Rational approaches to the prevention of destructive periodontitis should be based on a clear understanding of etiology and pathogenesis. However, we are dealing with a heterogeneous family of diseases in which different factors operate. It is an oversimplification to regard poor oral hygiene, and hence an accumulation of non-specific dental bacterial plaque, as the major risk factor. Epidemiological evidence indicates that host factors are likely to be of overriding importance for the most severe forms. The limitations of non-specific plaque control are therefore discussed. Specific inhibitors of virulence factors provide a logical approach, but their clinical application awaits improved knowledge. Improvement of general health and resistance to disease by proper nutrition, the avoidance of intercurrent disease, and elimination of smoking and stress-induced risk are encouraged. The genetic basis of susceptibility to periodontitis is increasingly understood, and, while gene therapy is not likely to be a practicable approach to prevention, genetic markers of risk are emerging.
Get full access to this article
View all access options for this article.
References
1.
Adams D., Addy M. ( 1994). Mouthrinses. Adv Dent Res8 :291-301.
2.
Addy M., Moran J., Wade W. ( 1991). The evaluation of toothpaste products in promoting gingival health. In: Embery G, Rølla G, editors. Clinical and biological aspects of dentifrices. Oxford: Oxford University Press, 249-262.
3.
Addy M., Moran J., Wade W. ( 1994). Chemical plaque control in the prevention of periodontal disease. In: Lang NP, Karring T, editors. Proceedings of the European workshop on periodontal diseases. Berlin and London: Quintessence (in press).
4.
Alaluusua S., Asikainen S., Lai CH (1991). Intrafamilial transmission of Actinobacillus actinomycetemcomitans . J Periodontol62:207-210.
5.
American Academy of Periodontology (1989). Proceedings of the World Workshop in Clinical Periodontics, 1-1 to 1-4.
6.
Axelsson P., Lindhe J. (1981). Effects of controlled oral hygiene procedures on caries and periodontal disease in adults: Results after 6 years. J Clin Periodontol8:238-248.
7.
Axelsson P., Lindhe J., Nystrom B. (1994). Improvement of dental health status in adults-a 15 year cohort study. CommunityDent Oral Epidemiol (in press).
8.
Baelum V., Manji F., Fejerskov O. (1991). The distribution of periodontal destruction in the populations of non-industrialized countries: Evidence for the existence of high risk groups and individuals. In: Johnson NW, editor. Risk markers for oral diseases. Vol. III. Periodontal diseases: Markers for disease susceptibility and activity . Cambridge: Cambridge University Press, 27-75.
9.
Baker EG, Crook GH, Schwabacher E. (1961). Personality correlates of periodontal disease . J Dent Res40:396-403.
10.
Barr C., Lopez MR, Rua-Dobles A. (1992). Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men. J Clin Periodontol19:794-801.
11.
Barrett AJ, Saklatvala J. (1981). Proteinases in joint disease. In: Kelly WN, Harriss ED , Ruddy S, Sledge CB (editors). Textbook of rheumatology. Philadelphia: Saunders, 195-209.
12.
Becker BC, Karp CL, Becker W., Berg L. ( 1988). Personality differences and stressful life events. Differences between treated periodontal patients, with and without maintenance. J Clin Periodontol15:49-52.
13.
Bergstrom J. (1989). Cigarette smoking as a risk factor in chronic periodontal disease. Community Dent Oral Epidemiol17:245-247.
14.
Bergstrom J., Eliasson S., Preber H. (1991). Cigarette smoking and periodontal bone loss. J Periodontol62:242-246.
15.
Bosman CW, Powell RN (1971). The reversal of localised experimental gingivitis: A comparison between mechanical toothbrushing procedures and a 0.2% chlorhexidine mouthrinse. J Clin Periodontol64:161-172.
16.
Boughman JA, Beatty TH, Yang P., Goodman SB, Wootten RK, Suzuki JB (1988). Problems of genetic model testing in early onset periodontitis. J Periodontol59:332-337.
17.
Boughman JA, Astemborski JA, Suzuki JB (1992). Phenotypic assessment of early onset periodontitis in sibships. J Clin Periodontol19:233-239.
18.
British Dental Association (1991). Targets for oral health. The British Dental Association response to the Consultative Document for Health in England, 'The Health of the Nation'. London: British Dental Association.
19.
Burt BA ( 1991). The distribution of periodontal destruction in the populations of industrialized countries. In: Johnson NW , editor. Risk markers for oral diseases. Vol. III. Periodontal diseases: Markers of disease susceptibility and activity. Cambridge: Cambridge University Press, 9-26.
20.
Carman RJ, Ramakrishnan MD, Harper FH (1990). Porphyromonas gingivalis (Bacteroides gingivalis): Haemin levels in culture medium regulate both haemin binding and trypsin-like protease production. Infect Immun58 :4016-4019.
21.
Chandra RK (1991). Nutrition and immunity: Lessons from the past and new insights into the future. Am J Clin Nutr53:1087-1101.
22.
Chen Z., Potempa J., Polanowski A., Wikstrom M., Travis J. (1992). Purification and characterization of a 50-kDa cysteine proteinase (Gingipain) from Porphyromonas gingivalis. J Biol Chem267:18896-18898.
23.
Cohen AB, editor (1983). Proteases and antiproteases in the lung. Am Rev Resp Dis127:2-58.
24.
Creeth JE, Abraham PJ, Barlow JA, Cummins D. (1993). Oral delivery and clearance of antiplaque agents from Triclosan-containing dentifrices. Int Dent J43(Suppl 1):387-398.
25.
Curtis MA, Ramakrishnan M., Slaney JM (1993). Characterization of the trypsin-like enzymes of Porphyromas gingivalis W83 using a radiolabelled active-site-directed inhibitor . J Gen Microbiol138:949-955.
26.
Cummins D. (1991). Mechanisms of action of clinically proven anti-plaque agents. In: Embery G, Rølla G, editors. Clinical and biological aspects of dentifrices. Oxford: Oxford University Press, 205-228.
27.
Cutress TW, Powell RN, Ball ME ( 1982). Differing profiles of periodontal disease in two similar South Pacific island populations. Community Dent Oral Epidemiol10:193-203.
28.
Dahlen G., Lindhe J., Sato K., Hanamura H., Okamoto H. (1992). The effect of supragingival plaque control on the subgingival microbiota in subjects with periodontal disease. J Clin Periodontol19:802-809.
29.
Davies M., Barrett AJ, Travis J., Sanders E., Coles GA (1978). Evidence for the pathogenetic role of the polymorphonuclear leucocyte in glomerulonephritis. Clin Sci Molec Med54 :233-240.
30.
Davies RM (1992). Rinses to control plaque and gingivitis. Int Dent J42:276-280.
31.
Dinarello CA (1985). An update on human interleukin-1 from molecular biology to clinical relevance. J Clin Immunol5:287-297.
32.
Ebersole JL, Brunsvold M., Steffensen B., Wood R., Holt SC ( 1991). Effects of immunisation with Porphyromonas gingivalis and Prevotella intermedia on progression of ligature-induced periodontitis in the non-human primate Macaca fascicularis. Infect Immun59:3351-3359.
33.
Embery G., Waddington R. (1994). Gingival crevicular fluid: Biomarkers of periodontal tissue activity. Adv Dent Res8:329-336.
34.
Emrich LJ, Shlossman M., Genco RJ (1991). Periodontal disease in non-insulin-dependent diabetes mellitus. J Periodontol62:123-131.
35.
Enwonwu CO (1992). Nutritional diseases in the tropics. In: Prabhu SR, Wilson DF, Daftary DK, Johnson NW, editors. Oral diseases in the tropics. Oxford: Oxford University Press, 309-324.
36.
Evans RT, Klausen B., Sojar HT, Bedi GS, Sfintescu C., Ramamurthy NS, et al. (1992). Immunization with Porphyromonas (Bacteroides) gingivalis fimbriae protects against periodontal destruction. Infect Immun60 :2926-2935.
37.
Feldman RS, Szeto B., Chauncey HH, Goldhaber P. (1983). Non-steroidal anti-inflammatory drugs in the reduction of human alveolar bone loss. J Clin Periodontol10: 131-136.
38.
Fletcher JM, Wilson M. (1993). The effect of a redox agent, methylene blue, on the survival of Porphyromonas gingivalis in vitro. Curr Microbiol26:85-90.
39.
Gaffar A., Volpe A., Lindhe J. (1991). Recent advances in plaque/gingivitis control. In: Embery G, Rølla G, editors. Clinical and biological aspects of dentifrices . Oxford: Oxford University Press , 229-247.
40.
Genco RJ (1990). Classification and clinical and radiographic features of periodontal disease. In: Genco RJ, Goldman HM, Cohen DW , editors. Contemporary periodontics. St. Louis: Mosby, 63-81.
41.
Genco RJ, Loos BG ( 1991). The use of genomic DNA fingerprinting in studies of the epidemiology of bacteria in periodontitis. J Clin Periodontol18:396-405.
42.
Gilbert AD, Sofaer JA (1988). Host genotype, pathogenic challenge and periodontal bone loss in the mouse. Arch Oral Biol33:855-861.
43.
Goldhaber P., Giddon DB (1964). Acute necrotising ulcerative gingivitis: A study of some of the contributing factors and their validity in an Army population . Int Dent J14:346-358.
44.
Golub LM, Suomalainen K., Sorsa T. (1992). Host modulation with tetracyclines and their clinically modified analogues. Curr Opinion Dent2:80-90.
45.
Green LW, Tryon WW, Marks B., Huryn J. (1986). Periodontal disease as a function of life events stress. J Human Stress12:32-36.
46.
Griffiths GS, Wilton JMA, Curtis MA, Maiden MFJ, Gillett IR, Wilson DT, et al. (1988). Detection of high risk groups and individuals forperiodontal diseases: Clinical assessment of the periodontium. J Clin Periodontol15:403-410.
47.
Grimble RF (1990). Nutrition and cytokine action. Nutr Res Rev3:192-210.
48.
Haber J., Kent RL ( 1992). Cigarette smoking in a periodontal practice. J Periodontol63:100-106.
49.
Hanes PJ, Schuster GS, Lubas S. (1991). Binding, uptake, and release of nicotine by human gingival fibroblasts. J Periodontol62:147-152.
50.
Hart TC, Marazita ML, Schenkein HA, Diehl SR (1992). Re-interpretation of the evidence for X-linked dominant inheritance of juvenile periodontitis. J Periodontol63:169-173.
51.
HeasemanPA,Seymour RA (1989). The effect of systemicallyadministered non-steroidal anti-inflammatory drug (flurbiprofen) on experimental gingivitis in human. J Clin Periodontol16:551-556.
52.
Heaseman PA, Seymour RA, Boston PF (1989). The effect of a topical non-steroidal anti-inflammatory drug on the development of experimental gingivitis in man. J Clin Periodontol16:353-358.
53.
Heaseman PA, Benn DK, Kelly PJ, Seymour RA, Aitken D. (1993). The use of topical flurbiprofen as an adjunct to non-surgical management of periodontal disease. J Clin Periodontol20:457-464.
54.
Hillman JD, Socransky SS (1987). Replacement therapy for the prevention of dental disease. Adv Dent Res1:119-125.
55.
Hinode D., Hayashi H., Nakamura R. (1991). Purification and characterization of three types of proteases from culture supernatants of Porphyromonas gingivalis. Infect Immun59:3060-3068.
56.
Holmstrup P., WestergaardJ. (1994). HIV-associated periodontal diseases. In: Lang NP, Karring T, editors. European workshop on periodontology. Berlin and London: Quintessence (in press).
57.
Holt SC, Ebersole J., Felton J., Brunswold M., Komman KS (1988). Implantation of Bacteroides gingivalis in non-human primates initiates progression of periodontitis. Science239:55-57.
58.
Horning GM, Hatch CL, Cohen ME (1992). Risk indicators for periodontitis in amilitary treatment population. J Periodontol63:297-302.
59.
Hugoson A., Laurell L., Lundgren D. (1992). Frequency distribution of individuals aged 20-70 years according to severity of periodontal disease experience in 1973 and 1983. J Clin Periodontol19:227-232.
60.
Ismail AI, Burt BA, Eklund SA (1983). Relation between ascorbic acid intake and periodontal disease in the United States. J Am Dent Assoc107:927-931.
61.
Jeffcoat MK, Williams RC, Reddy MS, English R., Goldhaber P. (1988). Flurbiprofen treatment of human periodontitis: Effects on alveolar bone height and metabolism. JPeriodont Res23:381-385.
62.
Johnson NW (1989). Detection of high-risk groups and individuals for periodontal diseases. Int Dent J39:33-47.
63.
Johnson NW, editor (1991). Risk markers for oral diseases. Vol. III. Periodontal diseases: markers of disease susceptibility and activity. Cambridge: Cambridge University Press.
64.
Johnson NW (1993). Hygiene & health: The value of antiplaque agents in promoting oral health. Int Dent J43(Suppl) :375-386.
65.
Johnson NW (1994). Riskfactors and diagnostic tests. In: Lang NP, Karring T, editors. European workshop on periodontology. Berlin andLondon: Quintessence (in press).
66.
Johnson NW, Langmaid P. (1992). Periodontal conditions in Anguilla. Data supplied to the World Health Organisation Global Oral Data Bank , Geneva.
67.
Johnson NW, Griffiths GS, Wilton JMA, Maiden MFJ, Curtis MA, Gillett IR, et al. (1988). Detection of high risk groups and individuals for periodontal diseases: Evidence for the existence of high risk groups and individuals and approaches to their detection. J Clin Periodontol15:276-282.
68.
Johnson NW, Huws DA, Maiden MFJ, Griffiths GS (1992). Inflammatory periodontal diseases. In: Prabhu SR, Wilson DF, Daftary DK, Johnson NW, editors. Oral diseases in the tropics. Oxford: Oxford University Press, 598-633.
69.
Karsten RH, Renggli HH, Pilot T. (1992). The validation of the community periodontal index of treatment need (CPITN) in a study in the Netherlands. In: Pilot T, Purdell-Lewis D, editors. Guidelines for community periodontal care; report of WHO/FDI/Joint Working Group 10. London: FDI World Dental Press, 42-44.
70.
Katsanoulas T., Renee I., Attstrom R. (1992). The effect of supragingival plaque control on the composition of the subgingival flora in periodontal pockets. J Clin Periodontol19:760-765.
71.
Kenney EB, Kraal JH, Saxe SR, Jones J. (1977). The effect of cigarette smoke on human polymorphonuclear leucocytes. J Periodont Res12:227-234.
72.
Kinane DF, Cullen CF, Johnston FA, Evans CW (1989a). Neutrophil chemotactic behaviour in patients with early-onset forms of periodontitis. I. Leading front analysis in Boyden chambers. J Clin Periodontol16:242-246.
73.
Kinane DF, Cullen DF, Johnston FA, Evans CW (1989b). Neutrophil chemotactic behaviour in patients with early onset forms of periodontitis. II. Assessment using the under agarose technique. J Clin Periodontol16:247-251.
74.
Kinane DF, Jenkins WMM, Adonogianaki E. (1991). Cross-sectional assessment of caries and periodontitis risk within the same subject. Community Dent Oral Epidemiol19 :78-81.
75.
Komman KS (1986). The role of supragingival plaque in the prevention and treatment of periodontal diseases: A review of current concepts. J Periodont Res (Suppl16):5-22.
76.
Kornman KS, Blodgett RF, Brunsvold M., Holt SC ( 1990). Effects of topical applications of meclofenamic acid and ibuprofen on bone loss, subgingival microbiota and gingival PMN response in the primate Macaca fascicularis. J Periodont Res25:300-307.
77.
Lang NP, Karring T, editors (1994). European workshop in periodontology. Berlin: Quintessence (in press).
78.
Lang NP, Cumming BR, Loe H. (1973). Toothbrushing frequency as it relates to plaque development and gingival health. J Periodontol44:396-405.
79.
Lang NP, Adler R., Joss A., Nyman S. (1990). Absence of bleeding on probing: An indicator of periodontal stability. J Clin Periodontol17:714-721.
80.
Leggot PJ, Robertson PB, Jacob RA, Zambon JJ, Walsh M., Armitage GC (1991). Effects of ascorbic acid depletion and supplementation on periodontal health and subgingival microflora in humans. J Dent Res70:1531-1536.
81.
Lindhe J. (1986). In: Pathogenesis of gingivitis: General discussion . J Clin Periodontol13:359.
82.
Listgarten MA (1988). The role of dental plaque in gingivitis and periodontitis . J Clin Periodontol15:485-487.
83.
Loe H. (1986). Progression of natural untreated periodontal disease in man. In: Lehner T, Cimasoni G, editors. Borderland between caries and periodontal disease. Vol. III. Geneve: Medecine et Hygiene, 11-29.
84.
Loe H., Anerud A., Boysen H., Morrison E. (1986). Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan labourers 14 to 46 years of age. J Clin Periodontol13:431-440.
85.
Loesche WJ, Schmidt E., Smith BA, Caffesse R., Stoll J. (1987). Metronidazole therapy for periodontitis. J Periodont Res11:224-226.
86.
Loos B., Claffey N., Crigger M. (1982). Effects of oral hygiene measures on clinical and microbiological parameters of periodontal disease. J Clin Periodontol15:211-216.
87.
Lucey EC, Stone PJ (1982). Effect of chloromethylketone on progression of elastase induced emphysema in hamsters. Am Rev Resp Dis126:174-175.
88.
Marsh PD (1994). Microbial ecology of dental plaque and its significance in health and disease. Adv Dent Res8:263-271.
89.
Marsh PD, Bradshaw DJ (1993). Microbiological effects of new agents in dentifrices for plaque control. Int Dent J43(Suppl 1):399-406.
90.
McCullough C. (1994). Host enzymes in gingival crevicular fluid as diagnostic indicators of periodontitis. J Clin Periodontol (in press).
91.
McNabb H., Mombelli A., Lang NP ( 1992). Supragingival cleaning three times a week: The microbiological effects in moderately deep pockets. J Clin Periodontol19:348-356.
92.
Meyer J., Huynh C. (1991). Bacterial contamination, familial occurrence and periodontal disease. J Parodontol10:393-405.
93.
Michalowicz BS, Aeppli D., Virag JG, Klump DG, Hinrichs JE, Segal NL, et al. (1991). Periodontal findings in adult twins. J Periodontol62:293-299.
94.
Michie HR, Marogue KR, Spriggs DR, Revhang A., O'Dwyer S., Dinarello CA, et al. (1988). Detection of circulating tumour necrosis factor after endotoxin administration. N Engl J Med318:1481-1486.
95.
Miyazaki H., Pilot T., LeClercq M-H., Barmes DH (1991). Profiles of periodontal conditions in adults, measured by CPITN. Int Dent J41:74-80.
96.
Moses JH, Tsichti H., Donaldson P., Smith PB, Johnson NW, Bodmer J. (1994). HLA-A and susceptibility to juvenile periodontitis in Afro-Caribbeans. Tissue Antigens (in press).
97.
Moulton R., Ewen S., Thiesman W. (1952). Emotional factors in periodontal disease. Oral Surg Oral Med Oral Pathol5:830-860.
98.
Nakagawa T., Yamaeda S., Osuka Y., Saito A., Hosaka Y., Ischikawa T., et al. (1991). Clinical and microbiological study of local minocycline delivery (Periocline) following scaling and root planing in recurrent periodontal pockets. Bull Tokyo Dent Coll32:63-70.
99.
Offenbacher S., Odle BM, Van Dyke TE (1986). The use of crevicular fluid prostaglandin E2 levels as a predictor of periodontal attachment loss. J Periodont Res21:101-112.
100.
Offenbacher S., Braswell LD, Loos AS, Johnson HG, Hall CM, McClure H., et al. (1987). Effects of flurbiprofen on the progression of periodontitis in Macaca mulatta. JPeriodont Res22:473-481.
101.
Offenbacher S., Williams RC, Jeffcoat MK, Howell TH, Odle BM, Smith MA, et al. (1992). Effects of NSAIDs on beagle crevicular cyclooxygenase metabolites and periodontal bone loss. J Periodont Res27:207-213.
102.
Otogoto J.-1, Kuramitsu HK (1993). Isolation and characterization of the Porphyromonas gingivalis prtT Gene, coding for protease activity. Infect Immun61:117-123.
103.
Pedrazzoli V., Kilian M., Karring T. (1992). Comparative clinical and microbiological effects of topical subgingival application of metronidazole 25% dental gel and scaling in the treatment of adult periodontitis. J Clin Periodontol19:715-722.
104.
Pilot T. (1991). Implications of the high risk strategy and of improved diagnostic methods for health screening and public health planning in periodontal diseases. In: Johnson NW, editor. Risk markers for oral diseases. Vol. III. Periodontal diseases: Markers of disease susceptibility and activity. Cambridge : Cambridge University Press, 441-453.
105.
Pilot T., Miyazaki H., LeClercq M-H., Barmes DH (1992). Periodontal conditions in older age cohorts. Int Dent J42:23-30.
106.
Polenik P. (1994). Dietary zinc sulphate supplementation in therapy of adult periodontitis. 1. Clinical findings. J Clin Periodontol (in press).
107.
Potter RH (1989). Etiology of periodontitis: The heterogeneity paradigm . J Periodontol60:593-597.
108.
Potter RH (1990). Genetic studies of juvenile periodontitis. J Dent Res69:94-95.
109.
Preber H., Bergstrom J., Linder LE (1992). Occurrence of periopathogens in smoker and non-smoker patients. J Clin Periodontol19:667-671.
110.
Rise J., Sogaard AJ (1988). Effect of a mass media periodontal campaign upon preventive knowledge and behaviour in Norway. Community Dent Oral Epidemiol16:1-4.
111.
Robinson P. (1992). Periodontal diseases and HIV infection: A review of the literature. J Clin Periodontol19:609-614.
112.
Rølla G., Ellingsen JE, Gaare D. (1994). Polydimethylsiloxane as a tooth surface-bound carrier of triclosan-A new concept in chemical plaque inhibition. Adv Dent Res8:272-277.
113.
Russell AL (1962). Periodontal disease in well- and malnourished populations. Arch Environ Hlth5:153-157.
114.
Russell AL (1967). Epidemiology of periodontal disease. Int Dent J17:282-296.
115.
Russell RRB (1994). Control of specific plaque bacteria. Adv Dent Res8:285-290.
116.
Safkan-Seppala B., Ainamo J. (1992). Periodontal conditions in insulin-dependent diabetes mellitus. J Clin Periodontol19:24-29.
117.
Schnebli H-P., Braun NJ (1986). Proteinase inhibitors as drugs. In: Barrett AJ, Salvesen G, editors. Proteinase inhibitors: Research monographs in cell and tissue physiology. Vol. 12. Amsterdam and New York: Elsevier, 613-627.
118.
Scott CF, Whitaker EJ, Hammond BF, Colman RW (1993). Purification and characterization of a potent 70-kDa thiol lysyl-proteinase (Lys-gingivain) from Porphyromonas gingivalis that cleaves kininogens and fibrinogen. J Biol Chem268:7935-7942.
119.
Seppala B., Seppala M., Ainamo J. (1993). A longitudinal study on insulin-dependent diabetes mellitus and periodontal disease. J Clin Periodontol20:161-165.
120.
Sixou M., Duffaut Lagarrigue D., Lodter JP (1991). The distribution and prevalence of Haemophilus actinomycetemcomitans in the oral cavity. J Biol Buccale19:221-228.
121.
Slots J., Rams TE ( 1991). New views on periodontal microbiota in special patient categories. J Clin Periodontol18 :411-420.
122.
Smith KA (1988). Interleukin-2 : inception, impact and implications . Science240:1164-1176.
123.
Socransky SS, Haffajee AD (1992). The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol63:322-331.
124.
Sofaer JA (1990). Genetic approaches in the study of periodontal diseases. J Clin Periodontol17:401-408.
125.
Speirs RL (1992). Stress and the immune system. Dent Update2(Nov):388-394.
126.
Sutton RBO, Smales FC (1983). Cross-sectional study of the effects of immuno-suppressive drugs on chronic periodontal disease in man. J Clin Periodontol10:317-326.
127.
US Public Health Service (1986). Health consequences of using smokeless tobacco. Bethesda (MD): NIH Publication Number 86-2874.
128.
van der Ouderaa FJG (1991). Human clinical studies of antiplaque and anti-gingivitis agents dosed from a dentifrice. In: Embery G, Rølla G, editors. Clinical and biological aspects of dentifrices. Oxford : Oxford University Press, 181-204.
129.
van Steenbergen TJM, Petit MDA, Scholte LHM, van der Velden U., de Graaff J. (1993). Transmission of Porphyromonas gingivalis between spouses. J -Clin Periodontol20:340-345.
130.
van Winkelhoff AJ, Pavicic Mjamp, de Graaff J. (1994). Antibiotics in periodontal therapy. In: Lang NP, Karring T, editors. European Workshop on Periodontology. Berlin and London: Quintessence (in press).
131.
Waite IM, Saxton CA, Young A., Wagg BJ, Corbett M. (1981). The periodontal status of subjects receiving non-steroidal anti-inflammatory drugs. J Periodont Res17:90-100.
132.
Watanabe K. (1990). Prepubertal periodontitis: A review of diagnostic criteria, pathogenesis and differential diagnosis. J Periodont Res25:31-48.
133.
Willershausen B., Barth S., Preac Mursic V., Haslbeck M. (1991). The periodontal findings and microflora in insulin-dependent (type 1) diabetics. Schweiz Monatsschr Zahnmed101:1399-1404.
134.
Williams RC, Jeffcoat MK, Howell TH, Reddy MS, Johnson HG, Hall CM, etal. (1988a). Topical flurbiprofen treatment of periodontitis in beagles. J Periodont Res23:166-169.
135.
Williams RC, Jeffcoat MK, Howell TH, Reddy MS, Johnson HG, Hall CM, et al. (1988b). Ibuprofen: An inhibitor of alveolar bone resorption in beagles. J Periodont Res23 :225-229.
136.
Wilton JMA (1991). Unchanging subject-based risk factors: Race, sex, genetic, congenital and childhood systemic diseases. In: Johnson NW, editor. Risk markers for oral diseases. Vol. III. Periodontal diseases. Markers of disease susceptibility and activity. Cambridge: Cambridge University Press, 109-138.
137.
World Health Organisation/Federation Dentaire Internationale (1992). Guidelines for community periodontal care. London: FDI World Dental Press .
