Parodontiitti
Käypä hoito -suositus |  Julkaistu: 2016-10-11   | Tila: voimassa  |  Aihepiiri(t): Hammaslääketiede
Mikä on Käypä hoito -suositus?
Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä
PDF Tulosta

Parodontiitti

Käypä hoito
11.10.2016
Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä

Opi ja ota käyttöön

Koosteet

Potilaalle

Muut suositukset

Miten viitata Käypä hoito -suositukseen? «»1

Keskeinen sanoma

  • Parodontiitti eli hampaan kiinnityskudosten sairaus on merkittävä kansantauti. Yleisimmin kyseessä on krooninen parodontiitti, joka on väestössä alidiagnosoitu ja jää sen takia osin hoitamatta.
  • Gingiviitin eli ientulehduksen ehkäisy ja hoito ovat keskeinen osa parodontiitin ehkäisyä.
  • Parodontiitin varhaisdiagnostiikkaan ja hoitoon on perusterveydenhuollossa kohdistettava erityistä huomiota, sillä vaikea parodontiitti ja sen seuraukset aiheuttavat huomattavia kustannuksia ja vaativat usein erikoishammaslääkäritasoista hoitoa.
  • Parodontiittiriskin toteaminen edistää ehkäisyn ja hoidon kohdentamista.
  • Parodontologinen tutkimus, johon kuuluu olennaisesti ientaskumittaus, on osa suun terveydentilan tutkimusta ja sisältää myös peri-implanttikudosten tutkimisen. Tutkimus pitää tehdä kaikenikäisille säännöllisin väliajoin, jotta hampaita ja hammasimplantteja ympäröivien kudosten sairaudet todetaan mahdollisimman varhaisessa vaiheessa.
  • Hammaslääkäri vastaa diagnostiikasta, hoidon suunnittelusta ja sen toteutuksesta.
  • Kun sairaus on diagnosoitu, se hoidetaan viipymättä. Vaikuttava hoito on toteutettavissa tehokkaasti lyhyellä aikavälillä.
  • Tärkeä osa hoitoa ovat omahoidon ohjaus, potilaan sitouttaminen hoitoon ja tarvittaessa tupakkatuotteista vieroitus.
  • Hyvän ja pysyvän hoitotuloksen edellytyksenä on potilaan toimiva omahoito.
  • Ylläpitohoito on olennainen osa kiinnityskudos- ja peri-implanttisairauksien hoitoa.
  • Terveet hampaan kiinnityskudokset ovat tärkeä osa yleisterveyttä.

Aiheen rajaus

Tavoitteet

  • Suosituksen tavoitteina on
    • kiinnittää huomiota erityisesti parodontiitin ehkäisyyn, varhaisdiagnostiikkaan ja -hoitoon
    • kiinnittää huomiota myös hammasimplantteja ympäröivien kudosten terveydentilaan
    • luoda hyvin toimivia hoitokäytäntöjä perusterveydenhuoltoon
    • lisätä tietoisuutta hampaan kiinnityskudos- ja peri-implanttisairauksista, jotta ihmiset osaisivat hakeutua riittävän ajoissa hoitoon ja pystyisivät toimimaan aktiivisesti osana hoitotiimiä
    • lisätä tietoisuutta parodontiitin vaikutuksista yleissairauksiin.

Kohderyhmät

  • Suosituksen kohderyhminä ovat
    • hammaslääkärit, suuhygienistit ja muu suun terveydenhuollon ammattihenkilöstö
    • muut terveydenhuollon ammattihenkilöt (mm. lääkärit, neuvola- ja kouluterveydenhoitajat, opiskeluterveydenhuolto, työterveyshuolto, diabeteshoitajat, vanhusten hoivatyötä tekevät)
    • potilasyhdistykset, kuten sydän-, diabetes- ja reumayhdistykset
    • muu väestö.

Määritelmät

Esiintyvyys

Altistavat tekijät

Taulukko 1. Krooniselle parodontiitille ja sen uusiutumiselle altistavia ja syytekijöitä
Väestö- ja/tai yksilötaso Hampaisto- ja/tai hammastaso

Lisäksi parodontiitin uusiutumiseen vaikuttavat
Taulukko 2. Peri-implanttisairauksille altistavia ja syytekijöitä
Väestö- ja/tai yksilötaso Hampaistotaso

Diagnostiikka

Tavoite

  • Diagnostiikan tavoitteena on tunnistaa jo varhaisvaiheessa
    • tulehduksen merkit (ienverenvuoto, punoitus, turvotus) hampaita ja hammasimplantteja ympäröivissä kudoksissa
      • gingiviitti: ienverenvuoto taskumittauksen yhteydessä (bleeding on probing, BOP)
      • peri-implanttimukosiitti: ienverenvuoto taskumittauksen yhteydessä implanttia ympäröivässä pehmytkudoksessa
    • kiinnityskato
      • parodontiitti: kliinisesti syventyneitä ientaskuja ja röntgenkuvissa havaittavaa alveoliluukatoa
      • peri-implantiitti: kliinisesti suurentunut taskusyvyys ja röntgenkuvissa havaittava alveoliluukato verrattuna implanttikruunun valmistumisvaiheen mittauksiin
    • taudin uusiutuminen (BOP, syventyneitä ientaskuja ja kiinnityskadon eteneminen) hoidetulla parodontiittipotilaalla.

Oireet

Esitiedot

Kliininen tutkimus

Kuvantamistutkimukset

Mikrobiologiset tutkimukset

Muut diagnostiset tutkimukset

Keskeiset diagnoosit

Taulukko 3. Yleisimpien parodontaali- ja peri-implanttisairauksien diagnoosit sekä niihin liittyvät löydökset «Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol 2015;42 Suppl 16:S158-71 »8, «Sanz M, Bäumer A, Buduneli N ym. Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consen»54, «Lindhe J, Meyle J, Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35:282-5 »69, «American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions. J Periodontol 2015;86:835-8 »87, «Tonetti MS, Claffey N, European Workshop in Periodontology group C. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in »88, «Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007;78:1387-99 »89, «Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol 2008;35:286-91 »90. Taulukon tulostettava versio: «»1
- = pintakohtaisesti negatiivinen löydös
+ = pintakohtaisesti positiivinen löydös
*) = Kun BOP < 15 %, kyseessä on paikallinen gingiviitti.
**) = Vaikka hoidetulla parodontiittipotilaalla olisi luukatoa ja kiinnityskatoa, diagnoosina voi olla gingiviitti, jos syventyneitä ientaskuja ei esiinny.
***) = prosentuaalinen osuus juuren pituudesta
Kliiniset löydökset Radiologiset löydökset
Diagnoosit ICD-10 Erityispiirteet Ienverenvuoto (BOP %) Taskusyvyydet Kiinnityskato Luukato
PARODONTAALISAIRAUDET K05
Krooninen gingiviitti K05.1 Ikenen punoitus ja turvotus mahdollista > 15 % *) ≤ 4 mm -**) -**)
Krooninen parodontiitti K05.3 Ikenen punoitus ja turvotus mahdollista > 15 % ≥ 4 mm + +
Komplisoitumaton K05.30 Ei komplisoivia tekijöitä > 15 % ≥ 4 mm + +
Komplisoitunut K05.31 Esim. tupakointi ja diabetes komplisoivat > 15 % ≥ 4 mm + +
Taudin vaikeusaste:
lievä + 4 mm 1–2 mm ≤ 15 %***) tai 2–3 mm
keskivaikea + 5–6 mm 3–4 mm > 15–30 %***) tai 4–5 mm
vaikea + ≥ 7 mm ≥ 5 mm > 30 %***) tai > 5 mm
Taudin yleisyys:
paikallistunut muoto ≤ 30 % hampaista affisioitunut
yleistynyt muoto > 30 % hampaista affisioitunut
Aggressiivinen parodontiitti K05.4 Nopeasti edennyt kudostuho + ≥ 4 mm + +
paikallistunut muoto Kiinnityskatoa ≥ 2 pysyvässä hampaassa, joista toisen on oltava molaari + ≥ 4 mm + +
yleistynyt muoto Kiinnityskatoa ≥ 3 muussa hampaassa kuin kuutosissa tai inkisiiveissä + ≥ 4 mm + +
PERI-IMPLANTTISAIRAUDET T84
Peri-implanttimukosiitti T84.60 Ikenen punoitus ja turvotus mahdollista + < 5 mm - -
Peri-implantiitti T84.62 Ikenen punoitus, turvotus ja märkävuoto ientaskusta mahdollista + ≥ 5 mm + +

Erotusdiagnostiikka

Ehkäisy

Kroonisen gingiviitin ja peri-implanttimukosiitin hoito

Kroonisen parodontiitin hoito

Hoidon komplikaatioita

Hoitotuloksen arviointi

  • 4–6 viikon kuluttua aktiivisen hoidon päättymisestä tehdään uusi parodontologinen tutkimus ja rekisteröidään saavutettu hoitotulos:
    • omahoidon toimivuus (plakin määrä ja paikantuminen)
    • tupakointitottumusten muutokset
    • ienrajan kulku
    • ientaskujen syvyydet
    • BOP, muut tulehduksen merkit ja furkaatiovauriot
    • hampaiden liikkuvuus.
  • Lisäksi arvioidaan mahdollinen lisähoidon tarve. Arvion perusteena ovat BOP-arvo (≥ 20 %), jäännöshammaskiven esiintyminen ja jäännöstaskujen (≥ 5 mm) lukumäärä.

Ylläpitohoito ja ajoitus

Tiimityö parodontologisessa hoidossa

  • Potilaan ja hammaslääkärin ohella parodontologisen hoitotiimin jäseniä voivat olla suuhygienisti, hammashoitaja ja erikoishammaslääkäri.
  • Potilaan omahoito ja sitoutuminen hoitoon ovat parodontologisen hoidon onnistumisen edellytys. Joissakin tapauksissa (esim. laitoshoidossa olevan potilaan) huoltaja tai omahoitaja avustaa omahoidossa.
  • Hammaslääkäri tekee parodontologisen diagnoosin ja laatii sen perusteella hoitosuunnitelman.
  • Hammaslääkäri osallistuu hoitoon ja vastaa aina sen toteutumisesta kokonaisuutena.
  • Suuhygienisti huolehtii suun terveyden ylläpitämisestä ja osallistuu hoitoon ja ylläpitohoitoon.
  • Jos tarvittavat hoitotoimenpiteet menevät oman osaamisalueen ulkopuolelle, potilas on ohjattava jatkohoitoon.
  • Säännöllisestä ylläpitohoidosta huolimatta etenevä tai uusiutuva parodontiitti (10–20 %:lla potilaista) edellyttää erikoishammaslääkäritasoista hoitoa «Pastagia J, Nicoara P, Robertson PB. The effect of patient-centered plaque control and periodontal maintenance therapy on adverse outcomes of periodontitis. J Evid Based Dent Pract 2006;6:25-32 »156.
  • Potilas lähetetään parodontologiseen hoitoon perehtyneelle (erikois-)hammaslääkärille, kun kyseessä on
    • vaikea parodontiitti, jossa toimenpiteet ovat erittäin vaativia (syvät taskut, furkaatiovauriot, vaikeapääsyiset pinnat)
    • parodontiitti, jossa purenta tai endodonttiset ongelmat ovat osana etiologiaa
    • yleissairauden komplisoima parodontiitti
    • vaikea nuoruusiän parodontiitti
    • vaativaa parodontaalikirurgista hoitoa tarvitseva potilas
    • peri-implantiitti
    • tilanne, jossa asianmukaisen hoidon jälkeen on merkkejä aktiivisesta sairaudesta.
  • Ks. myös kuva työnjaosta «Tiimityö parodontologisessa hoidossa»1 .

Parodontiitin yhteys yleissairauksiin

Kustannusasiat

Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä

Parodontiitti-suosituksen historiatiedot «Parodontiitti, Käypä hoito -suosituksen historiatiedot»5

Puheenjohtaja:

Eija Könönen, parodontologian professori, HLT, EHL, ylihammaslääkäri, oraalimikrobiologian dosentti; Turun yliopiston hammaslääketieteen laitos, Turun sosiaali- ja terveystoimi

Jäsenet:

Mervi Gürsoy, HLT, EHL, yliopisto-opettaja; Turun yliopiston hammaslääketieteen laitos

Erja Nuutinen, TtM, lehtori; Metropolia ammattikorkeakoulu

Marja Pöllänen, HLT, EHL; Suomalainen Lääkäriseura Duodecim (Käypä hoito -toimittaja)

Kimmo Suomalainen, parodontologian dosentti, HLT, EHL, ylihammaslääkäri; Tampereen yliopistollinen sairaala

Pekka Ylöstalo, kliinisen hammashoidon professori, ylihammaslääkäri, parodontologian ja geriatrisen hammaslääketieteen professori; Itä-Suomen yliopisto, Kuopion yliopistollinen sairaala, Oulun yliopisto ja Oulun yliopistollinen sairaala

Sidonnaisuudet

Mervi Gürsoy: Ei sidonnaisuuksia

Eija Könönen: Ei sidonnaisuuksia

Erja Nuutinen: Ei sidonnaisuuksia

Marja Pöllänen: Luentopalkkio (Novo Nordisk, MSD)

Kimmo Suomalainen: Osakeomistus (Orion Oyj)

Pekka Ylöstalo: Ei sidonnaisuuksia

Kirjallisuusviite

Parodontiitti. Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2016 (viitattu pp.kk.vvvv). Saatavilla internetissä: www.kaypahoito.fi

Tarkemmat viittausohjeet: «http://www.kaypahoito.fi/web/kh/viittaaminen»7

Vastuun rajaus

Käypä hoito -suositukset ja Vältä viisaasti -suositukset ovat asiantuntijoiden laatimia yhteenvetoja yksittäisten sairauksien diagnostiikan ja hoidon vaikuttavuudesta. Ne eivät korvaa lääkärin tai muun terveydenhuollon ammattilaisen omaa arviota yksittäisen potilaan parhaasta mahdollisesta diagnostiikasta, hoidosta ja kuntoutuksesta hoitopäätöksiä tehtäessä.

Tiedonhakukäytäntö

Systemaattinen kirjallisuushaku on hoitosuosituksen perusta. Lue lisää artikkelista khk00007

Kirjallisuutta

  1. Hammasperäiset äkilliset infektiot ja mikrobilääkkeet (online). Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonian asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2011 (27.5.2011). Saatavilla Internetissä: www.kaypahoito.fi
  2. Kansanterveyslaitos. Suomalaisten aikuisten suunterveys. Terveys 2000 -tutkimus. Kansanterveyslaitoksen julkaisuja B16/2004:88-97, http://www.terveys2000.fi/julkaisut/2004b16.pdf «http://www.terveys2000.fi/julkaisut/2004b16.pdf»1
  3. Terveys 2011. https://www.julkari.fi/bitstream/handle/10024/90832/Rap068_2012_netti.pdf?sequence «https://www.julkari.fi/bitstream/handle/10024/90832/Rap068_2012_netti.pdf?sequence»8
  4. Saxén L. Juvenile periodontitis in Finland. Proc Finn Dent Soc 1987;83:143-9 «PMID: 3303023»PubMed
  5. Thomson WM, Shearer DM, Broadbent JM ym. The natural history of periodontal attachment loss during the third and fourth decades of life. J Clin Periodontol 2013;40:672-80 «PMID: 23656174»PubMed
  6. Kassebaum NJ, Bernabé E, Dahiya M ym. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res 2014;93:1045-53 «PMID: 25261053»PubMed
  7. Jepsen S, Berglundh T, Genco R ym. Primary prevention of peri-implantitis: managing peri-implant mucositis. J Clin Periodontol 2015;42 Suppl 16:S152-7 «PMID: 25626479»PubMed
  8. Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol 2015;42 Suppl 16:S158-71 «PMID: 25495683»PubMed
  9. Axelsson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Results after 6 years. J Clin Periodontol 1981;8:239-48 «PMID: 6947990»PubMed
  10. Clerehugh V, Worthington HV, Lennon MA ym. Site progression of loss of attachment over 5 years in 14- to 19-year-old adolescents. J Clin Periodontol 1995;22:15-21 «PMID: 7706535»PubMed
  11. Ylöstalo P, Suominen-Taipale L, Reunanen A ym. Association between body weight and periodontal infection. J Clin Periodontol 2008;35:297-304 «PMID: 18294226»PubMed
  12. Kocher T, Schwahn C, Gesch D ym. Risk determinants of periodontal disease--an analysis of the Study of Health in Pomerania (SHIP 0). J Clin Periodontol 2005;32:59-67 «PMID: 15642060»PubMed
  13. Papapanou PN, Wennström JL. A 10-year retrospective study of periodontal disease progression. Clinical characteristics of subjects with pronounced and minimal disease development. J Clin Periodontol 1990;17:78-84 «PMID: 2303574»PubMed
  14. Löe H. Oral hygiene in the prevention of caries and periodontal disease. Int Dent J 2000;50:129-39 «PMID: 10967765»PubMed
  15. Schätzle M, Löe H, Ramseier CA ym. Clinical course of chronic periodontitis: effect of lifelong light smoking (20 years) on loss of attachment and teeth. J Investig Clin Dent 2010;1:8-15 «PMID: 25427181»PubMed
  16. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000 2013;62:59-94 «PMID: 23574464»PubMed
  17. Lee KS, Lee SG, Kim EK ym. Metabolic syndrome parameters in adolescents may be determinants for the future periodontal diseases. J Clin Periodontol 2015;42:105-12 «PMID: 25469423»PubMed
  18. Schätzle M, Löe H, Lang NP ym. Clinical course of chronic periodontitis. III. Patterns, variations and risks of attachment loss. J Clin Periodontol 2003;30:909-18 «PMID: 14710771»PubMed
  19. Grbic JT, Lamster IB. Risk indicators for future clinical attachment loss in adult periodontitis. Tooth and site variables. J Periodontol 1992;63:262-9 «PMID: 1573540»PubMed
  20. Chambrone L, Chambrone D, Lima LA ym. Predictors of tooth loss during long-term periodontal maintenance: a systematic review of observational studies. J Clin Periodontol 2010;37:675-84 «PMID: 20528960»PubMed
  21. Hart TC, Atkinson JC. Mendelian forms of periodontitis. Periodontol 2000 2007;45:95-112 «PMID: 17850451»PubMed
  22. Deas DE, Mackey SA, McDonnell HT. Systemic disease and periodontitis: manifestations of neutrophil dysfunction. Periodontol 2000 2003;32:82-104 «PMID: 12756035»PubMed
  23. Hodge P, Michalowicz B. Genetic predisposition to periodontitis in children and young adults. Periodontol 2000 2001;26:113-34 «PMID: 11452901»PubMed
  24. Kinane DF, Hart TC. Genes and gene polymorphisms associated with periodontal disease. Crit Rev Oral Biol Med 2003;14:430-49 «PMID: 14656898»PubMed
  25. Loos BG, Papantonopoulos G, Jepsen S ym. What is the Contribution of Genetics to Periodontal Risk? Dent Clin North Am 2015;59:761-80 «PMID: 26427567»PubMed
  26. Costa FO, Lages EJ, Cota LO ym. Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study. J Periodontal Res 2014;49:121-8 «PMID: 23647520»PubMed
  27. Klinge B, Norlund A. A socio-economic perspective on periodontal diseases: a systematic review. J Clin Periodontol 2005;32 Suppl 6:314-25 «PMID: 16128846»PubMed
  28. Knight ET, Liu J, Seymour GJ ym. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016;71:22-51 «PMID: 27045429»PubMed
  29. Könönen E, Paju S, Pussinen PJ ym. Population-based study of salivary carriage of periodontal pathogens in adults. J Clin Microbiol 2007;45:2446-51 «PMID: 17567788»PubMed
  30. Ezzo PJ, Cutler CW. Microorganisms as risk indicators for periodontal disease. Periodontol 2000 2003;32:24-35 «PMID: 12756031»PubMed
  31. Haffajee AD, Socransky SS, Smith C ym. Relation of baseline microbial parameters to future periodontal attachment loss. J Clin Periodontol 1991;18:744-50 «PMID: 1661304»PubMed
  32. Paju S, Pussinen PJ, Suominen-Taipale L ym. Detection of multiple pathogenic species in saliva is associated with periodontal infection in adults. J Clin Microbiol 2009;47:235-8 «PMID: 19020069»PubMed
  33. Machtei EE, Hausmann E, Dunford R ym. Longitudinal study of predictive factors for periodontal disease and tooth loss. J Clin Periodontol 1999;26:374-80 «PMID: 10382577»PubMed
  34. Lang NP, Schätzle MA, Löe H. Gingivitis as a risk factor in periodontal disease. J Clin Periodontol 2009;36 Suppl 10:3-8 «PMID: 19432625»PubMed
  35. Albandar JM. Some predictors of radiographic alveolar bone height reduction over 6 years. J Periodontal Res 1990;25:186-92 «PMID: 2141878»PubMed
  36. Matuliene G, Pjetursson BE, Salvi GE ym. Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol 2008;35:685-95 «PMID: 18549447»PubMed
  37. Schätzle M, Faddy MJ, Cullinan MP ym. The clinical course of chronic periodontitis: V. Predictive factors in periodontal disease. J Clin Periodontol 2009;36:365-71 «PMID: 19419434»PubMed
  38. Lang NP, Kiel RA, Anderhalden K. Clinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins. J Clin Periodontol 1983;10:563-78 «PMID: 6581173»PubMed
  39. Schwalm CA, Smith DE, Erickson JD. A clinical study of patients 1 to 2 years after placement of removable partial dentures. J Prosthet Dent 1977;38:380-91 «PMID: 333107»PubMed
  40. Reitemeier B, Hänsel K, Walter MH ym. Effect of posterior crown margin placement on gingival health. J Prosthet Dent 2002;87:167-72 «PMID: 11854673»PubMed
  41. Schätzle M, Land NP, Anerud A ym. The influence of margins of restorations of the periodontal tissues over 26 years. J Clin Periodontol 2001;28:57-64 «PMID: 11142668»PubMed
  42. Matthews DC, Tabesh M. Detection of localized tooth-related factors that predispose to periodontal infections. Periodontol 2000 2004;34:136-50 «PMID: 14717860»PubMed
  43. Burgett FG, Ramfjord SP, Nissle RR ym. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol 1992;19:381-7 «PMID: 1634627»PubMed
  44. Harrel SK, Nunn ME. The association of occlusal contacts with the presence of increased periodontal probing depth. J Clin Periodontol 2009;36:1035-42 «PMID: 19930093»PubMed
  45. Bernhardt O, Gesch D, Look JO ym. The influence of dynamic occlusal interferences on probing depth and attachment level: results of the Study of Health in Pomerania (SHIP). J Periodontol 2006;77:506-16 «PMID: 16512766»PubMed
  46. Heitz-Mayfield LJ, Huynh-Ba G. History of treated periodontitis and smoking as risks for implant therapy. Int J Oral Maxillofac Implants 2009;24 Suppl:39-68 «PMID: 19885434»PubMed
  47. Sgolastra F, Petrucci A, Severino M ym. Smoking and the risk of peri-implantitis. A systematic review and meta-analysis. Clin Oral Implants Res 2015;26:e62-7 «PMID: 24438442»PubMed
  48. Renvert S, Quirynen M. Risk indicators for peri-implantitis. A narrative review. Clin Oral Implants Res 2015;26 Suppl 11:15-44 «PMID: 26385619»PubMed
  49. Clementini M, Rossetti PH, Penarrocha D ym. Systemic risk factors for peri-implant bone loss: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2014;43:323-34 «PMID: 24373525»PubMed
  50. Dalago HR, Schuldt Filho G, Rodrigues MA ym. Risk indicators for Peri-implantitis. A cross-sectional study with 916 implants. Clin Oral Implants Res 2016;Jan 11.doi: 10.1111/clr.12772. [Epub ahead of print] «PMID: 26754342»PubMed
  51. Karbach J, Callaway A, Kwon YD ym. Comparison of five parameters as risk factors for peri-mucositis. Int J Oral Maxillofac Implants 2009;24:491-6 «PMID: 19587872»PubMed
  52. Renvert S, Polyzois I. Risk indicators for peri-implant mucositis: a systematic literature review. J Clin Periodontol 2015;42 Suppl 16:S172-86 «PMID: 25496066»PubMed
  53. Quirynen M, Dadamio J, Van den Velde S ym. Characteristics of 2000 patients who visited a halitosis clinic. J Clin Periodontol 2009;36:970-5 «PMID: 19811581»PubMed
  54. Sanz M, Bäumer A, Buduneli N ym. Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consensus report of group 4 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol 2015;42 Suppl 16:S214-20 «PMID: 25626357»PubMed
  55. Holmstrup P, Glick M. Treatment of periodontal disease in the immunodeficient patient. Periodontol 2000 2002;28:190-205 «PMID: 12013342»PubMed
  56. Bondon-Guitton E, Bagheri H, Montastruc JL. Drug-induced gingival overgrowth: a study in the French Pharmacovigilance Database. J Clin Periodontol 2012;39:513-8 «PMID: 22519416»PubMed
  57. American Academy of Periodontology-Research, Scicence and Therapy Committee. Periodontal diseases of children and adolescents. Pediatr Dent 2008;30:240-7 «PMID: 19216430»PubMed
  58. Sälzer S, Slot DE, Van der Weijden FA ym. Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review. J Clin Periodontol 2015;42 Suppl 16:S92-105 «PMID: 25581718»PubMed
  59. Daly CG, Mitchell DH, Highfield JE ym. Bacteremia due to periodontal probing: a clinical and microbiological investigation. J Periodontol 2001;72:210-4 «PMID: 11288795»PubMed
  60. Viisaudenhammas (online). Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2014 (18.8.2014). Saatavilla Internetissä: www.kaypahoito.fi
  61. Blakey GH, Marciani RD, Haug RH ym. Periodontal pathology associated with asymptomatic third molars. J Oral Maxillofac Surg 2002;60:1227-33 «PMID: 12420253»PubMed
  62. Offenbacher S, Beck JD, Moss KL ym. What are the local and systemic implications of third molar retention? J Oral Maxillofac Surg 2012;70:S58-65 «PMID: 22916700»PubMed
  63. Larsen C, Barendregt DS, Slot DE ym. Probing pressure, a highly undervalued unit of measure in periodontal probing: a systematic review on its effect on probing pocket depth. J Clin Periodontol 2009;36:315-22 «PMID: 19426178»PubMed
  64. Bulthuis HM, Barendregt DS, Timmerman MF ym. Probe penetration in relation to the connective tissue attachment level: influence of tine shape and probing force. J Clin Periodontol 1998;25:417-23 «PMID: 9650880»PubMed
  65. Wang SF, Leknes KN, Zimmerman GJ ym. Reproducibility of periodontal probing using a conventional manual and an automated force-controlled electronic probe. J Periodontol 1995;66:38-46 «PMID: 7891248»PubMed
  66. Grossi SG, Dunford RG, Ho A ym. Sources of error for periodontal probing measurements. J Periodontal Res 1996;31:330-6 «PMID: 8858537»PubMed
  67. Scott DA, Singer DL. Suppression of overt gingival inflammation in tobacco smokers - clinical and mechanistic considerations. Int J Dent Hyg 2004;2:104-10 «PMID: 16451473»PubMed
  68. Lang NP, Adler R, Joss A ym. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Periodontol 1990;17:714-21 «PMID: 2262585»PubMed
  69. Lindhe J, Meyle J, Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35:282-5 «PMID: 18724855»PubMed
  70. Nieminen M, Varrela T, könönen E, Pöllänen M. Furkaatioleesioiden etiologia, diagnostiikka ja hoito. Suom Hammaslääkäril 2015;(8):20-8
  71. Müller HP, Eger T. Masticatory mucosa and periodontal phenotype: a review. Int J Periodontics Restorative Dent 2002;22:172-83 «PMID: 12019713»PubMed
  72. De Rouck T, Eghbali R, Collys K ym. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009;36:428-33 «PMID: 19419444»PubMed
  73. Pepelassi EA, Tsiklakis K, Diamanti-Kipioti A. Radiographic detection and assessment of the periodontal endosseous defects. J Clin Periodontol 2000;27:224-30 «PMID: 10783834»PubMed
  74. Preshaw PM. Detection and diagnosis of periodontal conditions amenable to prevention. BMC Oral Health 2015;15 Suppl 1:S5 «PMID: 26390822»PubMed
  75. Graetz C, Plaumann A, Wiebe JF ym. Periodontal probing versus radiographs for the diagnosis of furcation involvement. J Periodontol 2014;85:1371-9 «PMID: 24605872»PubMed
  76. Renvert S, Wikström M, Helmersson M ym. Comparative study of subgingival microbiological sampling techniques. J Periodontol 1992;63:797-801 «PMID: 1328591»PubMed
  77. Jervøe-Storm PM, Alahdab H, Koltzscher M ym. Comparison of curet and paper point sampling of subgingival bacteria as analyzed by real-time polymerase chain reaction. J Periodontol 2007;78:909-17 «PMID: 17470026»PubMed
  78. Teles FR, Haffajee AD, Socransky SS. The reproducibility of curet sampling of subgingival biofilms. J Periodontol 2008;79:705-13 «PMID: 18380565»PubMed
  79. Shapira L, Wilensky A, Kinane DF. Effect of genetic variability on the inflammatory response to periodontal infection. J Clin Periodontol 2005;32 Suppl 6:72-86 «PMID: 16128831»PubMed
  80. Huynh-Ba G, Lang NP, Tonetti MS ym. The association of the composite IL-1 genotype with periodontitis progression and/or treatment outcomes: a systematic review. J Clin Periodontol 2007;34:305-17 «PMID: 17378887»PubMed
  81. Huynh-Ba G, Lang NP, Tonetti MS ym. Association of the composite IL-1 genotype with peri-implantitis: a systematic review. Clin Oral Implants Res 2008;19:1154-62 «PMID: 18983319»PubMed
  82. Heikkinen AM, Nwhator SO, Rathnayake N ym. Pilot Study on Oral Health Status as Assessed by an Active Matrix Metalloproteinase-8 Chairside Mouthrinse Test in Adolescents. J Periodontol 2016;87:36-40 «PMID: 26430926»PubMed
  83. Lorenz K, Keller T, Noack B ym. Evaluation of a novel point-of-care test for active matrix metalloproteinase-8: agreement between qualitative and quantitative measurements and relation to periodontal inflammation. J Periodontal Res 2016;May 23. doi: 10.1111/jre.12392. [Epub ahead of print] «PMID: 27214099»PubMed
  84. Herr AE, Hatch AV, Throckmorton DJ ym. Microfluidic immunoassays as rapid saliva-based clinical diagnostics. Proc Natl Acad Sci U S A 2007;104:5268-73 «PMID: 17374724»PubMed
  85. Izadi Borujeni S, Mayer M, Eickholz P. Activated matrix metalloproteinase-8 in saliva as diagnostic test for periodontal disease? A case-control study. Med Microbiol Immunol 2015;204:665-72 «PMID: 25841875»PubMed
  86. Johnson N, Ebersole JL, Kryscio RJ ym. Rapid assessment of salivary MMP-8 and periodontal disease using lateral flow immunoassay. Oral Dis 2016;22:681-7 «PMID: 27273425»PubMed
  87. American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions. J Periodontol 2015;86:835-8 «PMID: 26125117»PubMed
  88. Tonetti MS, Claffey N, European Workshop in Periodontology group C. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol 2005;32 Suppl 6:210-3 «PMID: 16128839»PubMed
  89. Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007;78:1387-99 «PMID: 17608611»PubMed
  90. Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol 2008;35:286-91 «PMID: 18724856»PubMed
  91. Mombelli A, Gusberti FA, van Oosten MA ym. Gingival health and gingivitis development during puberty. A 4-year longitudinal study. J Clin Periodontol 1989;16:451-6 «PMID: 2768539»PubMed
  92. Nakagawa S, Fujii H, Machida Y ym. A longitudinal study from prepuberty to puberty of gingivitis. Correlation between the occurrence of Prevotella intermedia and sex hormones. J Clin Periodontol 1994;21:658-65 «PMID: 7852609»PubMed
  93. Figuero E, Carrillo-de-Albornoz A, Martín C ym. Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. J Clin Periodontol 2013;40:457-73 «PMID: 23557432»PubMed
  94. Gürsoy M, Pajukanta R, Sorsa T ym. Clinical changes in periodontium during pregnancy and post-partum. J Clin Periodontol 2008;35:576-83 «PMID: 18430046»PubMed
  95. Trackman PC, Kantarci A. Connective tissue metabolism and gingival overgrowth. Crit Rev Oral Biol Med 2004;15:165-75 «PMID: 15187034»PubMed
  96. Seymour RA. Effects of medications on the periodontal tissues in health and disease. Periodontol 2000 2006;40:120-9 «PMID: 16398689»PubMed
  97. Löe H, Morrison E. Periodontal health and disease in young people: screening for priority care. Int Dent J 1986;36:162-7 «PMID: 3533788»PubMed
  98. Chapple IL, Van der Weijden F, Doerfer C ym. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 2015;42 Suppl 16:S71-6 «PMID: 25639826»PubMed
  99. Slot DE, Dörfer CE, Van der Weijden GA. The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review. Int J Dent Hyg 2008;6:253-64 «PMID: 19138177»PubMed
  100. Sambunjak D, Nickerson JW, Poklepovic T ym. Flossing for the management of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 2011;12:CD008829 «PMID: 22161438»PubMed
  101. Yost KG, Mallatt ME, Liebman J. Interproximal gingivitis and plaque reduction by four interdental products. J Clin Dent 2006;17:79-83 «PMID: 17022370»PubMed
  102. Abouassi T, Woelber JP, Holst K ym. Clinical efficacy and patients' acceptance of a rubber interdental bristle. A randomized controlled trial. Clin Oral Investig 2014;18:1873-80 «PMID: 24407549»PubMed
  103. Lindson-Hawley N, Thompson TP, Begh R. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev 2015;3:CD006936 «PMID: 25726920»PubMed
  104. Ramseier CA, Suvan JE. Behaviour change counselling for tobacco use cessation and promotion of healthy lifestyles: a systematic review. J Clin Periodontol 2015;42 Suppl 16:S47-58 «PMID: 25496370»PubMed
  105. Werner H, Hakeberg M, Dahlström L ym. Psychological Interventions for Poor Oral Health: A Systematic Review. J Dent Res 2016;95:506-14 «PMID: 26826109»PubMed
  106. Riley P, Lamont T. Triclosan/copolymer containing toothpastes for oral health. Cochrane Database Syst Rev 2013;12:CD010514 «PMID: 24310847»PubMed
  107. Kraglund F. Triclosan produces statistically significant reduction in plaque, gingivitis and caries but not clinically important benefit. Evid Based Dent 2014;15:6-7 «PMID: 24763165»PubMed
  108. Serrano J, Escribano M, Roldán S ym. Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: a systematic review and meta-analysis. J Clin Periodontol 2015;42 Suppl 16:S106-38 «PMID: 25495592»PubMed
  109. Hugoson A, Lundgren D, Asklöw B ym. Effect of three different dental health preventive programmes on young adult individuals: a randomized, blinded, parallel group, controlled evaluation of oral hygiene behaviour on plaque and gingivitis. J Clin Periodontol 2007;34:407-15 «PMID: 17448044»PubMed
  110. Hujoel PP, Cunha-Cruz J, Loesche WJ ym. Personal oral hygiene and chronic periodontitis: a systematic review. Periodontol 2000 2005;37:29-34 «PMID: 15655023»PubMed
  111. Needleman I, Nibali L, Di Iorio A. Professional mechanical plaque removal for prevention of periodontal diseases in adults--systematic review update. J Clin Periodontol 2015;42 Suppl 16:S12-35 «PMID: 25495962»PubMed
  112. Monje A, Aranda L, Diaz KT ym. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. J Dent Res 2016;95:372-9 «PMID: 26701350»PubMed
  113. al-Tannir MA, Goodman HS. A review of chlorhexidine and its use in special populations. Spec Care Dentist 1994;14:116-22 «PMID: 7871472»PubMed
  114. Moazzez R, Thompson H, Palmer RM ym. Effect of rinsing with ethanol-containing mouthrinses on the production of salivary acetaldehyde. Eur J Oral Sci 2011;119:441-6 «PMID: 22112029»PubMed
  115. Chevalier M, Sakarovitch C, Precheur I ym. Antiseptic mouthwashes could worsen xerostomia in patients taking polypharmacy. Acta Odontol Scand 2015;73:267-73 «PMID: 25601200»PubMed
  116. Bondonno CP, Liu AH, Croft KD ym. Antibacterial mouthwash blunts oral nitrate reduction and increases blood pressure in treated hypertensive men and women. Am J Hypertens 2015;28:572-5 «PMID: 25359409»PubMed
  117. McCullough MJ, Farah CS. The role of alcohol in oral carcinogenesis with particular reference to alcohol-containing mouthwashes. Aust Dent J 2008;53:302-5 «PMID: 19133944»PubMed
  118. Lachenmeier DW. Safety evaluation of topical applications of ethanol on the skin and inside the oral cavity. J Occup Med Toxicol 2008;3:26 «PMID: 19014531»PubMed
  119. La Vecchia C. Mouthwash and oral cancer risk: an update. Oral Oncol 2009;45:198-200 «PMID: 18952488»PubMed
  120. Currie S, Farah C. Alcohol-containing mouthwash and oral cancer risk: a review of current evidence. OA Alcohol 2014 Feb 10;2(1):4 1-9. issn2053-0285
  121. van Steenberghe D, Garmyn P, Geers L ym. Patients' experience of pain and discomfort during instrumentation in the diagnosis and non-surgical treatment of periodontitis. J Periodontol 2004;75:1465-70 «PMID: 15633322»PubMed
  122. Lockhart PB, Brennan MT, Thornhill M ym. Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia. J Am Dent Assoc 2009;140:1238-44 «PMID: 19797553»PubMed
  123. Mougeot FK, Saunders SE, Brennan MT ym. Associations between bacteremia from oral sources and distant-site infections: tooth brushing versus single tooth extraction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:430-5 «PMID: 25758845»PubMed
  124. Matthews D. Impact of everyday oral activities on the risk of bacteraemia is unclear. Evid Based Dent 2012;13:80 «PMID: 23059921»PubMed
  125. Tupakkariippuvuus ja tupakasta vieroitus (online). Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Yleislääketieteen yhdistyksen asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2012 (19.1.2012). Saatavilla Internetissä: www.kaypahoito.fi
  126. Diabetes (online). Käypä hoito -suositus. Suomalaisen Lääkäriseuran Duodecimin ja Suomen Sisätautilääkärien yhdistyksen ja Diabetesliiton Lääkärineuvoston asettama työryhmä. Helsinki: Suomalainen Lääkäriseura Duodecim, 2016 (22.3.2016). Saatavilla Internetissä: www.kaypahoito.fi
  127. Pihlstrom BL, Hargreaves KM, Bouwsma OJ ym. Pain after periodontal scaling and root planing. J Am Dent Assoc 1999;130:801-7 «PMID: 10377637»PubMed
  128. Ximénez-Fyvie LA, Haffajee AD, Som S ym. The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota. J Clin Periodontol 2000;27:637-47 «PMID: 10983597»PubMed
  129. Supranoto SC, Slot DE, Addy M ym. The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review. Int J Dent Hyg 2015;13:83-92 «PMID: 25059640»PubMed
  130. Haffajee AD, Socransky SS, Gunsolley JC. Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol 2003;8:115-81 «PMID: 14971252»PubMed
  131. Asikainen S, Dahlén G, Klinge B, Olsen I, Westergaard J. Antibiootit parodontaalihoidossa. Suom Hammaslääkäril 2002;8:438-43
  132. Jepsen K, Jepsen S. Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis. Periodontol 2000 2016;71:82-112 «PMID: 27045432»PubMed
  133. Smiley CJ, Tracy SL, Abt E ym. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015;146:508-24.e5 «PMID: 26113099»PubMed
  134. Shaddox LM, Walker C. Microbial testing in periodontics: value, limitations and future directions. Periodontol 2000 2009;50:25-38 «PMID: 19388951»PubMed
  135. Herrera D, Alonso B, León R ym. Antimicrobial therapy in periodontitis: the use of systemic antimicrobials against the subgingival biofilm. J Clin Periodontol 2008;35:45-66 «PMID: 18724841»PubMed
  136. Mombelli A, Almaghlouth A, Cionca N ym. Differential benefits of amoxicillin-metronidazole in different phases of periodontal therapy in a randomized controlled crossover clinical trial. J Periodontol 2015;86:367-75 «PMID: 25415250»PubMed
  137. Preshaw PM, Hefti AF, Bradshaw MH. Adjunctive subantimicrobial dose doxycycline in smokers and non-smokers with chronic periodontitis. J Clin Periodontol 2005;32:610-6 «PMID: 15882219»PubMed
  138. Nyman SR, Lang NP. Tooth mobility and the biological rationale for splinting teeth. Periodontol 2000 1994;4:15-22 «PMID: 9673190»PubMed
  139. Kwok V, Caton JG. Commentary: prognosis revisited: a system for assigning periodontal prognosis. J Periodontol 2007;78:2063-71 «PMID: 17970671»PubMed
  140. Eickholz P, Kaltschmitt J, Berbig J ym. Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol 2008;35:165-74 «PMID: 18199150»PubMed
  141. Graetz C, Schützhold S, Plaumann A ym. Prognostic factors for the loss of molars--an 18-years retrospective cohort study. J Clin Periodontol 2015;42:943-50 «PMID: 26399690»PubMed
  142. Miller PD Jr, McEntire ML, Marlow NM ym. An evidenced-based scoring index to determine the periodontal prognosis on molars. J Periodontol 2014;85:214-25 «PMID: 23725028»PubMed
  143. Holm-Pedersen P, Lang NP, Müller F. What are the longevities of teeth and oral implants? Clin Oral Implants Res 2007;18 Suppl 3:15-9 «PMID: 17594366»PubMed
  144. Tomasi C, Wennström JL, Berglundh T. Longevity of teeth and implants - a systematic review. J Oral Rehabil 2008;35 Suppl 1:23-32 «PMID: 18181931»PubMed
  145. Lang NP, Zitzmann NU, Working Group 3 of the VIII European Workshop on Periodontology. Clinical research in implant dentistry: evaluation of implant-supported restorations, aesthetic and patient-reported outcomes. J Clin Periodontol 2012;39 Suppl 12:133-8 «PMID: 22533953»PubMed
  146. Salvi GE, Mischler DC, Schmidlin K ym. Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol 2014;41:701-7 «PMID: 24766602»PubMed
  147. Klinge B, Flemming T, Cosyn J ym. The patient undergoing implant therapy. Summary and consensus statements. The 4th EAO Consensus Conference 2015. Clin Oral Implants Res 2015;26 Suppl 11:64-7 «PMID: 26385621»PubMed
  148. Holm-Pedersen P, Lang NP, Müller F. What are the longevities of teeth and oral implants? Clin Oral Implants Res 2007;18 Suppl 3:15-9 «PMID: 17594366»PubMed
  149. Jansson H, Wahlin Å, Johansson V ym. Impact of periodontal disease experience on oral health-related quality of life. J Periodontol 2014;85:438-45 «PMID: 23895254»PubMed
  150. Shanbhag S, Dahiya M, Croucher R. The impact of periodontal therapy on oral health-related quality of life in adults: a systematic review. J Clin Periodontol 2012;39:725-35 «PMID: 22694297»PubMed
  151. Eberhard J, Jepsen S, Jervøe-Storm PM ym. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev 2015;4:CD004622 «PMID: 25884249»PubMed
  152. Graziani F, Cei S, Orlandi M ym. Acute-phase response following full-mouth versus quadrant non-surgical periodontal treatment: A randomized clinical trial. J Clin Periodontol 2015;42:843-52 «PMID: 26309133»PubMed
  153. von Troil B, Needleman I, Sanz M. A systematic review of the prevalence of root sensitivity following periodontal therapy. J Clin Periodontol 2002;29 Suppl 3:173-7; discussion 195-6 «PMID: 12787217»PubMed
  154. West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of professionally and self-administered agents. J Clin Periodontol 2015;42 Suppl 16:S256-302 «PMID: 25495777»PubMed
  155. Axelsson P, Nyström B, Lindhe J. The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. J Clin Periodontol 2004;31:749-57 «PMID: 15312097»PubMed
  156. Pastagia J, Nicoara P, Robertson PB. The effect of patient-centered plaque control and periodontal maintenance therapy on adverse outcomes of periodontitis. J Evid Based Dent Pract 2006;6:25-32 «PMID: 17138393»PubMed
  157. Rosling B, Serino G, Hellström MK ym. Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol 2001;28:241-9 «PMID: 11284537»PubMed
  158. Lee CT, Huang HY, Sun TC ym. Impact of Patient Compliance on Tooth Loss during Supportive Periodontal Therapy: A Systematic Review and Meta-analysis. J Dent Res 2015;94:777-86 «PMID: 25818586»PubMed
  159. Teles RP, Patel M, Socransky SS ym. Disease progression in periodontally healthy and maintenance subjects. J Periodontol 2008;79:784-94 «PMID: 18454656»PubMed
  160. Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008;35:277-90 «PMID: 18294231»PubMed
  161. Lafon A, Pereira B, Dufour T ym. Periodontal disease and stroke: a meta-analysis of cohort studies. Eur J Neurol 2014;21:1155-61, e66-7 «PMID: 24712659»PubMed
  162. Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol 2011;7:738-48 «PMID: 21709707»PubMed
  163. Preshaw PM, Alba AL, Herrera D ym. Periodontitis and diabetes: a two-way relationship. Diabetologia 2012;55:21-31 «PMID: 22057194»PubMed
  164. Gomes-Filho IS, Santos CM, Cruz SS ym. Periodontitis and nosocomial lower respiratory tract infection: preliminary findings. J Clin Periodontol 2009;36:380-7 «PMID: 19419436»PubMed
  165. Gomes-Filho IS, de Oliveira TF, da Cruz SS ym. Influence of periodontitis in the development of nosocomial pneumonia: a case control study. J Periodontol 2014;85:e82-90 «PMID: 24171504»PubMed
  166. de Melo Neto JP, Melo MS, dos Santos-Pereira SA ym. Periodontal infections and community-acquired pneumonia: a case-control study. Eur J Clin Microbiol Infect Dis 2013;32:27-32 «PMID: 22855366»PubMed
  167. Offenbacher S, Beck JD, Moss K ym. Results from the Periodontitis and Vascular Events (PAVE) Study: a pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. J Periodontol 2009;80:190-201 «PMID: 19186958»PubMed
  168. D'Aiuto F, Orlandi M, Gunsolley JC. Evidence that periodontal treatment improves biomarkers and CVD outcomes. J Clin Periodontol 2013;40 Suppl 14:S85-105 «PMID: 23627337»PubMed
  169. Teeuw WJ, Slot DE, Susanto H ym. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis. J Clin Periodontol 2014;41:70-9 «PMID: 24111886»PubMed
  170. Artese HP, Foz AM, Rabelo Mde S ym. Periodontal therapy and systemic inflammation in type 2 diabetes mellitus: a meta-analysis. PLoS One 2015;10:e0128344 «PMID: 26010492»PubMed
  171. Teeuw WJ, Gerdes VE, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care 2010;33:421-7 «PMID: 20103557»PubMed
  172. Fardal Ø, Grytten J. A comparison of teeth and implants during maintenance therapy in terms of the number of disease-free years and costs -- an in vivo internal control study. J Clin Periodontol 2013;40:645-51 «PMID: 23534343»PubMed
  173. Fardal Ø, Grytten J. Applying quality assurance in real time to compliant long-term periodontal maintenance patients utilizing cost-effectiveness and cost utility. J Clin Periodontol 2014;41:604-11 «PMID: 24666095»PubMed
  174. Martin JA, Fardal Ø, Page RC ym. Incorporating severity and risk as factors to the Fardal cost-effectiveness model to create a cost-benefit model for periodontal treatment. J Periodontol 2014;85:e31-9 «PMID: 24144268»PubMed
  175. Schwendicke F, Plaumann A, Stolpe M ym. Retention costs of periodontally compromised molars in a German population. J Clin Periodontol 2016;43:261-70 «PMID: 27001032»PubMed
  176. Schwendicke F, Graetz C, Stolpe M ym. Retaining or replacing molars with furcation involvement: a cost-effectiveness comparison of different strategies. J Clin Periodontol 2014;41:1090-7 «PMID: 25255893»PubMed
  177. Needleman I, McGrath C, Floyd P ym. Impact of oral health on the life quality of periodontal patients. J Clin Periodontol 2004;31:454-7 «PMID: 15142215»PubMed
  178. O'Dowd LK, Durham J, McCracken GI ym. Patients' experiences of the impact of periodontal disease. J Clin Periodontol 2010;37:334-9 «PMID: 20447256»PubMed
  179. Braegger U. Cost-benefit, cost-effectiveness and cost-utility analyses of periodontitis prevention. J Clin Periodontol 2005;32 Suppl 6:301-13 «PMID: 16128845»PubMed
  180. Gjermo PE. Impact of periodontal preventive programmes on the data from epidemiologic studies. J Clin Periodontol 2005;32 Suppl 6:294-300 «PMID: 16128844»PubMed
  181. Gaunt F, Devine M, Pennington M ym. The cost-effectiveness of supportive periodontal care for patients with chronic periodontitis. J Clin Periodontol 2008;35:67-82 «PMID: 18724842»PubMed
  182. Almomani F, Williams K, Catley D ym. Effects of an oral health promotion program in people with mental illness. J Dent Res 2009;88:648-52 «PMID: 19605879»PubMed
  183. Antczak-Bouckoms A, Joshipura K, Burdick E ym. Meta-analysis of surgical versus non-surgical methods of treatment for periodontal disease. J Clin Periodontol 1993;20:259-68 «PMID: 8473536»PubMed
  184. Atieh MA, Alsabeeha NH, Faggion CM Jr ym. The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodontol 2013;84:1586-98 «PMID: 23237585»PubMed
  185. Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol 2006;77:1465-82 «PMID: 16945022»PubMed
  186. Bergström J. Periodontitis and smoking: an evidence-based appraisal. J Evid Based Dent Pract 2006;6:33-41 «PMID: 17138394»PubMed
  187. Brand VS, Bray KK, MacNeill S ym. Impact of single-session motivational interviewing on clinical outcomes following periodontal maintenance therapy. Int J Dent Hyg 2013;11:134-41 «PMID: 23279918»PubMed
  188. Cascaes AM, Bielemann RM, Clark VL ym. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica 2014;48:142-53 «PMID: 24789647»PubMed
  189. Chambrone L, Preshaw PM, Rosa EF ym. Effects of smoking cessation on the outcomes of non-surgical periodontal therapy: a systematic review and individual patient data meta-analysis. J Clin Periodontol 2013;40:607-15 «PMID: 23590649»PubMed
  190. Chávarry NG, Vettore MV, Sansone C ym. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent 2009;7:107-27 «PMID: 19583037»PubMed
  191. Chiu SY, Lai H, Yen AM ym. Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35-44 years (KCIS No. 32). Acta Diabetol 2015;52:123-31 «PMID: 24990094»PubMed
  192. Corbella S, Francetti L, Taschieri S ym. Effect of periodontal treatment on glycemic control of patients with diabetes: A systematic review and meta-analysis. J Diabetes Investig 2013;4:502-9 «PMID: 24843701»PubMed
  193. Costa FO, Cota LO, Lages EJ ym. Periodontal risk assessment model in a sample of regular and irregular compliers under maintenance therapy: a 3-year prospective study. J Periodontol 2012;83:292-300 «PMID: 21692626»PubMed
  194. Demmer RT, Holtfreter B, Desvarieux M ym. The influence of type 1 and type 2 diabetes on periodontal disease progression: prospective results from the Study of Health in Pomerania (SHIP). Diabetes Care 2012;35:2036-42 «PMID: 22855731»PubMed
  195. Demmer RT, Papapanou PN, Jacobs DR Jr ym. Bleeding on probing differentially relates to bacterial profiles: the Oral Infections and Vascular Disease Epidemiology Study. J Clin Periodontol 2008;35:479-86 «PMID: 18400025»PubMed
  196. Dietrich T, Bernimoulin JP, Glynn RJ. The effect of cigarette smoking on gingival bleeding. J Periodontol 2004;75:16-22 «PMID: 15025212»PubMed
  197. Dietrich T, Kaye EK, Nunn ME ym. Gingivitis susceptibility and its relation to periodontitis in men. J Dent Res 2006;85:1134-7 «PMID: 17122168»PubMed
  198. Dietrich T, Sharma P, Walter C ym. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol 2013;40 Suppl 14:S70-84 «PMID: 23627335»PubMed
  199. Engebretson SP, Hyman LG, Michalowicz BS ym. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA 2013;310:2523-32 «PMID: 24346989»PubMed
  200. Fardal Ø, O'Neill C, Gjermo P ym. The lifetime direct cost of periodontal treatment: a case study from a Norwegian specialist practice. J Periodontol 2012;83:1455-62 «PMID: 22414260»PubMed
  201. Farina R, Tomasi C, Trombelli L. The bleeding site: a multi-level analysis of associated factors. J Clin Periodontol 2013;40:735-42 «PMID: 23713685»PubMed
  202. Fiorini T, Musskopf ML, Oppermann RV ym. Is there a positive effect of smoking cessation on periodontal health? A systematic review. J Periodontol 2014;85:83-91 «PMID: 23600995»PubMed
  203. Flemmig TF, Arushanov D, Daubert D ym. Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Periodontol 2012;83:444-52 «PMID: 21861637»PubMed
  204. Gao X, Lo EC, Kot SC ym. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodontol 2014;85:426-37 «PMID: 23805818»PubMed
  205. Godard A, Dufour T, Jeanne S. Application of self-regulation theory and motivational interview for improving oral hygiene: a randomized controlled trial. J Clin Periodontol 2011;38:1099-105 «PMID: 22092542»PubMed
  206. Hanioka T, Ojima M, Tanaka K ym. Causal assessment of smoking and tooth loss: a systematic review of observational studies. BMC Public Health 2011;11:221 «PMID: 21477320»PubMed
  207. Harrison R. Motivational interviewing (MI) compared to conventional education (CE) has potential to improving oral health behaviors. J Evid Based Dent Pract 2014;14:124-6 «PMID: 25234212»PubMed
  208. Heikkinen AM, Pajukanta R, Pitkäniemi J ym. The effect of smoking on periodontal health of 15- to 16-year-old adolescents. J Periodontol 2008;79:2042-7 «PMID: 18980511»PubMed
  209. Heitz-Mayfield LJ, Trombelli L, Heitz F ym. A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:92-102; discussion 160-2 «PMID: 12787211»PubMed
  210. Heitz-Mayfield LJ. How effective is surgical therapy compared with nonsurgical debridement? Periodontol 2000 2005;37:72-87 «PMID: 15655026»PubMed
  211. Hugoson A, Thorstensson H, Falk H ym. Periodontal conditions in insulin-dependent diabetics. J Clin Periodontol 1989;16:215-23 «PMID: 2785536»PubMed
  212. Hung HC, Douglass CW. Meta-analysis of the effect of scaling and root planing, surgical treatment and antibiotic therapies on periodontal probing depth and attachment loss. J Clin Periodontol 2002;29:975-86 «PMID: 12472990»PubMed
  213. Ioannou I, Dimitriadis N, Papadimitriou K ym. Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial. J Clin Periodontol 2009;36:132-41 «PMID: 19207889»PubMed
  214. Janket SJ, Baird AE, Chuang SK ym. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:559-69 «PMID: 12738947»PubMed
  215. Jansson H, Norderyd O. Evaluation of a periodontal risk assessment model in subjects with severe periodontitis. A 5-year retrospective study. Swed Dent J 2008;32:1-7 «PMID: 18540515»PubMed
  216. Jimenez M, Hu FB, Marino M ym. Type 2 diabetes mellitus and 20 year incidence of periodontitis and tooth loss. Diabetes Res Clin Pract 2012;98:494-500 «PMID: 23040240»PubMed
  217. Jönsson B, Ohrn K, Lindberg P ym. Evaluation of an individually tailored oral health educational programme on periodontal health. J Clin Periodontol 2010;37:912-9 «PMID: 20561115»PubMed
  218. Jönsson B, Ohrn K, Oscarson N ym. The effectiveness of an individually tailored oral health educational programme on oral hygiene behaviour in patients with periodontal disease: a blinded randomized-controlled clinical trial (one-year follow-up). J Clin Periodontol 2009;36:1025-34 «PMID: 19930092»PubMed
  219. Lalla E, Cheng B, Lal S ym. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol 2007;34:294-8 «PMID: 17378885»PubMed
  220. Lalic M, Aleksic E, Gajic M ym. Does oral health counseling effectively improve oral hygiene of orthodontic patients? Eur J Paediatr Dent 2012;13:181-6 «PMID: 22971253»PubMed
  221. Lang NP, Suvan JE, Tonetti MS. Risk factor assessment tools for the prevention of periodontitis progression a systematic review. J Clin Periodontol 2015;42 Suppl 16:S59-70 «PMID: 25496279»PubMed
  222. Leininger M, Tenenbaum H, Davideau JL. Modified periodontal risk assessment score: long-term predictive value of treatment outcomes. A retrospective study. J Clin Periodontol 2010;37:427-35 «PMID: 20507367»PubMed
  223. Li C, Lv Z, Shi Z ym. Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis. Cochrane Database Syst Rev 2014;8:CD009197 «PMID: 25123257»PubMed
  224. Liew AK, Punnanithinont N, Lee YC ym. Effect of non-surgical periodontal treatment on HbA1c: a meta-analysis of randomized controlled trials. Aust Dent J 2013;58:350-7 «PMID: 23981218»PubMed
  225. Lobene RR, Weatherford T, Ross NM ym. A modified gingival index for use in clinical trials. Clin Prev Dent 1986;8:3-6 «PMID: 3485495»PubMed
  226. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-51 «PMID: 14121956»PubMed
  227. López-Jornet P, Fabio CA, Consuelo RA ym. Effectiveness of a motivational-behavioural skills protocol for oral hygiene among patients with hyposalivation. Gerodontology 2014;31:288-95 «PMID: 23480201»PubMed
  228. Mai X, Wactawski-Wende J, Hovey KM ym. Associations between smoking and tooth loss according to the reason for tooth loss: the Buffalo OsteoPerio Study. J Am Dent Assoc 2013;144:252-65 «PMID: 23449901»PubMed
  229. Matuliene G, Studer R, Lang NP ym. Significance of Periodontal Risk Assessment in the recurrence of periodontitis and tooth loss. J Clin Periodontol 2010;37:191-9 «PMID: 20041980»PubMed
  230. Mauri-Obradors E, Jané-Salas E, Sabater-Recolons Mdel M ym. Effect of nonsurgical periodontal treatment on glycosylated hemoglobin in diabetic patients: a systematic review. Odontology 2015;103:301-13 «PMID: 25062756»PubMed
  231. Moëne R, Décaillet F, Andersen E ym. Subgingival plaque removal using a new air-polishing device. J Periodontol 2010;81:79-88 «PMID: 20059420»PubMed
  232. Morozumi T, Kubota T, Sato T ym. Smoking cessation increases gingival blood flow and gingival crevicular fluid. J Clin Periodontol 2004;31:267-72 «PMID: 15016254»PubMed
  233. Müller N, Moëne R, Cancela JA ym. Subgingival air-polishing with erythritol during periodontal maintenance: randomized clinical trial of twelve months. J Clin Periodontol 2014;41:883-9 «PMID: 25041441»PubMed
  234. Paulander J, Wennström JL, Axelsson P ym. Some risk factors for periodontal bone loss in 50-year-old individuals. A 10-year cohort study. J Clin Periodontol 2004;31:489-96 «PMID: 15191581»PubMed
  235. Pennington M, Heasman P, Gaunt F ym. The cost-effectiveness of supportive periodontal care: a global perspective. J Clin Periodontol 2011;38:553-61 «PMID: 21554375»PubMed
  236. Pretzl B, Wiedemann D, Cosgarea R ym. Effort and costs of tooth preservation in supportive periodontal treatment in a German population. J Clin Periodontol 2009;36:669-76 «PMID: 19566541»PubMed
  237. Ramseier CA, Mirra D, Schütz C ym. Bleeding on probing as it relates to smoking status in patients enrolled in supportive periodontal therapy for at least 5 years. J Clin Periodontol 2015;42:150-9 «PMID: 25469634»PubMed
  238. Rinke S, Ohl S, Ziebolz D ym. Prevalence of periimplant disease in partially edentulous patients: a practice-based cross-sectional study. Clin Oral Implants Res 2011;22:826-33 «PMID: 21198898»PubMed
  239. Roos-Jansåker AM, Renvert H, Lindahl C ym. Nine- to fourteen-year follow-up of implant treatment. Part III: factors associated with peri-implant lesions. J Clin Periodontol 2006;33:296-301 «PMID: 16553639»PubMed
  240. Rosa EF, Corraini P, Inoue G ym. Effect of smoking cessation on non-surgical periodontal therapy: results after 24 months. J Clin Periodontol 2014;41:1145-53 «PMID: 25265872»PubMed
  241. Rosa GM, Lucas GQ, Lucas ON. Cigarette smoking and alveolar bone in young adults: a study using digitized radiographs. J Periodontol 2008;79:232-44 «PMID: 18251656»PubMed
  242. Salvi GE, Ramseier CA. Efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis. A systematic review. J Clin Periodontol 2015;42 Suppl 16:S187-201 «PMID: 25495416»PubMed
  243. Schwarz F, Becker K, Sager M. Efficacy of professionally administered plaque removal with or without adjunctive measures for the treatment of peri-implant mucositis. A systematic review and meta-analysis. J Clin Periodontol 2015;42 Suppl 16:S202-13 «PMID: 25496187»PubMed
  244. Schätzle M, Löe H, Bürgin W ym. Clinical course of chronic periodontitis. I. Role of gingivitis. J Clin Periodontol 2003;30:887-901 «PMID: 14710769»PubMed
  245. Sgolastra F, Severino M, Pietropaoli D ym. Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials. J Periodontol 2013;84:958-73 «PMID: 23106512»PubMed
  246. Shiloah J, Patters MR, Waring MB. The prevalence of pathogenic periodontal microflora in healthy young adult smokers. J Periodontol 2000;71:562-7 «PMID: 10807119»PubMed
  247. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-35 «PMID: 14158464»PubMed
  248. Simpson TC, Needleman I, Wild SH ym. Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database Syst Rev 2010;5:CD004714 «PMID: 20464734»PubMed
  249. Sjödin B, Matsson L, Unell L ym. Marginal bone loss in the primary dentition of patients with juvenile periodontitis. J Clin Periodontol 1993;20:32-6 «PMID: 8421113»PubMed
  250. Sjödin B, Matsson L. Marginal bone loss in the primary dentition. A survey of 7-9-year-old children in Sweden. J Clin Periodontol 1994;21:313-9 «PMID: 8034775»PubMed
  251. Sjögren P, Nilsson E, Forsell M ym. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc 2008;56:2124-30 «PMID: 18795989»PubMed
  252. Stenman J, Lundgren J, Wennström JL ym. A single session of motivational interviewing as an additive means to improve adherence in periodontal infection control: a randomized controlled trial. J Clin Periodontol 2012;39:947-54 «PMID: 22845421»PubMed
  253. Stewart JE, Wolfe GR, Maeder L ym. Changes in dental knowledge and self-efficacy scores following interventions to change oral hygiene behavior. Patient Educ Couns 1996;27:269-77 «PMID: 8788355»PubMed
  254. Sun QY, Feng M, Zhang MZ ym. Effects of periodontal treatment on glycemic control in type 2 diabetic patients: a meta-analysis of randomized controlled trials. Chin J Physiol 2014;57:305-14 «PMID: 25575518»PubMed
  255. Tanner AC, Kent R Jr, Kanasi E ym. Clinical characteristics and microbiota of progressing slight chronic periodontitis in adults. J Clin Periodontol 2007;34:917-30 «PMID: 17877747»PubMed
  256. Tanner AC, Kent R Jr, Van Dyke T ym. Clinical and other risk indicators for early periodontitis in adults. J Periodontol 2005;76:573-81 «PMID: 15857098»PubMed
  257. Taylor GW, Borgnakke WS. Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 2008;14:191-203 «PMID: 18336370»PubMed
  258. Trombelli L, Tatakis DN, Scapoli C ym. Modulation of clinical expression of plaque-induced gingivitis. II. Identification of "high-responder" and "low-responder" subjects. J Clin Periodontol 2004;31:239-52 «PMID: 15016251»PubMed
  259. Tunkel J, Heinecke A, Flemmig TF. A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:72-81; discussion 90-1 «PMID: 12787208»PubMed
  260. Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol 1970;41:41-3 «PMID: 5264376»PubMed
  261. Wan CP, Leung WK, Wong MC ym. Effects of smoking on healing response to non-surgical periodontal therapy: a multilevel modelling analysis. J Clin Periodontol 2009;36:229-39 «PMID: 19236535»PubMed
  262. Wang X, Han X, Guo X ym. The effect of periodontal treatment on hemoglobin a1c levels of diabetic patients: a systematic review and meta-analysis. PLoS One 2014;9:e108412 «PMID: 25255331»PubMed
  263. Wennström JL, Dahlén G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol 2011;38:820-7 «PMID: 21736599»PubMed
  264. Yaacob M, Worthington HV, Deacon SA ym. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev 2014;6:CD002281 «PMID: 24934383»PubMed
Käypä hoito -suositukset ovat riippumattomia, tutkimusnäyttöön perustuvia kansallisia hoitosuosituksia. Lue lisää
OPI JA OTA KÄYTTÖÖN
KOOSTEET
POTILAALLE
MUUT SUOSITUKSET
YHTEISTYÖSSÄ
LINKKIEN TYYPIT JA VÄRIKOODIT
Kirjallisuusviite
Kuva
Linkki toiselle sivustolle
Lisätietoa
Näytönastekatsaus
PDF-tiedosto
PubMed-abstrakti
Taulukko