Links to research studies and other source documents used to develop the Guidelines and to supporting studies published since the release of the Guidelines...

Resource List for the AAP Guidelines

Research studies and other source documents used to prepare the Guidelines for the Management of Patients With Periodontal Diseases.

The following materials were used to develop the AAP's Guidelines for the Management of Patients With Periodontal Diseases Can't open this PDF page? Download Acrobat Reader. Also included are supporting studies that have been published since the release of the Guidelines.

The research represents sources both within and outside of dentistry, including research with the AAP membership, and diverse articles in the areas of guidelines, periodontal maintenance, regeneration, moderate to severe periodontal disease, risk assessment, periodontal-systemic links and referral patterns.

Research with AAP Membership

Three sources of internal research contributed to developing the Guidelines. Specifically, in 2005 the AAP conducted an extensive focus group evaluation of over 100 AAP members, in ten locations throughout the United States. This focus group process asked questions about the practice of periodontics, including patient care, relationships with referring colleagues, technology, technique, and tools. This qualitative evaluation informed the Academy’s understanding of the current environment for a practicing periodontist in the United States.

Secondly, data from the Academy’s Practice Profile Survey was used to develop the Guidelines. This tri-annual survey began in 1997, and data from all surveys was used. This comprehensive survey of periodontal practice evaluated the profiles of practice characteristics including organizational structure, referral patterns, treatment procedures performed, patient characteristics, and demographic data. This information allowed the Academy to identify and understand the needs and concerns of members in clinical practice. This information, as collected, provides a benchmark for members to understand how their practice compares to others. Twenty-five hundred questionnaires were mailed to a random sample of Active AAP members across the country. Follow up post-cards were mailed 2 months after the initial mailing, encouraging response. The survey response rates averaged 34.7%, with a distribution across districts which matched Academy demographics. Therefore, the survey samples did reflect the Academy membership for demographic characteristics.

Thirdly, a membership survey is sent annually to all 8,000 Academy members. This survey collects further information on demographic and practice characteristics, which informs the Academy’s strategy when providing services to its members. This information was also used to develop the Guidelines.

Clinical Guidelines

Endodontic Case Difficulty Assessment and Referral. The American Association of Endodontics. Spring/Summer 2005.

Starr CB, Collins JF. Determining When to Refer Periodontal Patients: Clinical Guidelines. Gen Dent 1999;July-Aug:381-384.

The American Association of Clinical Endocrinologists Medical Guidelines for the Management of Diabetes Mellitus: The AACE System of Intensive Diabetes Self-Management—2002 Update. American Association of Clinical Endocrinologists, American College of Endocrinology. Endocrine Practice 2002;8(Suppl.1).

American Academy of Periodontology. Position Paper: Guidelines for Periodontal Therapy. J Periodontol 2001;72(11):1624-1628.

American Academy of Periodontology. Parameters of Care. J Periodontol 2000;71(5) suppl.:847-883.

General Research

American Academy of Periodontology. Annals of Periodontology 2003: 8(1):i-i;1-352.*

*The Annals provide an extensive body of literature, which was consulted during the development of the Guidelines.

Periodontal Maintenance

Preshaw PM, Heasman PA: Periodontal maintenance in a specialist periodontal clinic and in general dental practice. J Clin Periodontol 2005;32:280–286.

Lang NP, Lindhe J, van der Velden U on behalf of the European Workshop in Periodontology group D. Advances in the prevention of periodontitis. Consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol 2005;32 (Suppl.6):291–292.

Cohen RE, Research, Science and Therapy Committee, American Academy of Periodontology. Position Paper: Periodontal Maintenance. J Periodontol 2003 ;74(9):1395-401.

Axelsson P, Nystrom 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(9):749-57.

Regeneration

Sculean A, Schwarz F, Miliauskaite A, Kiss A, Arweiler N, Becker Jurgen, Brecx M. Treatment of intrabony defects with an enamel matrix protein derivative or bioabsorbable membrane: An 8-year follow-up split-mouth study. J Periodontol 2006;77(11):1879-1886.

American Academy of Periodontology. Position Paper: Periodontal Regeneration. J Periodontol 2005;76(9):1601-22.

Cortellini P, Tonneti M. Clinical performance of a regenerative strategy for intrabony defects: Scientific evidence and clinical experience. J Periodontol 2005;76(3):341-50.

Tonetti M, Cortellini P, Lang N, Suvan J, Adriaens P, Dubravec D, Fonzar A, Fourmousis I, Rasperini G, Rossi R, Silvestri M, Topoll H, Wallkamm B, Zybutz M. Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap alone. A multicenter randomized controlled clinical trial. J Clin Periodontol 2004;31(9):770-776.

Cortellini P, Tonetti M. Long-term tooth survival following regenerative treatment of intrabony defects. J Periodontol 2004;75(5):672-678.

Sanz M, Tonetti M, Zabalegui I, Sicilia A, Blanco J, Rebelo H, Rasperini G, Merli M, Cortellini P, Suvan J. Treatment of intrabony defects with enamel matrix proteins or barrier membranes: Results from a multicenter practice-based clinical trial. J Periodontol 2004;75(5):726-733.

Cochran D, Jones A, Heijl L, Mellonig J, Shoolfield J, King, G. Periodontal regeneration with a combination of enamel matrix proteins and autogenous bone grafting. J Periodontol 2003;74(9):1269-1281.

Bowers G, Schallhorn R, McClain P, Morrison G, Morgan R, Reynolds M. Factors influencing the outcome of regenerative therapy in mandibular class II furcations: Part I. J Periodontol 2003;74(9):1255-1268.

Gunsolley JC, Murphy KG. Guided tissue regeneration for the treatment of periodontal intrabony and furcation defects. A systematic review. Annals of Periodontol 2003;8(1):266-302.

Cury PR, Sallum EA, Nociti FH, Sallum AW, Jeffcoat MK. Long-term results of guided tissue regeneration therapy in the treatment of class II furcation defects: A randomized clinical trial. J Periodontol 2003;74(1):3-9.

McClain PK, Schallhorn RG. Focus on furcation defects: guided tissue regeneration in combination with bone grafting. Periodontology 2000 2000;22:190-212.

McClain PK, Schallhorn RG. Long term assessment of combined osseous composite grafting, root conditioning, and guided tissue regeneration. Int J Periodont and Rest Dent 1993; 13:9-27.

Papapanou PW, Wennstrom JL. The angular bony defect as indicator of further alveolar bone loss. J Clin Perio 1991;18(5):317.

Moderate to Severe Periodontal Disease

Sculean A, Schwarz F, Miliauskaite A, Kiss A, Arweiler N, Becker J, Brecx M. Treatment of intrabony defects with enamel matrix protein derivative or bioabsorbable membrane: An 8-year follow up split-mouth study. J Periodontol 2006;77(11):1879-1886.

Kloostra PW, Eber RM, Wang HL, Inglehart MR. Surgical versus non-surgical periodontal treatment: psychosocial factors and treatment outcomes. J Periodontol 2006;77(7):1253-1260.

Heden G, Wennstrom JL. Five-year follow-up of regenerative periodontal therapy with enamel matrix derivative at sites with angular bone defects. J Periodontol 2006;77(2):295-301.

Sanz M, ,Tonetti M, Zabalegui I, Sicilia A, Blanco J, Rebelo H, Rasperini G, Merli M, Cortellini P, Suvan J. Treatment of intrabony defects with enamel matrix proteins or barrier membranes: results from a multicenter practice-based clinical trial. J Periodontol 2004;75(5):726-733.

Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL, Gunsolley JC. The efficacy of bone replacement grafts in the treatment of periodontal osseous defects: A systematic review. Annals of Periodontol 2003;8(1):227-265.

Becker W, Becker B, Caffesse R, Kerry G, Oschsenbein C, Morrison E, Prichard J. A longitudinal study comparing scaling, osseous surgery, and modified Widman procedures: Results after 5 yrs. J Periodontol 2001;72(12):1675-1684.

Harrel S, Nunn M. Longitudinal comparisons of the periodontal status of patients with moderate to severe periodontal disease receiving no treatment, non-surgical treatment, and surgical treatment utilizing individual sites for analysis. J Periodontol 2001;72(11):1509-1519.

Risk Assessment

Andriankaja OM, Genco RJ, Dorn J, Dmochowski J, Hovey K, Falkner KL, Scannapieco F, Trevisan M. The use of different measurements and definitions of periodontal disease in the study of the association between periodontal disease and risk of myocardial infarction. J Periodontol 2006;77(6):1067-1073.

Bouchard P, Boutouyrie P, Mattout C, Bourgeois D. Risk assessment for severe clinical attachment loss in an adult population. J Periodontol 2006;77(3):479-489.

Van der Velden U, Abbas F, Armand S, Loos BG, Timmerman MF, Van der Weijden GA, Van Winkelhoff AJ, Winkel EG. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants. J Clin Periodontol 2006;33(8):540-8.

Mombelli A. Critical issues in periodontal diagnosis. Periodontol 2000 2005;39:9-12. No abstract available.

Borrell LN, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol 2005;32(Suppl. 6):132-58. Review.

Tanner AC, Kent R, Van Dyke T, Sonis ST, Murray LA. Clinical and other risk indicators for early periodontitis in adults. J Periodontol 2005;76(4):573-581.

Formolo Dalla Vecchia C, Susin C, Rösing C, Oppermann RV, Albandar J. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 2005;76(10):1721-1728.

Al-Shammari KF, Al-Khabbaz AK, Al-Ansari JM, Neiva R, Wang HL. Risk indicators for tooth loss due to periodontal disease. J Periodontol 2005;76(11):1910-1918.

Johnson G, Hill M. Cigarette smoking and the periodontal patient. J Periodontol 2004;75(2):196-209.

Al-Zahrani MS, Bissada NF, Borawski EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol 2003;74(5):610-615.

Persson GR, et al. Perceived risk of deteriorating periodontal conditions. J Clin Periodontol 2003;30:982.989.

Page RC, Martin J, Krall EA, Mancl L, Garcia R. Longitudinal validation of a risk calculator for periodontal disease. J Clin Periodontol 2003;30(9):819-27.

Persson GR, Mancl LA, Martin J, Page RC. Assessing periodontal disease risk: A comparison of clinicians' assessment versus a computerized tool. J Am Dent Assoc 2003;134(5):575-82.

American Academy of Periodontology. Position paper: Diagnosis of Periodontal Diseases. J Periodontol 2003;74(8):1237-47.

Page RC, Krall EA, Martin J, Mancl L, Garcia RI. Validity and accuracy of a risk calculator in predicting periodontal disease. J Am Dent Assoc 2002;133(5):569-76.

Diabetes and Periodontal Diseases

Lalla E, Kaplan S, Chang SM, Roth GA, Celenti R, Hinckley K, Greenberg E, Papapanou PN. Periodontal infection profiles in type 1 diabetes. J Clin Periodontol 2006;33(12):855-62.

Kumar MS, Vamsi G, Sripriya R, Sehgal PK. Expression of matrix metalloproteinases (MMP-8 and -9) in chronic periodontitis patients with and without diabetes mellitus. J Periodontol 2006;77(11):1803-1808.

Al-Shammari KF, Al-Ansari JM, Moussa NM, Ben-Nakhi A, Al-Arouj M, Wang HL. Association of periodontal disease severity with diabetes duration and diabetic complications in patients with type 1 diabetes mellitus. J Int Acad Periodontol 2006;8(4):109-14.

Mealey BL. Periodontal disease and diabetes: A two-way street. J Am Dent Assoc 2006;137(Suppl 2):26S-31S.

Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology 2006 Sep;94(1):10-21.

Mealey BL, Oates TW; American Academy of Periodontology. Diabetes mellitus and periodontal diseases. J Periodontol 2006;77(8):1289-303. Review.

Moles DR. Evidence of an association between diabetes and severity of periodontal diseases. Evid Based Dent 2006:7(2):45.

Liu R, Bal HS, Desta T, Krothapalli N, Alyassi M, Luan Q, Graves DT. Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation. J Dent Res 2006;85(6):510-4.

Jansson H, Lindholm E, Lindh C, Groop L, Bratthall G. Type 2 diabetes and risk for periodontal disease: a role for dental health awareness. J Clin Periodontol 2006;33(6):408-14.

Faria-Almeida R, Navarro A, Bascones A. Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis. J Periodontol 2006;77(4)591-8.

Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 2005;76(11 Suppl):2075-84.

Heart Disease and Periodontal Diseases

Geismar K, Stoltze K, Sigurd B, Gyntelberg F, Holmstrup P. Periodontal disease and coronary heart disease. J Periodontol 2006;77(9)1547-54.

Behle JH, Papapanou PN. Periodontal infections and atherosclerotic vascular disease: an update. Int Dent J 2006;56(4) Suppl.1:256-62. Review.

Healthy hearts and gums. Br Dent J 2005;199(5):257.

Geerts SO, Legrand V, Charpentier J, Albert A, Rompen EH. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol 2004;75(9)1274-80.

My dentist says taking better care of my teeth may have heart benefits. What’s the connection? Mayo Clin Health Lett 2003 Dec;21(12):8.

Seymour RA, Preshaw PM, Thomason JM, Ellis JS, Steele JG. Cardiovascular diseases and periodontology. J Clin Periodontol 2003 Apr;30(4):279-92. Review.

Preterm Birth and Periodontal Diseases

Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, Buchanan W, Bofill J, Papapanou PN, Mitchell DA, Matseoane S, Tschida PA; OPT Study. Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 2006;355(18):1885-94.

Meurman JH, Furuholm J, Kaaja R, Rintamaki H, Tikkanen U. Oral health in women with pregnancy and delivery complications. Clin Oral Investig 2006;10(2):96-101. Epub 2006 Feb 18.

Lopez NJ, Da Silva I, Ipinza J, Gutierrez J. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol 2005;76(11 Suppl):2144-53.

Khader YS, Ta’ani Q. Periodontal diseases and the risk of preterm birth and low birth weight: a meta-analysis. J Periodontol 2005;76(2):161-5. Review.

Marin C, Segura-Egea JJ, Martinez-Sahuquillo A, Bullon P. Correlation between infant birth weight and mother’s periodontal status. J Clin Periodontol 2005;32(3)299-304.

Jarjoura K, Devine PC, Perez-Delboy A, Herrera-Abreu M, D’Alton M, Papapanou PN. Markers of periodontal infection and preterm birth. Am J Obstet Gynecol 2005;192(2);513-9.

Carta G, Persia G, Falciglia K, Iovenitti P. Periodontal disease and poor obstetrical outcome. Clin Exp Obstet Gynecol 2004;31(1):47-9.

Tobacco and Periodontal Diseases

Baharin B, Palmer RM, Coward P, Wilson RF. Investigation of periodontal destruction patterns in smokers and non-smokers. J Clin Periodontol 2006;33(7):485-90.

Lung ZH, Kelleher MG, Porter RW, Gonzalez J, Lung RF. Poor patient awareness of the relationship between smoking and periodontal diseases. Br Dent J 2005;199(11)731-7; discussion 725.

Nitzan D, Mamlider A, Levin L, Schwartz-Arad D. Impact of smoking on marginal bone loss. Int J Oral Maxillofac Implants 2005;20(4):605-9.

Fisher MA, Taylor GW, Tilashalski KR. Smokeless tobacco and severe periodontal disease, NHANES III. J Dent Res 2005;84(8):705-10.

Bergstrom J. Tobacco smoking and chronic destructive periodontal disease. Odontology 2004;92(1)1-8. Review.

Copeland LB, Krall EA, Brown LJ, Garcia RI, Streckfus CF. Predictors of tooth loss in two US adult populations. J Public Health Dent 2004;64(1):31-7.

Perio-Systemic (general)

Dietrich T, Garcia RI. Associations between periodontal disease and systemic disease: evaluating the strength of the evidence. J Periodontol 2005;76(11 Suppl):2175-84.

Scannapieco FA. Systemic effects of periodontal diseases. Dent Clin North Am 2005 Jul;49(3):533-50, vi. Review.

Hamilton J. The link between periodontal disease and systemic diseases: state of the evidence 2005. J Calif Dent Assoc 2005;33(1):29-38. Review.

Seidel-Bittke D. The link between oral health and systemic health: A review. Dent Today 2004;23(12):50, 52-3.

Molloy J, Wolff LF, Lopez-Guzman A, Hodges JS. The association of periodontal disease parameters with systemic medical conditions and tobacco use. J Clin Periodontol 2004;31(8):625-32.

Referral Patterns

Dockter KM, Williams KB, Bray KS, Cobb CM. Relationship between prereferral periodontal care and periodontal status at time of referral. J Periodontol 2006;77(10):1708-1716.

Preshaw, PM, et al. Periodontal maintenance in a specialist periodontal clinic and in general dental practice. J Clin Periodontol 2005;32:280-286.

Cobb, Charles, et al. Periodontal referral patterns, 1980 versus 2000: A preliminary study. J Periodontol 2003;74(10):1470-1474.

McGuire, Michael, et al. A referral-based periodontal practice—yesterday, today, and tomorrow. J Periodontol 2003;74(10):1542-1544.

Fardal, O. et al. Pre-treatment conceptions of periodontal disease and treatment in periodontal referrals. J Clinical Perio 2001;28:790-795.

Veisman, Herbert, et al. Refer is not a four letter word. Ontario Dentist 1999;Jan-Feb:24-29.

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