Background: A multitude of studies suggest an association between periodontal disease and adverse birth outcomes. Although the evidence is controversial, it is biologically plausible, and the key link maybe inflammation. Purpose: To correlate levels of periodontal disease as measured by conventional methods with PMN counts from an oral rinse in pregnant women. Methods: Sixty-three pregnant women were recruited. Periodontal examinations were carried out. Fifteen-second saline rinses were collected. ABTS, a colour changing redox agent was added to each rinse. The intensity of the colour reaction was measured by absorbance to count the oral PMNs. Results: A statistically significant difference in oral PMN counts was observed between those with periodontal disease and the healthy patients (P < .05). The sensitivity and specificity using the bleeding index was 0.94 and 0.76 respectively. Conclusions: The rinse assay can be used as a screening tool for periodontal disease and oral inflammation in pregnant women.

Purpose: To validate and assess the feasibility of using an assay of oral neutrophils to measure periodontal inflammation in uncooperative patients with special needs. Methods: Periodontal examination and neutrophil counts derived from oral swabs were performed on patients with special needs having comprehensive dental treatment under general anaesthesia (GA). The conventional periodontal measurements were compared to neutrophil levels while patients were under GA, and later at their recall examination. Results: Forty-nine patients were assessed under GA and 30 (61%) returned for recall examination. Spearman’s correlation allowed for comparisons between periodontal parameters and oral neutrophil counts. Despite limited cooperation, it was possible to acquire neutrophils (using swabs) for all patients that presented for recall examination in the ambulatory dental clinic. Conclusions: Oral neutrophil levels correlated significantly with conventional parameters of gingival inflammation and may serve as a standardized method for clinical assessment of periodontal diseases in the special needs population.

Background: A multitude of studies suggest an association between periodontal disease and adverse birth outcomes. Although the evidence is controversial, it is biologically plausible, and the key link maybe inflammation. Purpose: To correlate levels of periodontal disease as measured by conventional methods with PMN counts from an oral rinse in pregnant women. Methods: Sixty-three pregnant women were recruited. Periodontal examinations were carried out. Fifteen-second saline rinses were collected. ABTS, a colour changing redox agent was added to each rinse. The intensity of the colour reaction was measured by absorbance to count the oral PMNs. Results: A statistically significant difference in oral PMN counts was observed between those with periodontal disease and the healthy patients (P < .05). The sensitivity and specificity using the bleeding index was 0.94 and 0.76 respectively. Conclusions: The rinse assay can be used as a screening tool for periodontal disease and oral inflammation in pregnant women.

Purpose: To validate and assess the feasibility of using an assay of oral neutrophils to measure periodontal inflammation in uncooperative patients with special needs. Methods: Periodontal examination and neutrophil counts derived from oral swabs were performed on patients with special needs having comprehensive dental treatment under general anaesthesia (GA). The conventional periodontal measurements were compared to neutrophil levels while patients were under GA, and later at their recall examination. Results: Forty-nine patients were assessed under GA and 30 (61%) returned for recall examination. Spearman’s correlation allowed for comparisons between periodontal parameters and oral neutrophil counts. Despite limited cooperation, it was possible to acquire neutrophils (using swabs) for all patients that presented for recall examination in the ambulatory dental clinic. Conclusions: Oral neutrophil levels correlated significantly with conventional parameters of gingival inflammation and may serve as a standardized method for clinical assessment of periodontal diseases in the special needs population.

The purpose of this thesis was to assess the prevalence and management of established cardiovascular (CV) risk factors and the prevalence and influence of self-reported markers (number of teeth and frequency of gum bleeding) of periodontal disease (PD), a less explored CV risk factor, in patients with stable chronic coronary heart disease (CHD). We studied patients from the global STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial (n=15,828), in which patients with stable chronic CHD were randomized to either darapladib or placebo. Our studies were performed using descriptive statistics and multivariable linear, logistic and Cox regression models. The use of secondary preventive medications was generally high across the whole study population. Despite this, CV risk factors were highly prevalent, including obesity, hypertension and hypercholesterolemia. Achievement of guideline-recommended treatment targets was lacking and little improvement was seen throughout the study duration. Approximately 40% of patients reported having &lt;15 remaining teeth and 25% reported gum bleeding. More tooth loss was associated with a greater CV risk factor burden after adjustment, while the associations for gum bleeding were less evident. After multivariable adjustment for CV risk factors and socioeconomic status, more tooth loss was associated with an increased risk of major adverse CV events (a composite of CV death, myocardial infarction and stroke), CV mortality, all-cause mortality and fatal or non-fatal stroke. We found associations between a higher degree of tooth loss and elevated levels of several prognostic biomarkers known to reflect various pathophysiological mechanisms involved in CV morbidity and mortality. Most biomarkers had little attenuating effect on the relationship between tooth loss and outcomes in a multivariable model. In conclusion, we found an inadequate CV risk factor control despite a high use of evidence-based pharmacological therapies, likely to explain some of the excess risk in CHD patients. Further, we demonstrated a high prevalence of PD markers, tooth loss in particular, that were associated with a wide range of established CV risk factors, prognostic biomarkers and outcomes. Collectively, these findings indicate that tooth loss may be a significant risk factor among patients with stable chronic CHD.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1983.

Mémoire (M.Ed.)--Université du Québec à Chicoutimi, 2000. / Document électronique également accessible en format PDF. CaQCU