10,713 individuals in the United States, participants in NHANES 2009 to 2014, and 3,071 individuals in Pomerania, Germany, participants in the SHIP-Trend 2008 to 2012. NHANES used a full-mouth examination protocol to collect data on recession (R), pocket depth (PD) and clinical attachment loss (CAL) for six sites/tooth on a maximum of 28 teeth; SHIP-Trend used a half-mouth examination at four sites/tooth. In both samples, percentile distributions of mean CAL/person were generated for each 5-year age interval. Age-dependent thresholds defining the upper quintile of mean CAL were calculated for both samples. The topographic intraoral distribution of CAL and the relative contribution of R and PD on CAL was assessed. RESULTS: Mean CAL increased linearly with age in both samples and was higher in SHIP-Trend than NHANES across the age spectrum. In contrast, mean PD was constant across age groups in both populations. R contributed increasingly to CAL with age, especially after 45 to 49 years. Upper quintile mean CAL thresholds in NHANES were < 3 mm for ages up to 39 years, and under 3.58 mm in all other age groups. Corresponding values in SHIP-Trend were also < 3 mm in ages up to 39 years but increased linearly with age up to 7.21 mm for ages ≥75 years. CONCLUSIONS: Despite substantial differences in the overall severity of attachment loss between the two samples, common patterns of CAL and of the relative contribution of R and PD to CAL with increasing age were identified. Although periodontitis severity may vary in different populations, empirical evidence-driven definitions of CAL thresholds signifying disproportionate severity of periodontitis by age are feasible.
Authors: Henry Völzke; Dietrich Alte; Carsten Oliver Schmidt; Dörte Radke; Roberto Lorbeer; Nele Friedrich; Nicole Aumann; Katharina Lau; Michael Piontek; Gabriele Born; Christoph Havemann; Till Ittermann; Sabine Schipf; Robin Haring; Sebastian E Baumeister; Henri Wallaschofski; Matthias Nauck; Stephanie Frick; Andreas Arnold; Michael Jünger; Julia Mayerle; Matthias Kraft; Markus M Lerch; Marcus Dörr; Thorsten Reffelmann; Klaus Empen; Stephan B Felix; Anne Obst; Beate Koch; Sven Gläser; Ralf Ewert; Ingo Fietze; Thomas Penzel; Martina Dören; Wolfgang Rathmann; Johannes Haerting; Mario Hannemann; Jürgen Röpcke; Ulf Schminke; Clemens Jürgens; Frank Tost; Rainer Rettig; Jan A Kors; Saskia Ungerer; Katrin Hegenscheid; Jens-Peter Kühn; Julia Kühn; Norbert Hosten; Ralf Puls; Jörg Henke; Oliver Gloger; Alexander Teumer; Georg Homuth; Uwe Völker; Christian Schwahn; Birte Holtfreter; Ines Polzer; Thomas Kohlmann; Hans J Grabe; Dieter Rosskopf; Heyo K Kroemer; Thomas Kocher; Reiner Biffar; Ulrich John; Wolfgang Hoffmann Journal: Int J Epidemiol Date: 2010-02-18 Impact factor: 7.196
Authors: Bruce A Dye; Xianfen Li; Brenda G Lewis; Tim Iafolla; Eugenio D Beltran-Aguilar; Paul I Eke Journal: J Public Health Dent Date: 2014-05-22 Impact factor: 1.821
Authors: Birte Holtfreter; Ryan T Demmer; Olaf Bernhardt; Panos N Papapanou; Christian Schwahn; Thomas Kocher; Moise Desvarieux Journal: J Clin Periodontol Date: 2012-10-14 Impact factor: 8.728
Authors: Keith L Kirkwood; Lixia Zhang; Ramkumar Thiyagarajan; Kenneth L Seldeen; Bruce R Troen Journal: Immunol Invest Date: 2018-11 Impact factor: 3.657
Authors: Francisco Santos; Frederico Beato; Vanessa Machado; Luís Proença; José João Mendes; João Botelho Journal: Int J Environ Res Public Health Date: 2021-02-02 Impact factor: 3.390