Swedish dental journal最新文献

The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of lateral sinus floor elevation (LSFE). A total of 347 medium rough surface implants were placed in both xenogenic bone and natural bone in 103 patients. A two-stage surgical technique was performed with a lateral window approach followed by a healing period of 9 months prior to implant placement. Patients were analysed with regard to pre- and post-augmentation bone height data (Group A), levels of mar- ginal bone (Group B) and implant survival rates/complications. A total of 6 implants were lost in the present investigation, of which two were still osseoin- tegrated, albeit mechanically damaged.The implant survival rate was 99.0% considering those engaging BioOss, and the corresponding figure for implants placed in natural bone was 96.2%. The average follow-up time was 2.5 years.The mean preoperative bone height was 3.8 mm and the mean postoperative bone height was 13.7 mm. It may be advocated that preoperative bone heights exceeding 7 mm are not indicative of LSFE treatment and that preoperative bone heights of 4-7 mm may imply alternative treatment options. A group of subjects, corresponding to 16.5%- of the patient material, had some sort of postoperative complication. One may conclude that LSFE is a predictable and safe treatment procedure, with a high implant survival rate. LSFE resulted in gained bone height in the range of 10 mm.

The aim of this study was to evaluate the compliance and short-term effects of eruption guidance appliance (EGA) in adolescents with class II division 1 malocclusion in comparison with twin-block appliance (TBA) and activator-headgear appliance (A-HG). Dental records of 1886 patients were viewed in this retrospective study 129 patients treated with one of these three functional appliances were identified. 123 fulfilled the inclusion criteria and data were extracted from the dental records. Gender, age, compliance, overjet change at every visit, number of appliance breakages and number of emergency visits apart from appliance breakage were studied. The data were analyzed with Chi-square test, General Linear Model and Fisher scoring test. Results showed that 47 patients were treated with EGA, 38 patients with TBA and 38 patients with A-HG. Mean ages starting the treatment were slightly lower with EGA (11.5 years) than with TBA (12.3 years) and A-HG (11.8 years). Non-compliance was higher in the EGA group (31.9%) than TBA group (26.3%) and A-HG group (23.7%). Mean overjet reduction per month was 0.6 mm for EGA which was lower than TBA group (0.7 mm) and A-HG groups (0.7 mm).The number of emergency visits and appliance breakage were lower in EGA group. However, there was no statistically significant difference between the 3 groups regarding ages,compliance, mean overjet reduction, emergency visits and appliance breakage aspects. In conclusion, this study indicates that EGA is an alternative choice in the treatment of adolescent patients with class II division 1 malocclusion. However, long-term follow-up and cephalometric prospective study should be performed to continue our understanding more about the mechanisms of EGA and more definite conclusions can be made.

With the aim of studying frequency of aural symptoms and associations with symptoms of TMD new patients referred to the Orofacial Pain Clinic, Odontologen, Göteborg, were asked, at their first appointment and before meeting a specialist, to report any symptoms regarding pain or fullness/swelling of the ear, impaired hearing, sensitivity to sound, and irritation/itching of the ear. They also answered a standardized questionnaire regarding temporomandibular pain and/or dysfunction, and classified their degree of TMD symptoms on a five-point verbal scale and a visual analogue scale. 108 consecutive patients were included in the study, they completed the questionnaires and were examined and diagnosed by different specialists at the clinic. Any ear symptoms were reported by 68% of the patients, fullness of ear by 44% and impaired hearing by 37%. 38% of the patients had previously consulted a physician, and most of them had had pharmacological treatment due to their ear symptoms. Females reported more pain in the ear (P = 0.034) and more sensitivityto sound (P = 0.046) than men. No significant association was found between age and aural symptoms. The degree of TMD- symptoms, as reported by the five grade scale, showed significant association with aural symptoms (P < 0.001), as did the clinical dysfunction index of Helkimo (P = 0.005). The diagnoses of myalgia, arthralgia, arthritis and headache showed significant association with aural symptoms, while no association with crepitus (osteoartrosis) and disc displacement. Itching in the ear was frequently reported (24%) and was associated with myalgia (P = 0.003) and tension headache (P = 0.018). A medical examination by an ear-nose-throat specialist of 19 patients reporting a sensation of fullness of ear, did not reveal any objectifiable ear disease. To conclude, aural symptoms are common in patients with temporomandibular pain and/or dysfunction, are associated with TMD-symptoms and should be regarded as possible symptoms of TMD. A cooperation between physicians and dentists can give these patients a good treatment.

Like many other countries Sweden is becoming more multicultural and many residents do not fully master the national language and are not completely familiar with national norms and habits. The key to good interaction between dentists and patients is communication. Therefore this study aimed to examine whether there are differences in the experience of communication and care between native-born (NB) and foreign-born (FB) patients in the Swedish Public Dental Service (PDS). Consecutive patients at four PDS clinics in a major Swedish city (Gothenburg) were asked to complete the Dental Visit Satisfaction Scale (DVSS), eight additional items concerning communication and care, and a questionnaire eliciting background information.The questionnaires were available in English, Swedish, Arabic and Farsi. The response rate was 74% (204 patients, mean age: 42 years, range 18-86). Of the participants, 96 (47%) were NB and 108 (53%) were FB; 80 (40%) were men and 121 (60%) women. The NB group was significantly older, had higher education and more regular dental care habits, and reported higher dental fear than the FB group. Fewer FB than NB patients thought the dentist treated them in the same manner as he or she would treat other patients and this applied particularly to those who had lived in Sweden for more than 5 years. FB patients were as satisfied with the information and communication they received from the dentist as those born in Sweden, but they were more sceptical about the dentist's technical competence. The differences between the two groups were otherwise smaller than might have been expected in view of probable language difficulties and differences in dental care background.

The aim of the present study was to obtain baseline information about oral health, oral health behaviours and knowledge about prevention of oral diseases in newly arrived Somali children. All 310 Somali children arriving in four municipalities in Kronoberg County, Sweden, during 2013 participated. We collected interview data (background factors related to oral health) and performed a clinical examination (oral hygiene, marginal bone loss, malocclusion, dental caries) within the first two months after arrival.The children were analysed in three age groups: 3-6 years (n=49), 7-11 years (n=125), and 12-17years (n=136). The interview revealed that 78-82% of the children in the three groups had never visited a dental clinic in Somalia. Toothache was reported by 18-28% of the children. In the youngest group,71% of the parents did not assist with tooth-cleaning and children commonly used a Miswak stick for cleaning. About half the children had poor oral hygiene while 25-33% repor- ted daily intake of sugary snacks. Malocclusion affected 40% of the 7-11-year-olds and 50% of the 12-17-year-olds. Bone loss affected 13% of the 12-17-year-olds.The 3-6-year-olds had a high prevalence (37%) of missing primary, lower cuspids. Their mean number of decayed, extracted and filled primary teeth (deft) was 2.3, and 43% were free from caries. In the 7-11-year-olds, mean decayed and filled permanent teeth (DFT) was o.8, while in the 12--17-year-olds DFT was 2.2 with 40% caries-free. Comparison with resident children indicates substantially higher caries preva- lence among the Somali children. The study has shown that newly arrived Somali children often present with oral diseases and are in urgent need of treatment and have great need for oral health promotion.

The investigation documents caries prevalence and associated factors in a sample of16-year- olds from Troms County, Northern Norway. DMFT/S-values were 4.2/6.1, indicating dental health being similar to the south of Norway and the rest of Scandinavia. No ethnic differences were recorded. Out of a total of 22 tested variables, the following nine showed an independent strong association (p=0,001) with prevalence of dental caries: parental education, tooth brushing frequency, parental control of oral hygiene in young age, dental fear, self-rated dental health, BMI, self-rated general health, use of smokeless tobacco, and initial approximal caries. The final multivariate regression analysis indicated that use of smokeless tobacco, dental fear, self-rated dental health and initial approximal caries showed a strong independent association with prevalence of manifest dental caries. In addition, parental education and sugar consumption appeared to be of importance. Sedentary lifestyle with low level of physical activity or hours spent in front of a TV/computer screen did not show any correlation with prevalence of dental caries. Tooth brushing frequency, gingival bleeding, obesity and aspects of general health showed a strong bi-variate association that disappeared when controlling for other variables in a multivariate regression model.The results highlight the importance of including attitude and lifestyle modifiable factors in oral and general health education approaches. Additionally, focus should be set on the management of dental fear in the context of targeted oral health strategies. Fi- nally, it would be beneficial to include initial approximal caries, life style factors, and perception and attitudes to general as well as dental health in caries prediction models.

Objectives: The objectives of this study were to present the subjective knowledge level and the use of image processing on digital intraoral radiographs amongst general dental practitioners at Distriktståndvrden AB, Stockholm.

Material and methods: A questionnaire, consisting of12 questions, was sent to 12 dental prac- tices in Stockholm. Additionally, 2000 radiographs were randomly selected from these clinics for evaluation of applied image processing and its effect on image quality. Descriptive and analytical statistical methods were applied to present the current status of the use of image proces- sing alternatives for the dentists' daily clinical work.

Results: 50 out of 53 dentists participated in the survey.The survey showed that most of dentists in.this study had received education on image processing at some stage of their career. No correlations were found between application of image processing on one side and educa- tion received with regards to image processing, previous working experience, age and gender on the other. Image processing in terms of adjusting brightness and contrast was frequently used. Overall, in this study 24.5% of the 200 images were actually image processed in practice, in which 90% of the images were improved or maintained in image quality.

Conclusions: According to our survey, image processing is experienced to be frequently used by the dentists at Distriktstandvåden AB for diagnosing anatomical and pathological changes using intraoral radiographs. 24.5% of the 200 images were actually image processed in terms of adjusting brightness and/or contrast. In the present study we did not found that the dentists' age, gender, previous working experience and education in image processing influence their viewpoint towards the application of image processing.

In many parts of Sweden today, school-based fluoride varnish programmes (FVP) are perfor- med by dental nurses. Studies have shown that the dental personnel are largely responsible for creating the atmosphere related to children's and adolescents'experiences of the program- mes. Knowledge of dental nurses'experiences of performing FVP is therefore crucial in order to develop and improve these programmes and the dental health of children and adolescents.The aim of this study was to describe dental nurses'experiences of performing FVP for children and adolescents in Sweden. Fifteen female dental nurses, strategically chosen, aged 40-63, from the Public Dental Service in the Vistra Gtaland Region, Sweden, were individually interviewed.The interviews were transcribed verbatim and analysed according to the phenomenographic ap- proach.Three themes with a total of 11 categories, all describing the dental nurses' conceptions of performing FVP, emerged in the analysis. The main conclusions were that in overall terms, performing an FVP was found to be a positive experience for the dental nurses, as it meant mee- ting children and adolescents in a context in which the children and adolescents are comforta- ble and relaxed.The opportunity to identify children and adolescents with poor dental health or poor health and to be able to offer them assistance was regarded as a major advantage. In addition,the participants described a feeling of professional development originatingfrom the challenges associated with working in an arena outside the dental clinic.

At a national level, planning and management of dental services should be based on assess- ments of equity, effectiveness and costs. In Sweden, data for the adult population are now acces- sible through The Swedish dental health register, at The National Board of Health and Welfare. This study, on two large cohorts of Swedish adults, is based on longitudinal follow-up data, retrieved from the Swedish dental health register.The aims were twofold: to assess frequencies and costs of fillings and crowns, including subsequent repair; secondly to study the relationship between preventive and restorative dental treatment.The Swedish dental health register pro- vides data on the adult population which offers a new perspective on public health aspects of management of dental care at the national level. A longitudinal, prospective study model was used to follow-up two large cohorts for over four years. In the first cohort, data on 1,088,923 adult patients were analysed with reference to provision of single crowns and fillings over a period of 42 -48 months.The second cohort comprised 1,703,147 adult patients: the data were analysed with reference to preventive interventions over a period of 48 - 54 months. Frequencies of distribution of dental care by age group showed that the cohorts were representative for the whole patient group.With respect to equity, the average number of dentist appointments per i,ooo inhabitants for all 21 regions of Sweden was 140 to 160, despite major variations in geographic conditions and population densities. With respect to effectiveness, about 76% of the teeth with index interven- tions required no additional intervention over four consecutive years of follow-up. For the remain- ing 24% of the teeth 77% had only one additional intervention. When differences of case-mix were taken into account, the costs of repairs to earlier ihterventions were basically similar, regardless of age-group.There were no gender differences. However, there were pronounced differences, of up to three intact teeth, among patients from different regions of Sweden. Follow-up of effects of caries prevention showed no gender differences. However, costs for reparative interventions increased with higher costs for preventive treatment. Moreover, the longer the interval between preventive interventions, the lower the costs for reparative interventions.The national dental health register is a potentially valuable source of data for dental research. In this study, longitu- dinal registry data on restorative and preventive treatment were retrieved and analysed, with reference to efficacy, costs and equity. The results have potential application in improving mana- gement of public dental health.

The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults.