Search

The general acceptance and use of the CPITN system worldwide has provided, in a very short time, a vast amount of data on periodontal diseases. This data has been entered into the WHO Global Oral Data Bank, from which, after analysis, much valuable information has been derived. Overall the CPITN system is seen as having more than fulfilled the initial hopes invested in it. It has provided a simple yet effective method for measuring and monitoring the magnitude, prevalence and severity of periodontal diseases throughout the world, as well as helping in our understanding of the disease process.

Results of more than 80 CPITN surveys from almost 30 countries for the age groups of 45 years and above are assembled. In this first overview, data for the older age cohorts are presented, showing the percentages of persons according to the highest score per person and the mean numbers of sextants affected per person. Results for three age groups are presented: 45-54, 55-64 and 65-74 years, with two additional surveys in older persons. There were marked variations in periodontal conditions between surveys. The assumed differences between industrialized and non-industrialized countries with regard to periodontal diseases did not show in the data examined. Also, the expected increase in periodontal destruction with increasing age was not reflected in values for pocketing or deep pocketing in the successive age groups. Some variations between surveys was also noted for the rate of tooth loss, expressed in the mean number of excluded CPITN sextants. However, on average, at age 50, almost one sextant was excluded, increasing to 1.5 sextants at 60 and almost 2.5 sextants at age 70. It is therefore suggested that the progress of periodontal destruction with age is not shown in an increase in periodontal CPITN scores, but in increased tooth loss, specified by an increasing number of excluded CPITN sextants. For the age group 65-74 years, this results in, on average, almost half of all sextants being excluded. Of the remaining sextants, approximately half had shallow and/or deep pockets.

The aim of the present overview is to evaluate the periodontal conditions in European populations. Study was made of a number of extensive surveys of periodontal diseases carried out in a number of European countries, primarily North West Europe. These surveys often provide considerable detail. However, international comparisons are difficult to perform because of the different methods applied. Therefore, the latest overviews of results of periodontal surveys, based on the CPITN method and stored in the WHO Global Oral Data Bank, are given for the age groups 15-19 years and 35-44 years. Based on this approach, the conclusions are as follows. Trends and prevalences in periodontal health and disease in Europe are clear, at least up to the age of 60 year. Severe periodontal destruction seems to be a limited problem, seldom leading to tooth loss before age 50 and certainly not a major cause of edentulousness before age 60. For a large majority, in most of the populations observed, the progress of periodontal destruction seems to be compatible with the retention of a natural, functioning dentition into older age. However, the periodontal problem might still be of considerable magnitude and importance as bleeding on probing is widely encountered in the younger age groups. Furthermore, 5-15% of populations affected by a serious, irreversible condition at age 40 years is high, compared with most other diseases.

Results of more than 100 CPITN surveys from over 60 countries for the age group 15-19 years, stored in the WHO Global Oral Data Bank as of 1 August 1990, are assembled. They are presented in the form of graphs showing the mean number of sextants affected per person and arranged by country according to WHO regions. It is hoped that these overviews provide a frame of reference for the evaluation of periodontal conditions in populations and population subgroups. The most frequently observed condition in adolescents was score 2 (calculus with or without bleeding). Calculus seems to be much more prevalent in non-industrialized than in industrialized countries. Although some shallow pocketing of 4 or 5 mm was present in two-thirds of all populations observed, it affected mostly only a minority of the sample and then only in one or two sextants. However, a few surveys showed a relatively high prevalence of pocketing. As the surveys were carried out in adolescents, such high figures indicate serious problems ahead.

Results of almost 100 CPITN surveys in more than 50 countries for the age group 35-44 years, stored in the WHO Global Oral Data Bank as of 1 August 1990, are assembled. They are presented in the form of graphs showing the percentages of persons according to the highest score per person and arranged by country according to WHO regions. It is hoped that these overviews provide a frame of reference for the evaluation of periodontal conditions in populations and population subgroups. Calculus and shallow pocketing were the most frequently observed conditions. With a few exceptions, the percentages of persons and the mean number of sextants per person with deep pockets were small to very small. The assumed differences between industrialized and non-industrialized countries with regard to periodontal health were not reflected in the survey data examined. Severe periodontal destruction seems to be a limited problem, seldom leading to tooth loss before the age of 50. For the large majority in most of the populations observed, the progress of periodontal diseases seems to be compatible with the retention of a natural dentition into older age. Nevertheless, the periodontal problem is of considerable magnitude and importance, as 5-20 per cent of populations are affected by a serious, irreversible condition at the age of 40, which is a high percentage compared with almost every other disease that afflicts mankind.

HLA-matched bone marrow transplantation from related or unrelated donors appears to be effective. To supply HLA-matched bone marrow for patients who do not have HLA-matched family donors, registration of unrelated HLA-typed donors and selection of matched donors will be necessary. In this study, the frequencies of each possible HLA phenotype and of corresponding, potentially matched donors were calculated by a computer from the table of frequencies of HLA-A, -B, and -DR haplotypes using data from 300 families in Japan and from the Eighth International Histocompatibility Workshop for European and North American whites. Appropriate sizes of such donor pools were evaluated theoretically in the Japanese population and in European and North American whites. To enable more than 80 percent of patients to have at least one identical donor, only 50,000 potential donors would be necessary for Japanese persons, whereas 1,000,000 and 400,000, respectively, would be required for European and North American whites.