Biomedical subjects

Christian Schwahn

Publications and source records attributed to Christian Schwahn.

32 records · Page 2Linked to original sources

PubMed2004

Caries and periodontal disease of the elderly in Pomerania, Germany: results of the Study of Health in Pomerania.

OBJECTIVE: The aim of this study was to describe the oral health status of older adults living in northeastern Germany. MATERIALS AND METHODS: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross-sectional, population-based study. Data on 1446 subjects aged 60-79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss. RESULTS: The prevalence of edentulousness varied from 16% in the 60-65-year-old group to 30% in the 75-79-year-old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60-65 years) to one in the oldest (75-79 years). Among subjects aged 60-69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70-79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70-79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60-69 years: 85% vs. 71% in 70-79-year-old men; women aged 60-69 years: 71% vs. 62% in 70-79-year-olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern. CONCLUSIONS: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.

Age Factors↗

PubMed2004

Plasma fibrinogen levels are associated with a strong family history of myocardial infarction.

Family history of myocardial infarction (MI) is a known risk factor for coronary artery disease (CAD). The aim of the present study was to investigate whether there is a specific risk factor profile for CAD in individuals with a strong family history of MI occurring at any age. The Study of Health in Pomerania is a cross-sectional, population-based study in the north-east of Germany. A random sample was drawn from the population aged 20-79 years. From 3793 subjects with siblings, 34 (0.9%) reported a history of MI in at least one parent and one sibling. We matched these cases with 136 controls (1 : 4 matching for age, sex and presence of sibling). We then compared cases and controls with respect to known risk factors for MI. Subjects with a dual parental and sibling history of MI had higher plasma fibrinogen levels (3.5 versus 3.0 g/l, respectively), and also more often angina pectoris than the matched controls (P < 0.05). Multivariable analysis revealed an independent association between dual parental and sibling history of MI and plasma fibrinogen levels. We conclude that plasma fibrinogen levels may indicate an inheritable risk for CAD in subjects with a strong family history of MI.

Adult↗

PubMed2004

Periodontal disease, but not edentulism, is independently associated with increased plasma fibrinogen levels. Results from a population-based study.

The systemic response to periodontal disease was analyzed in the cross-sectional Study of Health in Pomerania (SHIP). The completed data of 2,738 subjects aged 20 to 59 years were used for logistic regression analysis with an increased plasma fibrinogen level (> or =3.25 g/L according to Clauss) as the dependent variable. Participants were divided into four groups according to the number of periodontal pockets > or =4 mm (0, 1-7, 8-14, > or =15 pocketing). An additional group comprised the 52 edentulous subjects. The adjusted odds ratio (OR) of > or =15 periodontal pockets for increased plasma fibrinogen levels was 1.88 (95% CI: 1.25-2.83). Edentulism per se was not associated with increased plasma fibrinogen levels but was contained in a two-way interaction with the number of cigarettes/day in current smokers (p = 0.031). For edentulous nonsmokers the adjusted OR was 1.10 (95% CI: 0.51-2.39). Furthermore, body mass index, the interaction between gender and body mass index, serum LDL cholesterol, medication, the interaction between LDL cholesterol and medication, aspirin, smoking, school education, chronic bronchitis, and the interaction between alcohol consumption and chronic gastritis were associated with plasma fibrinogen levels. Our results show that periodontal disease but not edentulism per se is associated with an increased plasma fibrinogen level.

Adult↗

PubMed2004

Prevalence of signs and symptoms of temporomandibular disorders in an urban and rural German population: results of a population-based Study of Health in Pomerania.

OBJECTIVE: Based on a randomized, population study (Study of Health in Pomerania [SHIP]), the objective of the present study was to determine incidence of signs and symptoms of temporomandibular disorders (TMD) in adults 20 years or older and to compare the data with TMD prevalence of other exclusively random sample studies that fulfilled criteria similar to those of this study (age > or = 20 years, age range > or = 40 years, sample size > or = 500 subjects, equal gender distribution). METHOD AND MATERIALS: Men and women (n = 7,008) 20 to 79 years of age from mid- and small-sized towns in a rural region in northeast Germany were randomly sampled from resident registry office files. The response rate was 68.8%. Adults between the ages of 20 and 81 years (n = 4,289) were clinically and anamnestically examined. RESULTS: Half of the subjects (49.9%) had one or more clinical signs of TMD, but only 2.7% were subjectively aware of temporomandibular joint (TMJ) pain symptoms. Women showed higher frequency for all signs and symptoms of TMD than men. However, these differences were not significant for all signs and symptoms in all age groups. The influence of age on TMD signs and symptoms was less pronounced. The prevalence for the following variables found in the present study compared to those of other comparable, random sample studies was: clinical examination; (TMJ) tenderness to palpation (5% versus 2% to 6%); masticatory muscle tenderness (15% versus 19% to 21%); joint sounds (25% versus 15% to 25%); limited maximum mouth opening < 40 mm (9% versus 5% to 8%); pain upon movement of the mandible (1% versus 1% to 3%); irregular jaw movements (deviation, deflection) (28% versus 28%); interview: subjective joint sounds (9% versus 11% to 13%); and subjective TMJ pain (3% versus 4% to 7%). CONCLUSION: The TMD incidence in the current study agreed quite well with the other studies based on random samples with similar subjects and design. The large range of prevalence for signs and symptoms of TMD documented in reviews and meta-analyses could therefore not be confirmed.

Adult↗

PubMed2003

The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area.

OBJECTIVE: The aim of the present study was to analyze the current status of morphologic and functional thyroid abnormalities in a previously iodine-deficient area. METHODS: The population based Study of Health in Pomerania (SHIP) comprised 4310 participants, aged 20-79 years. Thyroid function (thyrotropin [TSH] free triiodothyronine [FT(3)], and free thyroxine [FT(4)]) and serum autoantibodies to thyroperoxidase (TPOAb) were evaluated from blood samples. Thyroid structure and size were measured by ultrasound. Data from 3941 participants with no known thyroid disorders were analyzed. RESULTS: The median iodine urine excretion was 12.4 microg/dL. The rate of decreased serum TSH levels (<0.3 mIU/L) was 11.3%; 2.2% of participants had suppressed serum TSH levels (<0.1 mIU/L). The prevalence of subclinical hyperthyroidism was 1.8%, the prevalence of overt hyperthyroidism 0.4%. Elevated TSH levels were found in 1.2% of individuals. Subclinical hypothyroidism was observed in 0.5%, overt hypothyroidism in 0.7% of the sample. Elevated TPOAb were detected in 7% of subjects, 4.1% of participants had TPOAb greater than 200 IU/mL. The prevalence of goiter was 35.9%. An inhomogeneous echo pattern was detected in 35.2% and nodules in 20.2% of participants. Diffuse autoimmune thyroiditis was diagnosed in 47 subjects (1.2%). CONCLUSION: There are a number of thyroid disorders in this previously iodine-deficient region. Further studies are required to investigate the change of thyroid disorders during iodine supplementation programs.

Adult↗

PubMed2003

Preoperative plasma fibrinogen levels predict mortality after coronary artery bypass grafting.

This study was designed to investigate whether plasma fibrinogen levels as well as the beta-fibrinogen -455 G/A genotype are associated with outcome after coronary artery bypass graft (CABG) operation. We enrolled 249 consecutive CAD patients one day before they underwent a CABG operation. Data from 220 patients with available plasma fibrinogen levels were analyzed. The primary end-point was total mortality, the secondary end-point mortality from cardiac causes or the need for myocardial revascularization. The 2-year total mortality was 9.1% in the entire cohort. Multivariable analysis revealed an independent relationship between the primary end-point and preoperative plasma fibrinogen levels but not the beta-fibrinogen -455 G/A genotype. Neither preoperative plasma fibrinogen levels nor the beta-fibrinogen -455 G/A genotype could predict the secondary end-point. We conclude, that elevated preoperative plasma fibrinogen levels, but not the beta-fibrinogen -455 G/A genotype predict the total mortality after CABG operation.

Adult↗

PubMed2002

Angiotensin I-converting enzyme insertion/deletion polymorphism and cardiac mortality and morbidity after coronary artery bypass graft surgery.

STUDY OBJECTIVES: This study was designed to evaluate whether the insertion (I)/deletion (D) polymorphism of the angiotensin I-converting enzyme (ACE) gene is associated with mortality and cardiac morbidity after coronary artery bypass graft surgery (CABG). METHODS AND RESULTS: The ACE I/D genotype was determined in 249 consecutive patients who underwent CABG. Follow-up information (after 2 years) was obtained in 247 patients (99.2%). The primary end point was total mortality; the secondary end point was mortality from cardiac reasons, or the need for myocardial revascularization (coronary angioplasty or recurrent CABG) during follow-up. At follow-up, total mortality was 9.7% (all patients). None of the 51 patients with the ACE II genotype, 14 of 125 patients with the ACE ID genotype (11.2%), and 10 of 71 with the ACE DD genotype (14.1%) died during follow-up (p < 0.05). The ACE DD genotype, older age, diabetes mellitus, decreased left ventricular ejection fraction, and lack of internal mammary artery graft were independently related to an increased mortality after CABG. The incidence of the secondary end point was 14.5% (all patients): ACE II, 5.8%; ACE ID, 9.4%; ACE DD, 30.3% (p < 0.05). The ACE DD genotype and the presence of a left main coronary artery stenosis >or= 50% were independent predictors for the secondary end point. CONCLUSION: The ACE DD genotype is associated with increased midterm mortality and cardiac morbidity after CABG.

Adult↗

PubMedDate not supplied

Menopause and determinants of quality of life in women at midlife and beyond: the study of health in pomerania (SHIP).

OBJECTIVE: Determinants of quality of life (QoL) in pre- and postmenopausal women including nonhormonal modulators of QoL in adult women are not well understood; there is an ongoing controversy about the impact of menopause on health-related QoL. We investigated the extent to which diverse mental and physical symptoms are associated with (a) menopausal status; (b) sociodemographic, psychosocial, and lifestyle factors; and (c) menopausal hormone therapy (MHT) in adult women after the German reunification in a region of the former German Democratic Republic. DESIGN: The Study of Health in Pomerania is a cross-sectional, population-based survey. Computer-based structured interviews and self-administered questionnaires were used to capture QoL (Zerssen Symptom List) and sociodemographic parameters, psychosocial, and lifestyle indicators (age, socioeconomic status, abuse, social support, nutrition, body mass index, self-rated health, chronic diseases, and use of MHT) in 1,119 pre- and postmenopausal women with an intact uterus. RESULTS: Analyses suggest that menopausal status was not associated with QoL. MHT was associated with physical, mental, and gastrointestinal symptoms. Age was a significant predictor for cardiopulmonary symptoms and sensory impairment. The relationship between age and both physical and mental complaints was inverse as was the relationship between age and both mood and gastrointestinal symptoms. Age, socioeconomic status, physical and sexual abuse, perceived social support, nutrition, body mass index, self-rated health, chronic diseases, and MHT modulated QoL. CONCLUSIONS: Our findings do not support the hypothesis that QoL is reduced after menopause. Differences between pre- and postmenopausal women can be explained by sociodemographic, psychosocial, and lifestyle factors.

Affect↗

PubMedDate not supplied

Prosthodontic status among old adults in Pomerania, related to income, education level, and general health (results of the Study of Health in Pomerania, SHIP).

PURPOSE: The aim of the study was to evaluate associations among prosthetic status, socioeconomic factors, and general health of subjects aged 55 to 79 years. The data were taken from the Study of Health in Pomerania (SHIP). MATERIALS AND METHODS: Socioeconomic information (age, sex, education level), medical information (number of diseases), and details on smoking and alcohol consumption were obtained. Prosthetic status in the maxilla and mandible was classified into complete denture (CD), removable partial denture (RPD), > or = 10 natural teeth or teeth replaced with fixed prosthodontics (10T+), and < or = nine natural teeth including fixed prosthodontics (9T-). RESULTS: The data of 1,877 subjects were evaluated. CDs in the maxilla were more frequent than in the mandible. RPDs were more frequent in the mandible and in the group aged 65 to 74 years. Of the individuals with a low education level, 47% had a CD in the maxilla, and only 21% had 10T+. However, of subjects with a high education level, 22% had a CD in the maxilla, and 54% had 10T+. The odds ratio of having a CD in the maxilla increased to 11.9 at the age of 75 to 79 years, compared to 0.6 at the age of 55 to 59 years. Logistic regression analyses showed that the risk of wearing a CD was significantly associated with old age, low education level, low income, smoking, and alcohol abuse, whereas the number of diseases (used as an indicator of general health) was not. CONCLUSION: Alcohol abuse, smoking, low education level, low income, and old age were significant predictors of wearing CDs.

Age Factors↗

PubMedDate not supplied

Study of Health in Pomerania (SHIP): Relationship among socioeconomic and general health factors and dental status among elderly adults in Pomerania.

OBJECTIVE: The aim of this study was to evaluate associations among the dental status, socioeconomic factors, and general health of 1,877 subjects between the ages of 55 and 79. METHOD AND MATERIALS: Socioeconomic information (age, sex, education level) and questions on smoking and alcohol abuse were taken from an interview; income and medical information (number of diseases) were taken from a self-administered questionnaire; and HbA1C and CDT (diabetes and alcoholism markers) were taken from blood analyses. RESULTS: Of the subjects, 73% had a low education level, and 27% of the subjects had a monthly income of < 1,000 Euro and 13% of > 2,000 Euro. Twenty-six percent of the subjects were edentulous, and 29% had 20 or more teeth. The odds ratio of edentulism increased to 9.0 (95% confidence interval = 7.0-11.5) at the ages of 75 to 79 years compared to ages 55 to 79. Logistic regression analyses showed that edentulism was significantly associated with age, low education level, low income, smoking, and alcohol abuse. However, the retention of more than 20 teeth was associated with age. CONCLUSIONS: Age, low income, low education level, smoking, and alcohol abuse seemed to be risk markers for edentulism; whereas, the number of diseases, diabetes, and gender were not.

Age Distribution↗

PubMedDate not supplied

Risk factors for high occlusal wear scores in a population-based sample: results of the Study of Health in Pomerania (SHIP).

PURPOSE: Using a population-based sample of the cross-sectional epidemiologic "Study of Health in Pomerania" (SHIP), this study evaluated whether certain occlusal and sociodemographic factors besides age and gender are risk factors for high dental wear. MATERIALS AND METHODS: Medical history and dental and sociodemographic parameters of 2,529 dentate subjects selected representatively and according to age distribution were checked for correlations with the occurrence of high occlusal wear symptoms using a multivariate logistic regression model. Occlusal wear was recorded using the attrition index by Ekfeldt et al and was age adjusted by determining high occlusal wear for every 10-year age group as index values > or = 90th percentile. RESULTS: The following independent variables were found to be correlated with high occlusal wear: male gender, odds ratio 2.2; frequent bruxism, odds ratio 2.5; loss of molar occlusal contact (Eichner classification), odds ratio from 1.5 to 3.1; edge-to-edge relation of incisors, odds ratio 1.7; unilateral buccolingual cusp-to-cusp relation, odds ratio 1.8; and unemployment, odds ratio 1.6. In contrast, anterior cross-bite, unilateral posterior cross-bite, and anterior crowding were protective for high occlusal wear levels, as shown by significantly reduced odds ratios. Gender-separated analysis showed that self-reported bruxism was a risk factor only for men. CONCLUSION: In addition to some occlusal factors, the main factors associated with occlusal wear were bruxism and gender.

Adult↗

PubMedDate not supplied

Gender differences in associations between occlusal support and signs of temporomandibular disorders: results of the population-based Study of Health in Pomerania (SHIP).

PURPOSE: The aim of this study was to investigate whether gender-dependent associations exist between signs of temporomandibular disorders (TMD) and occlusal support. MATERIALS AND METHODS: Stratified by gender, the data of 2,963 35- to 74-year-old participants from the epidemiologic Study of Health in Pomerania were used in logistic regression analyses with temporomandibular joint (TMJ) tenderness and muscle tenderness as the dependent variables. Occlusal support was classified according to the Eichner index, a classification system based on occluding pairs of teeth. The final model was adjusted for bruxism, age, and various sociodemographic data. RESULTS: Logistic regression analyses revealed increased odds ratios for TMJ tenderness in men with loss of all four molar and premolar supporting zones (odds ratio 3:9) and without antagonist contact (odds ratio 2:7). Significant relationships in men were also found between muscle tenderness and loss of one (odds ratio 2:1), three (odds ratio 2:1), or four supporting zones (odds ratio 2:7), and loss of any tooth contact (odds ratio 2:3). In women, significant associations between occlusal support and TMD signs were absent. Subjects with bruxism were more likely to have TMJ tenderness (odds ratio women 2:0, men 1:9). In women, an additional relationship existed between bruxism and muscle tenderness (odds ratio 1:7). The following habits showed no significance: gum chewing, unilateral chewing, and lip/tongue/cheek biting. CONCLUSION: Only in men was the loss of occlusal support significantly associated with muscle and TMJ tenderness. The association between bruxism and TMD signs supports the theory that repetitive adverse loading of the masticatory system may cause functional disturbances.

Adult↗

PubMedDate not supplied

The impact of tooth loss on general health related to quality of life among elderly Pomeranians: results from the study of health in Pomerania (SHIP-O).

PURPOSE: It is important to know whether tooth loss has an impact on an individual's quality of life, since tooth loss is common. The aim of this study was to determine whether oral status is associated with general health and related to quality of life. MATERIALS AND METHODS: Data of 1,406 subjects aged 60 to 79 years were taken from the Study of Health in Pomerania (SHIP). Sociodemographic (age, sex, and education level) and medical information (including the most common diseases in Germany) were gathered through an interview, and income data were obtained from a self-administered questionnaire. The prosthetic status in the maxilla and mandible was classified into complete denture or removable partial denture or with > or = 10 natural teeth including teeth replaced with fixed prosthodontics (> or = 10T) or with < or = 9 natural teeth including fixed prosthodontics (< or = 9T). The health-related quality of life was measured using the Short Form (SF-12) questionnaire. Multiple linear logistic regression analyses were used to identify the nonstandardized beta coefficient using physical and psychologic indices from the SF-12 as dependent variables and sociodemographic information, prosthetic status, and disease state as independent variables. RESULTS: Prosthetic status is related to the physical scale of the SF-12. Additionally, we found that < or = 9T had a significant effect on the physical index of general health-related quality of life. CONCLUSION: Reduced dentition without replacement of missing teeth by removable or fixed prosthodontics reduces the physical index of quality of life to the same extent as cancer or renal diseases.

Aged↗

PubMedDate not supplied

Private practice results of screw-type tapered implants: survival and evaluation of risk factors.

PURPOSE: The aims of this study were to examine the long-term survival and the prosthetic treatment outcome of screw-type, tapered implants placed in a private practice setting and to explore potential risk factors of implant failures. MATERIALS AND METHODS: In this retrospective analysis of patients treated with endosseous screw-type tapered implants, data relative to implant placement and failure, implant length, location, prosthetic treatment, medical history, smoking habits, and oral health behavior were gathered by chart review and questionnaire. An oral examination was also conducted. Cumulative survival rates were estimated through Kaplan-Meier methods. Comparisons between subgroups of patients were made using the log-rank statistical test. The association between several factors and implant failures was analyzed using Cox regression analyses (random and dependent models). Differences were considered significant when P < .05. RESULTS: The survival rate of 663 implants placed in 159 patients (65 men, 94 women; 80.7% of 197 eligible patients) was 91.8% after 120 months. Mandibular implants had a higher survival rate than maxillary implants (96% versus 89%, P = .011). The failure rates for implants were 15.0% among current smokers, 9.6% among former smokers, and 3.6% among nonsmokers. The differences between nonsmokers, former smokers, and current smokers were significant (nonsmokers versus former smokers: P = .036, nonsmokers versus current smokers: P < .001, former smokers versus current smokers: P = .003). Only number of years of smoking was significantly associated with an increased risk of implant failures (P = .036 using dependent estimation; P = .004 using independent estimation). The HR increased to 6.6 for patients who had smoked for 45 years. Loosening of prosthetic components were rare (n=12). No fractures of screws or implants were found. DISCUSSION: Higher failure rates for former smokers and a dose-response effect between duration of smoking and implant failure rates suggested that permanent tissue damage from smoking may occur in addition to immediate local and systemic effects. The frequency of prosthetic complications was comparable to other studies. CONCLUSIONS: Screw-type tapered implants placed in a private dental office demonstrated a cumulative survival rate of 91.8%. The relative risk of implant failure increased with the duration of smoking.

Adolescent↗