Swedish dental journal最新文献

There are few long-term follow-up studies of treatment of temporomandibular disorders (TMD).The aim of this questionnaire study was to evaluate eight-year outcomes of appliance therapy in patients suffering from arthralgia/osteoarthritis and/or myofascial pain. The subjects comprised 120 patients, originally randomly assigned to treatment with an occlusal or a control (palatal) appliance. Eight years later, a questionnaire was sent to 118 eligible patients: 90 (76%) responded. The outcome measures were intensity and frequency of pain, physical and emotional functioning, and overall improvement of pain and headache. Maximum pain intensity had decreased by > 30% in 54 patients (60%); frequency of pain had also decreased significantly. A majority, 57/90, reported improved physical function. Fifty-nine patients reported moderate to severe depression and 61 reported non-specific physical symptoms. Sixty-eight patients reported an overall improvement in TMD pain and 61 perceived overall improvement in severity of headaches. In the intervening years, 57 patients had undergone further treatment, most frequently in the form of another occlusal appliance. The majority of respondents reported improvement in TMD pain and headache. However, it is difficult to evaluate the long-term outcome of appliance therapy as more than 60% of the patients had additional treatments during the eight years.

The purpose of the present study was to investigate the prevalence of adolescents with high periodontal risk and to identify factors with influence on the decision to refer a patient to a specialist clinic of Periodontology, on compliance rate and on treatment outcome. The investigation was conducted as a retrospective study on adolescents at age 13-17. In total, clinical examinations and risk evaluations according to caries- and periodontal risk were performed on 50347 adolescents in general dentistry at ages 13, 15 and 17 in 2007. Individuals with a high periodontal risk were included in the present investigation. A high periodontal risk was defined as presence of sites with periodontal pocket depths >6mm and loss of periodontal tissue support. Multiple logistic regression analyses were adopted to calculate the influence of the potential predictors on the investigated dependent variables. In total, 0.5% of the adolescents were found to have high periodontal risk. The diagnosis local periodontitis and the number of periodontal pockets with probing depths >6 mm were positively and significantly correlated to referral to a periodontist. Eighteen percent dropped out before the treatment was completed. Smokers had a significantly lower compliance than non-smokers. The success rate was significantly lower for individuals with many periodontal pockets and for those with the diagnosis local periodontitis. The prevalence of adolescents classified as having high periodontal risk was low. A large frequency of subjects dropped out before the periodontal treatment was completed, especially at the specialist clinics.

Biofilms are formed in the dental unit waterlines, which leads to unacceptable high levels of bacteria in the water used for dental treatment. Public Dental Health in Västra Götaland, Sweden, decided in 2010 to install water cleaning systems in all dental units. This report shows the effect of this water-cleaning program comprising 841 dental units. The 841 dental units in 111 clinics in the Public Dental Health Service of Västra Götaland region participated in the study. 50 ml water was sampled from the air-water syringe after 2-3 hrs of use and were analyzed for the number of fast-growing (2 days incubation) and slow-growing (7 days incubation) bacteria calculated as colony forming units (CFU) per ml. Approved water quality was set to <100 CFU/ml accordingto the recommendations from the Board of Health and Wellfare (Socialstyrelsen). Altogether 77.3% of the dental units reached approved levels, which was considerable higher than the 25.2% that were approved in a similar study at FTV in the city of Göteborg 4 years earlier when no water cleaning systems were installed. Further, 474 dental units using the Alpron/ Bilpron weekend system 83.4% were approved, 136 units using Unit Clean system 87.5% were approved and 15 using the Sterilox system all reached below 100 CFU/ml. The 199 dental units with inbuilt cleanings systems by the manufacturers based on hydrogen peroxide only 56.3% were approved. A number of 45 (22.6%) showed very high levels (> 10 000 CFU/ml) indicating serious problems with the practical procedures or installation of the systems that needs further attention. The study showed generally improved conditions of the water in the dental units after the introduction of water cleaning systems in the clinics of Public Dental Health Service of Västra Götaland Region, Sweden although the problem still remains in many units.

Unlabelled: The aim of this study was to investigate the prevalence and extent of periodontal disease registered as marginal bone loss and subject characteristics in the adult population in the county of Skåne in Sweden. One thousand individuals, 20-89 years old, were randomly selected and 451 subjects agreed to participate in the study. They answered a questionnaire and in conjunction with the clinical and radiological examination the subjects answered questions about their medical history. The examiners were co-ordinated regarding the diagnostic criteria through comprehensive written instructions, practice and discussions of clinical cases. One observer estimated marginal bone loss around the teeth on digital panoramic radiographs and bitewings. The individuals were classified regarding periodontal disease experience according to the following criteria: PD- = loss of supporting bone tissue < 1/3 of the root length, PD = loss of supporting bone tissue > or = 1/3 of the root length in < 30% of the teeth and PD+ = loss of supporting bone tissue > or = 1/3 the root length in > or = 30% of the teeth. Subjects with no or minor bone loss, i.e. PD- constituted 69% of the population. Twenty percent of the study population had marginal bone loss corresponding to localised periodontal disease (PD) and 11% exhibited generalised periodontal bone loss (PD+). The periodontal treatment need, defined as probing pocket depth > or = 6 mm and bleeding on probing > or = 20%, was 53% in the PD+ group. An interesting result was that there were no differences in periodontal disease experience between the genders.

Conclusions: The prevalence and extent of periodontal disease in this study correlates well with recent other studies. Eleven percent of the population has experienced generalised periodontal disease, and 53% of them have a periodontal treatment need defined as 1 or more site with PPD > or = 6 mm and BoP > or = 20%.

Dental materials are perceived as a health problem by some people, although scientists do not agree about possible causes of such problems. The aim of this paper was to gain a deeper knowledge and understanding of experiences from living with health problems attributed to dental materials. Addressed topics were the type of problem, both as to general and oral health, perceived causes of the problems,their experienced effect on life, and reception by health professionals. Persons, who in a previous large questionnaire study had answered that they had experienced troubles from dental materials and also agreed to answer follow-up questions, were contacted with a request to take part in an interview study. Eleven individual interviews were held.The interviews were transcribed verbatim and the material was analysed according to the Qualitative Content Analysis method. Meaning units were extracted and condensed into a number of codes, which were combined into subcategories, categories, and themes. Four themes were identified: 1) Long-term oral, mental, and somatic difficulties of varying character, caused by dental amalgam. 2) Problems treated mainly by replacement of dental material in fillings. 3) Powerful effects on life, mostly negative. 4) The reception by health professionals was generally good, but with elements of encounters where they felt treated with nonchalance and lack of respect. In conclusion, people who attributed their health difficulties to dental materials had a complex range of problems and the perception was that amalgam/mercury was the cause of the troubles. The reception from health professionals was perceived as generally good, although with occasional negative experiences.

The etiological factors and timing of the onset of molar incisor hypomineralization (MIH) are still not clear. The aim of this study was to examine ground radial and sagittal sections from teeth diagnosed with MIH using light microscopy, polarized light microscopy and X-ray micro-computed tomography (XMCT) and to estimate the onset and timing of the MIH and to relate the hypomineralized enamel to the incremental lines. Thirteen extracted permanent first molars diagnosed MIH, were analyzed with light microscopy and XMCT. The hypomineralized areas were mainly located in the mesio-buccal cusps, starting at the enamel-dentin-junction and continuing towards the enamel surface. In a relative gray scale analysis the values decreased from the EDJ towards the enamel surface. The findings indicate that the ameloblasts in the hypomineralized enamel are capable of forming an enamel of normal thickness, but with a substantial reduction of their capacity for maturation of enamel. Chronologically, it is estimated that the timing of the disturbance is at a period during the first 6-7 months of age.

The aim of this study was to evaluate the long term outcome of furcation involved molars in a population treated for periodontal disease. Initially, the study sample was 147 referred periodontal patients. Periodontal treatment consisted of oral hygiene instructions, supra- and subgingival scaling and periodontal surgery. After treatment 99 patients participated in a two year study on root caries. The patients got maintenance treatment every third to fourth month during 2 years. At the end of that study the patients were periodontally healthy and were referred back for supportive treatment to the referring dentist. Thirteen to 16 years after periodontal treatment 81 patients were still alive and 64 accepted a re-examination. At the start of the observation period the remaining 64 patients had in total 1537 teeth. During the 13 to 16 year follow up 217 teeth were lost. The number of molars at baseline was 361. The number of furcation involvement with different degrees were; 267 (0), 67 (I), 25 (II) and 2 (III) respectively. Totally 69 molars were lost during follow up. The proportion of molar loss according to the degree of furcation involvements 0 to III at baseline were 15%, 29%, 40% and 100% respectively. It was a significant greater risk of loosing an initially furcation involved molar than a single rooted tooth (p<0.0001). The risk of loosing an initially furcated molar increased with the degree of furcation involvement (degree I; p<0.05, degree II; p<0.01). I N CONCLUSION: During a long term observation period molars with furcation involvements are more frequently lost than not furcation involved molars. However, two thirds are still in function 13 to 16 years after treatment which indicate that molars with furcation involvements might survive long after periodontal treatment.

Although caries prevalence in preschool children has dramatically decreased during the last decades it is still a large problem for a minor group of these children. Great efforts have been invested in finding effective preventive programs for the high caries active preschool children. However, few studies have evaluated and discussed which approach will give the best effect. The aim of the present study was to compare the effect of a "standard" preventive program with a series of programs with more extensive measures during a two-year period. At start one hundred and sixty high caries active preschool children (mean age 4 years) were included in the study. The children were randomly distributed to four groups. All groups were exposed to the basic program composed of dietary counselling, oral hygiene instructions and fluoride varnish application. Three groups were exposed to one additional preventive measure e.g. 1% chlorhexidine gel in trays, 0.2% NaF gel in trays or daily tooth brushing with 1% chlorhexidine gel. The programs were repeated seven times during the two-year study period and were executed by trained dental hygienists. Caries examination and saliva sampling for Streptococcus mutans measurements were performed at start of the study and after two years. The mean defs at start was between 10.8 and 12.6 for the four groups (NS). After two years the caries increment was 1.9 ds in the basic preventive group and between 1.9 and 2.6 (NS) in the other groups. Numerically there were more children in the chlorhexidine groups that showed reduction of Streptococcus mutans counts compared to the other groups, but the differences were small. The mean caries increment of about 1.9 ds per year in all groups indicate that all programs were effective taken into account that the children had about 11 defs at start. There were no differences in caries increment between the basic preventive group and the other groups. The conclusion was that addition of preventive measures on top of an effective basic program is a waste of resources. The effect on oral health of individual reinstruction and motivation, by a dental hygienist, seven times during the two-year study period should not be underestimated.

Orthognathic surgery is a frequent procedure at Swedish Oral and Maxillofacial Surgery Departments.The number of clinical and radiographic postoperative follow-up examinations and the choice of radiographic methods seem to vary.The intention with this study was to find out when postoperative clinical and radiographic follow-up was performed following orthognathic surgery and the type of radiographic examinations that were used. In 2009, all Swedish Oral and Maxillofacial Surgery Departments in the Public Health Service (25 centres) were given a form containing standardized questions on the time for clinical follow-up after orthognathic surgery and the radiographic examinations used. A pilot study on 49 consecutive patients at one of the centres was performed to determine if the postoperative radiographic examinations added additional information, leading to further procedures compared to the clinical observations only. A one-year follow-up was the most frequently used clinical control reported by 15 centres, and a six-month follow-up, the next most frequent. At 14 of the 15 centres, radiographic examinations were included at the one-year follow-up. A five-year clinical and radiographic follow-up was reported by two centres. One or, at the most, two postoperative radiographic follow-up sessions were reported by 68% of the centres. Profile and panoramic imaging were most often used. In the evaluation of the postoperative handling of the 49 consecutive patients in the pilot study, a radiolucency around a fixation screw noted radiographically was the only additional postoperative radiological finding that resulted in a surgical procedure. Postoperative clinical and radiographic follow-up routines following orthognathic surgery vary considerably between the Swedish Oral and Maxillofacial Surgery Departments.There appears to be a need for studies on the value of the information,which repeated postoperative clinical and radiographic follow-up controls add in routine medical attendance.

The aim of the study was to evaluate the effect of a toothpaste containing high concentrations of Aloe vera on the reduction of plaque and gingivitis in patients attending regular dental care by a dental hygienist. Fifteen subjects participated in this randomized, double-blind, intra-individual and controlled clinical study. Participants were non-smokers, with signs of gingivitis (bleeding index 30%) and no signs of periodontitis. Subjects were followed for three 6-month periods during which they used either their own toothpaste, or an Aloe vera or a control toothpaste. Plaque and gingival indices were recorded atthe start and end of each period. There was a statistically and clinically significant reduction of about 20% of the plaque and gingivitis indices at the end of the clinical trial compared to baseline values, but no differences between the Aloe vera and the control toothpaste. It may be concluded that in patients motivated to improve their oral hygiene habits, the use of a toothpaste containing Aloe Vera showed no additional effect on plaque and gingivitis compared to a control toothpaste.