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C!

AP',R "- Formal Reports

FIG RE !"#$
% sam&le formal re&ort
$. A g st, $%&& "# 'im)er Drive St/ Pa l, M( ##000
A Sample Formal Report

(ame and affiliation of intended recipient is given

Recommendation for a Study of the Effects of Professor Janet Belding Periodontal Disease on University of Minnesota low Birth Weight Babies School of Dentistry
Minneapolis, M( ##111 Dear Dr/ Belding2
*etter of transmittal targets and than+s specific reader and provides additional conte&t

New Preterm
A thor provides name and affiliation

'han+ yo for providing me 3ith this opport nity to research the potential ir224 of periodontal disease on )irth 3eights/ ,nclosed in this envelope is my fina report, 5Recommendation for a (e3 St dy on the ,ffects of Periodontal Dis,6$ Preterm *o3 Birth 7eight Ba)ies/5 8n this report, 8 recommend that f rther 6 )e nderta+en to e&plore this potential ca sal connection/ for Professor Janet Belding University of Minnesota School of Dentistry 8f 8 can provide any other information as yo revie3 this report, please do9hesitate to contact me/ 8 loo+ for3ard to meeting 3ith yo at a later dateyo r tho ghts/ 8 hope this report is sef l in yo r research program/ :o rs tr ly,
Date of distri) tion of the report appears on the title page

66
Crystal C nningham, B/S/, Dental !ygiene

by
Crystal C nningham University of Minnesota Division of Dental !ygiene

March "#, $%&&

FIG RE !"#$ (Continued)


'itle is clear and encompasses entire foc s of the report

A)stract /

FIGURE 17.4
(Continued)
'a)le of contents helps readers find information and vis ali;e the str ct re of the report

8ntrod ction /////////////////////////////////////////////////////////////////////////////////////////////////////////////9 Bac+gro nd ///////////////////////////////////////////////////////////////////////////////////////////////////////////=9 Methodologies of the St dies ////////////////////////////////////////////////////////////////////////////////= Res lts of the St dies ///////////////////////////////////////////////////////////////////////////////////////////// *imitations of the St dies ///////////////////////////////////////////////////////////////////////////////////// Concl sion //////////////////////////////////////////////////////////////////////////////////////////////////////////=9=/

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Recommendation ////////////////////////////////////////////////////////////////////////////////////////////////// References /////////////////////////////////////////////////////////////////////////////////////////////////////////////// =959"


Recommendation Reoc<22 ///////////////////, //////////////////////, //////////////////////, //////////////////////////////////////// Appendi&

'able of (ontents

A Sample Formal Report


Recommendation Report iii

%bstract
-"'e p rpose of this report is to assess ten recent st dies concerning periodontal >
sease and its association 3ith preterm and lo3 )irth 3eight infants and to 2commend, )ased on the inconcl siveness of these st dies, that a ne3 st dy )e =5derta+en at the University/ A n m)er of these st dies have fo nd a correlation >>et3een periodontal disease and premat re )irth?lo3 )irth 3eight/ !o3ever, a 9 m)er of them have )een limited in their scope and the res lts have )een 2ontradictory, indicating the need for the ne3 comprehensive st dy 8 propose at <5@e end of this report/

FIG RE !"#$ (Continued)

A)stract f lly s mmari;es the content of the report

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FIGURE 17.4
(Continued)
Recommendation Report A

8ntrod ction sets p the pro)lem and clearly indicates the report@s ca sal analytical approach

Introduction
8n the lastten to fifteen years, interesting findings in dental and o)stetric research have lin+ed periodontal disease in mothers to preterm lo3 )irth 3eight conditions in their )a)ies/ Many st dies have fo nd a correlation, 3hile adeB ately controlling for confo nding varia)les> the varia)les incl de age, smo+ing, dia)etes and other factors already contri) ting to preterm lo3 )irth 3eight )a)ies/ !o3ever a definitive lin+ has yet to )e fo nd/ 'his report e&amines the e&isting st dies, charting their methodologies and res lts, and concl des 3ith a recommendation for a ne3 comprehensive st dy of the possi)le correlation/

Bac+gro nd section provides helpf l ) t not overly detailed conte&t

Bac)ground
'he 3orld has seen a rise in preterm lo3 )irth 3eight )irths in the last fe3 decades/ 'his fact has alarmed many physicians and o)stetricians, )eca se there have )een so many advancements in the medical field aiming to promote the health and longevity of life/ Many reasons have )een proposed to e&plain the reasons for preterm lo3 )irth 3eight )irths, ) t no concl sive ans3ers have yet emerged/ 8n the last ten years, some researchers have s ggested that gingivitis and periodontal disease may )e to )lame for this occ rrence/ Cne possi)le ca se co ld )e the increase in harmf l )acteria entering the )loodstream/ Preterm )irth is considered to )e any )irth that occ rs )efore D- 3ee+s of gestatior lo3 )irth 3eight is recogni;ed as a 3eight of fe3er than $,#%% grams/ Many st dies since the middle "EE%s have attempted to find a correlation )et3een periodontal disease and preterm lo3 )irth 3eight )a)ies/ !o3ever, research related to the possi)ility that periodontal disease increases the5,is+ for preterm lo3 )irth 3eigt92 )a)ies has varied immensely over the years/ 'his report is an assessment of ten peer9revie3ed Fo rnal articles that see+ to e&amine 3hether periodontal disease has any correlation 3ith preterm lo3 )irth 3eight )a)ies/ 'he goal of this report is to find a correlation )et3een gingivitis? periodontal disease and preterm lo3 )irth 3eight infants in previo s st dies and offer a recommendation to cond ct a ne3 st dy/

Clear p rpose statement leads into the )ody of the report

*ethodologies of the Studies


Follo3ing is a s mmary of the methodologies sed in the vario s st dies2 S )heads 3ithin the Methodologies section ma+e the section easy to follo3

'Ime
St dies )y Farrell, 8de, and 7ilson G$%%0H and Dort) da+, ,)erhardt, Ulm, and Perssor G$%%#H e&amined 3omen d ring pregnancy/ 8n the Farrell et al/ st dy, pregnant 3omer 3ere recr ited at "$ 3ee+s of gestation Gp/ ""0H/ S )Fects 3ere e&cl ded if gestatio5I age 3as )elo3 "% 3ee+s or a)ove "# 3ee+s/ 'he Dort) da+ et al/ st dy maintained9@29# it 3as cr cial to e&amine patients d ring 3ee+s "#99$% of gestational age, )eca se a sapie of amniotic fl id is needed to assess for partic lar )acteria Gp/ 10H/ !o3ever, mos> st dies 3aited to collect fl id samples ntil immediately after the )irth/

A Sample Formal Report

Recommendation Report $

Setting
of these st dies 3ere cond cted in hospital settings/ 'he remaining st dies _"'a cond cted after the s )Fects ret rned home from the hospital and 3ere either /s>2> cted to ret rn to their dental office or 3ait for an e&aminer to visit their home ""1. ho rs after )irth/ Some st dies had a lengthier time frame to collect data C@/@ling the )irth, s ch as -$ ho rs, or five days as in a UJ st dy GB d neli et a8/, !l:5 p/ "-0> Moore, Randha3a, K 8de, $%%#, p/ DH/

+aminers
L/ l"iners in these st dies 3ere cali)rated, )lind, and often a single e&aminer -s sed GAlves K Ri)eiro, $%%0, p/ D$$> Bassani, C8into, K Jreiger, $%%-, p/ D-> 2222olla et al/, $%%-, p/ .11> JarFo ra et a8/, $%%#, p, #"0> Moliterno, Monteiro, 0= 26eredo, K Fischer, $%%#, p/ ..-> 9Moore et a8/, $%%#, p/ $H/ 'he st dy )y Farrell et al/ ,,./// involved three e&aminers, 3hich allo3ed more s )Fects to )e eval ated '17). =3estionnaire?intervie3 3as given to patients GBassani et a8/, $%%-, p/ D$> BosnFa+, 9= a, M cicevic9Boras, PlasaF, & Planca+, $%%0, p/ -"$> Farrell et al/, $%%0, p/ ""-> //NlC ra et a8/, $%%#, p/ #"0> Moliterno et a8/, $%%#, p/ ...> Moore et a8/, $%%#, p/ DH/ 'hese >stions pertained to socioeconomic stat s, race, ed cation, occ pation, marital 6, smo+ing, drin+ing, medications, pregnancies, preterm deliveries, and prenatal 2 GOa;olla et al/, $%%-, p/ .1DH/ 96e information gathered from B estions and patients@ medical records e&cl ded .a-y s )Fects from the st dy/ ,&cl sion criteria incl ded dia)etes, anemia, ,//2rFFovasc lar disorders, hepatic deficiency, high )lood press re, 'B, cancer, sei; re 2ns>22rders, psychopathology, asthma, S'D, !8M, fetal or terine anomalies, cervical /;mpetence, la)or ind ction, and m ltiple )irth pregnancies GB d neli et al/, $%%#, p / /9 Oa;olla et al/, $%%-, p/ .11> JarFo ra et al/, p/ #"0> Moliterno et a8/, p/ ..-> Moore et 9 1H/ Another common e&cl sion involved s )Fects 3ho reB ired prophylactic 4C22iotics prior to dental treatment GFarrell et a8/, p/ ""-> JarFo ra et a8/, p/ #"D> Moore tr~ p/DH/ 995, most common meas rements in each trial 3ere poc+et depths, clinical attachment 6 s, and )leeding on pro)ing/ A periodontal pro)e of varying mar+ings 3as sed to ~..ss the e&tent of periodontal involvement/ A fe3 st dies incl ded a plaB e inde& .lG0-10g 3ith the previo sly mentioned tests GFarrell et al/, $%%0, p/ ""-> JarFo ra et a8/, m p/ #"#> Moore et a8/, $%%#, p/ DH/ Cne st dy, )y Alves and Ri)eiro, also incl ded c l s detection G$%%0, p/ D"EH/ DMF' scores 3ere ta+en into acco nt in t3o other 50:..' es GBosnFa+ et a8/, $%%0, p/ -"$> B d neli et a8/, $%%#, p/ "-0H/ @/8ost of the st dies gathered periodontal meas rements from si& different 3S on one tooth thro gho t the entire dentition GAlves K Ri)eiro, $%%0, p/ D"E> 2/nsani et a8/, $%%-, p/ D0> B d neli et a8/, $%%#, p/ "-0> Oa;olla et a8/, $%%-, p/ .1#>

FIG RE !"#$ (Continued)

Sentence variety and clear prose give the report a reada)le style

7riter ses acc rate and clearly interpreted data

(o year needed for 3or+ that follo3s closely after the initial reference All information from o tside so rces is doc mented in te&t 7riter not only descri)es ) t critiB es the previo s st dies e&amined

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FIGURE 17.4
(Continued)
Recommendation Repo9

Moliterno et al/, 2005, p/ 887). !o3ever other st dies assessed fe3er sites, fc~ e&ample mesial, distal, ) ccal and ling al s rfaces GBosnFa+ et al/, 200 , p/ T" Dort) da+/ et al/, 2005, p/ 47). Col m)ia University collected data from three sr:! mesio) ccal, mid) ccal, and disto) ccal in t3o randomly selected B adrants GJarFo ra et al/, 2005, p/ 514). 'he fe3est meas rements 3ere ta+en from one t6 3: only t3o sites, in a UJ st dy/ 'hese sites 3ere mid) ccal and mesio) ccal in the ma&illary, and midling al and mesioling al in the mandi) lar GMoore et ai/, 2005, p/2 'hree st dies incl ded a s )gingival plaB e sample from the mesial and disa aspect of certain teeth/ 'he sample 3as o)tained )y placing a paperpoint into29oi s lc s and analy;ing the type of )acteria collected GB d neli et al/, 2005, p/ 117 Dort) da+ et al/, 10> JarFo ra et al/, 518). An interesting st dy 3as cond cted )y Dort) da+ et al/ A periodontal e&ar completed as in other st dies> ho3ever, this st dy incl ded collection of am5@2@> fl id at 15-20 3ee+s/ 'hese 3omen 3ere already sched led to have amnioce6 tests for medical p rposes/ '3o milliliters of additional fl id 3ere collected B5L analy;ed for partic lar )acteria/ 'he res lts concl ded that an increased n 592 of certain )acteria from the fl id placed these 3omen at a higher ris+ for prePa )irth/ An o)vio s limitation to this st dy, ho3ever, 3as that 3omen nderBo@Q> amniocentesis are already at an increased ris+ for pro)lems d ring their preg622 or they 3o ld not )e having the test in the first place Gp/ 51).

Results of the Studies


7riter provides )ottom line res lts of previo s st dies

'he research analy;ed for this report demonstrates varying degrees of corre r" )et3een periodontal disease and )irth 3eight of preterm lo3 3eight )a)ies GP'*7BH/ See 'a)le 1 for s rnrnarv/
'a)le "/ Res lts of maFor st dies

A Sample Formal Report

Concl sion provides a s mmary of the report Beca se the report ta+es the ca sal approach, 3riter is caref l to sho3 that correlation does not al3ays eB al ca sation

Recommendation Report 1

A s mmari;ed in 'a)le " Gprevio s pageH, recent st dies offer conflicting /s=lts a)o t the relationship )et3een periodontal disease and the )irth of sterm lo3 3eight )a)ies/ 'he t3o st dies to esta)lish high, statistically signif #'#t correlations are Aalves and Ri)eiro $%%# and Dort) da+ et a"/$%%#, ) t as ;sd, Dort) da+ et al/ did not act ally find )acteria in the amniotic fl id, th s ,,2Jiring the a thors to ma+e something of cas al leap/ As noted in the ne&t /2non, there 3ere also other limitations to all these st dies/

'his report incl des a recommendation section

itations of the Studies


2nese st dies involved limitations, the most o)vio s )eing the sample si;e/ '3o s>/6ies had a sample of less than "%% s )Fects GAlves K Ri)eiro, $%%0, p/ D".> : c-t$%&a' et a8/, $%%#, p/ 1#H/ Another limitation 3as the location of the st dies/ iny3ell9+no3n st dies 3ere cond cted o tside the United States, in co ntries :11 as Croatia, United Jingdom, ' r+ey, and t3o in Bra;il/ 2/Jmost all of these st dies 3ere cond cted in lo3er socioeconomic areas, in /6/eloping co ntries, 3ith more niform ethnic and racial gro ps/ Pregnant 292atian 3omen 3ere st died )eca se they tend to develop more prono nced @2@"odontal disease GBosnFa+ et al/, $%%0, p/ -"%H/ /imitetions in only a co ple cases 3ere the ages of the s )Fects/ 8t is 3ell +no3n -a: having a child a)ove or )eneath a certain age poses potential pro)lems forthe 29cher and child, not to mention the strong correlation )et3een age and increased 6riodontal disease/ Cnly t3o st dies imposed a restriction on age/ Cne st dy only ii // 3ed an age range of ". to D# years GB d neli et a8/, $%%#, p/ "-1H> another only o3ed an age range of ". to D% years GOa;olla et a8/, $%%-, p/ .1$H/

(onclusion

9 concl sion, several st dies fo nd a correlation )et3een periodontal disease r~ preterm lo3 )irth 3eight )a)ies, even 3hen acco nting for possi)le confo nding 2@"a)les/ Cn the other hand, many fo nd no correlation )et3een periodontal saase and preterm lo3 )irth 3eight )a)ies/ 'hese researchers ma+e the i9>Jmentthat their co nterparts 3ho did find a correlation did not acco nt for all 66fo nding varia)les/ @Ce research cond cted pertaining to the correlation )et3een preterm lo3 )irth :( ght )a)ies and periodontal disease, then, contin es to res lt in conflicting 22"cl sions/ More research is needed in order to arrive at definitive concl sions/

Recommendation
-)3

Correlation percentages

Comments

research B estion is 3hether periodontal disease has an effect on preterm "t" )irth 3eight )a)ies/ 8 propose a ne3 st dy sing different methods of data 22 ection to e&plore a possi)le correlation )et3een periodontal disease and FIG RE !"#$ (Continued)
'he 3riter is caref l to list the limitations of previo s st dies
(o significant correlation/ (o significant correlation/ (o significant correlation/

B d neli et al/ $%%#, p/"."> Farrell et al/ $%%0/ %%/"$%/ Oa;olla et al/ $%%-, pg .-E/

FIG RE !"#$
(Continued)
7riter cross9 references to emphasi;e importance of Appendi&

preterm lo3 )irth 3eight )a)ies/ GSee the Appendi& for the specifics of this propose> ne3 st dy/H 'his st dy 3ill meas re si& s rfaces on every tooth, and most lrnportarc 3ill gather a )aseline periodontal reading 3ithin eight 3ee+s after conception/ UsI9> approach, the e&aminers can meas re to see if there has )een a significant differe92 periodontal disease d ring pregnancy, or if the s )Fect has al3ays had the same 8e/I disease/ 'his more e&acting approach sho ld increase the acc racy and relia)ilitv ,//2 test findings/

References
Alves, R/ *., K Ri)eiro, R/ A/ G$%%0H/ Relationship )et3een maternal periodontal disease and )irth of preterm lo3 3eight )a)ies/ Pesquisa Odontologica Brasileira,

Reference page immediately follo3s the report and lists all so rces cons lted in APA style

20(4), 319-323.

Bassani, D/ O/, C8into, M/ *., K Jreiger, (/ G$%%-H/ Periodontal disease and perinara o tcomes2 a case9control st dy/ ournal of Clinical Periodontolog!, D1 G"H, D$9l2, BosnFa+, A/, RelFa, *., M cicevic9Boras, ", PlasaF, !/, K Planca+, D/ G$%%0H2 Pre9tadelivery and periodontal disease2 a case9control st dy from Croatia/ ourna 222Clinical
Periodontolog!, DDG"%H@ -"%9-"0/

C ! A P ' , R " F o r m a l R e p o r t s

B d neli, (/, Baylas, !/, B d neli, ,/, ' r+ogl , %/, Jose, *., K Dahlen, O/ G$%%# Periodontal infections and pre9term lo3 )irth 3eight2 a case9control st d6
ournal o# Clinical Periodontolog!, D$G$H,"-19"."/

Dort) da+, %/, ,)erhardt, +., Ulm, M/, K Persson, O/ Rt G$%%#H/ Periodontitis, a -.!: of ris+ in pregnancy for preterm )irth/ ournal o# Clinical Periodontolog!, 3$. 109#$/ Farrell, S/, 8de, M/, K 7ilson, +. ,. G$%%0H/ 'he relationship )et3een maternal periodontitis, adverse pregnancy o tcome and miscarriage in never smo62 ournal o# Clinical
Periodontolog!, DD G$H, ""09"$%/

Oa;olla, C/ M/, Ri)eiro, A/, Moyses, M/ R/, Cliveira, */ -., Pereira, */ J/, K Sall rr 5G$%%-H/ ,val ation of the incidence of preterm lo3 )irth 3eight in patients ndergoing periodontal therapy/ ournal o# Periodontolog!, -.G#H, .1$9M42 JarFo ra, J/, Devine, P/ C/, Pere;9Del)oy, A/, !errera9A)re , M/, D@ Alton, M/, K Papapano , P/ (/ G$%%#H/ Mar+ers of periodontal infection and preterm )lr/>9, %&erican
ournal o# O'stetrics and (!necolog!, "E$G$H/ #"D9#$$/

Moliterno, */ ,., Monteiro, B/, Fig eredo, C/ M/, K Fischer, R/ O/ G$%%#H/ Associa6)et3een periodontitis and lo3 )irth 3eight a case9control st dy/ ournal ./,~ Periodontolog!,
D$G.H, ..-9.E%/

Moore, S/, Randha3a, M/, K 8de, M/ G$%%#H/ A case9control st dy to investig;2; association )et3een adverse pregnancy o tcome and periodontal disease ournal o# Clinical
Periodontolog!, D$G"H,$91/

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