Acta Odontologica Scandinavica最新文献

Objective: This cross-sectional study aimed to compare oral manifestations between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-positive and SARS-CoV-2-negative patients and to examine associations between oral symptoms, Ct values of E and N SARS-CoV-2 viral genes, and the implications of low Ct values indicating a high viral load, which is a predictive factor for the outcome of COVID-19.

Methods: A total of 353 participating patients were aged ≥18 years with clinical manifestations of COVID-19 infection and tested for SARS-CoV-2 carriage at the medical center, by reverse transcriptase polymerase chain reaction (RT-PCR). All patients filled out an anonymous digital questionnaire regarding oral and general symptoms and overall medical health.  Results: A significant association was found between SARS-CoV-2 carriage and dry mouth, unpleasant taste and changes in taste (p < 0.001); for example, 37.4% of the 147 SARS-CoV-2- positive participants had a dry mouth, compared to 18.9% of the 206 SARS-CoV-2- negative participants. Oral blisters were experienced by patients with an E gene Ct value of 10-20 (50%) or 21-30 (50%) (p = 0.041). Bad breath, dry mouth, unpleasant taste and changes in taste were mostly present in participants whose Ct values of both E and N genes were between 21 and 30.  Conclusions: This study found significant associations between low Ct values of E and N SARS-CoV-2 viral genes and high viral load, indicating that Ct values can serve as predictive factors for COVID-19 outcomes. The findings suggest that while oral symptoms are present, the Ct values and associated high viral loads are more critical indicators of disease severity and prognosis.

Objective: The use of midazolam (MZ) has increased in dentistry, but the effect in adults is sparsely studied. The aim of this study was to investigate doses, effects, and side effects of orally administered MZ as a sedative for adults in a dental care organization.

Material and methods: A retrospective record review was performed including all adult patients in the dental care organization ≥20 years receiving MZ, identified through a logbook for addictive drugs, during 2020. From patients' records, the following data were extracted: age, gender, medical history, reason for sedation, performed treatments, doses, effects, and side effects of MZ.  Results: In total, 265 patients on 418 occasions had been sedated, which constituted 2.3 sedations per 1,000 visits and 3.3 sedations per 1,000 treated patients. Mean age was 40.8 years and 67.7% were females. The most common reason for sedation was anxiety. Mean dose in primary dental clinics was 7.9 mg and in specialist clinics, 6.8 mg (p < 0.001). Older patients (>70 years) had lower doses than younger (p < 0.001), while no difference was found between ages 55-70 years and those who were younger. Dental treatment was completed in 91.9% of occasions, and side effects were registered in 2.2%. Successful dental treatment was related to type of treatment performed.

Conclusions: Sedation is rarely used, particularly in primary dental care, and the use varies widely between clinics. MZ administered by dentists seems to be safe and effective. A sedation record should be used to make patient data such as weight and medical conditions available.

Purpose: To investigate the correlation between the marginal bone height of implants in the posterior maxilla of patients with periodontal disease and the inclination of cusp, providing a theoretical basis for the occlusal design of implant restorations in such patients.  Methods: A total of 80 patients with periodontal disease who underwent implant restoration in the posterior maxilla (55 men and 25 women; mean age 56.66 ± 12.70 years) were selected, with a total of 80 implant restorations (one implant restoration per patient). In addition to recording the main research factor of the inclination of cusp, general patient information, implant characteristics and restoration characteristics were taken, and retrospective analysis of the case data and imaging data of the 80 patients from over 3 years was conducted. Cone beam computed tomography was performed preoperatively and 3 years after implant loading to measure and calculate the marginal bone height of the implants using the One Volume Viewer software. Correlation analysis was performed to determine the relationship between the inclination of the cusp and marginal bone height.  Results: There was a positive correlation between the inclination of cusp and the marginal bone height of the implants, with a correlation coefficient of 0.661 (p < 0.001); the diameter of the implants, implant type and restoration type were negatively correlated with the marginal bone height of the implants, with correlation coefficients of -0.364 (p = 0.001), -0.232 (p = 0.038) and -0.298 (p = 0.007), respectively.  Conclusion: When designing the occlusion of implant restorations in the posterior maxilla of patients with periodontal disease, it is advisable to appropriately reduce the restoration's inclination of cusp.

Objective: Purpose of this research was to examine the onset, progression and wear rates of dental erosion in an established mouse model.

Material and methods: Dental erosion in mice was experimentally induced, and the acidic effects of cola drink on their teeth after 2, 4 and 6-weeks were closely analysed by scanning electron microscopy. The tooth height and enamel or dentin loss were established.  Results: The dental erosion on the molars showed clear progression from 2 to 6 weeks. By the 2-week mark, a significant portion of enamel was already eroded, revealing the dentin on the lingual cusps. When adjusted for attritional wear, molars exposed to cola for 2 weeks showed a 35% drop in lingual tooth height compared to controls (533 μm vs. 818 μm). At 4 and 6 weeks, the cola-exposed group continued to display decreased lingual tooth heights by 40% (476 μm vs. 799 μm) and 43% (440 μm vs. 767 μm), respectively.

Conclusion: This study revealed significant acidic effects of cola drink on mouse molars as early as 2 weeks. These findings highlight the challenge of monitoring dental erosion clinically and underscore the importance of early preventive and intervention measures.

Objective: To identify mechanisms and types of injuries in patients having sustained craniofacial fractures under the influence of alcohol, and to compare the frequencies of them between males and females.

Materials and methods: Patients included were adults who had been diagnosed with craniofacial fractures at Töölö Hospital Emergency Department, Helsinki University Hospital, Finland, and who had been under the influence of alcohol at the time of injury. The primary outcome variables were assault-related and fall-related injury mechanisms. The secondary outcome variables were other injury mechanisms, time of accident, type of craniofacial fracture and severity of facial fracture. The primary predictor variable was sex. The control variable was age at the time of injury. The statistical modelling was executed using logistic regression.

Results: Of the total of 2,859 patients with craniofacial fractures, 1,014 patients (35.5%) fulfilled the inclusion criteria. Males predominated (84.6%). Assault (38.0%) was the most frequent aetiology. Compared to the odds of females, males had 2.8 times greater odds for assault, 2.4 times greater odds for isolated cranial fracture and 1.7 times greater odds for a facial injury severity score of ≥ 3. Females had 2.0 times greater odds for any fall compared to the odds of males.

Conclusions: Particularly male patients are frequently under the influence of alcohol at the time of injury, predisposing them to assault and severe facial fractures more often than females. Codes of practice on how to identify unhealthy alcohol use and how to intervene are recommended.

Objective: Deep neck space infections (DNSI), caused by the spread of an odontogenic infection to the floor of the mouth and neck, are potentially life-threatening but preventable. We explored the total cost of illness (COI) for patients with DNSI of odontogenic origin.

Material and methods: Cross-sectional, register-based, multi-centre study of the health economics of DNSI treatment. Included were patients aged > 18 years who were treated in hospital for DNSI of odontogenic origin. Subjects were identified from the regional healthcare database VEGA based on the International Classification of Diseases (ICD) codes and surgical procedure codes. The cost per patient (CPP) values for the hospital care, prescription medications and sick leave were extracted.

Results: In total, 148 patients were included. The average length of the hospital stay was 6 days. Total COI was estimated as 15,400 EUR per patient and 2,280,000 EUR in total. Direct costs accounted for 93% of the COI, and indirect costs were 7%.

Conclusion: The total COI for patients with DNSI of odontogenic origin was six-fold higher than the average COI for patients in otorhinolaryngology (ORL) care. Preventing DNSI will entail substantial cost savings for the specialised healthcare units and will have a significant impact on the patients.

Objectives: This study investigated obstructive sleep apnea (OSA)-related risk factors in children and adolescents.

Materials and methods: Records of 187 subjects from a private medical clinic were reviewed. Overnight polysomnography recordings and self/parent reports were gathered. Descriptive analysis of sociodemographic, anthropometric, sleep quality and sleep architecture variables and OSA diagnosis were performed. Associations between independent variables and OSA diagnosis were assessed through multivariable logistic regression with robust variance, with a significance level of 5%.  Results: 132 participants were diagnosed with OSA, and 55 were classified as "no OSA" (29.41%). Those overweight or obese were 4.97 times more likely to have OSA than those with normal weight (P =  0.005). Those who reported loud snoring were 2.78 times more likely to have OSA than those who reported mild or moderate snoring intensity. A one-unit increase in arousal index leads to 1.39 increase in the odds ratio (OR) of individuals diagnosed with OSA (P < 0.001), and each one-unit increase in sleep efficiency leads to 1.09 higher odds of not having OSA (P =  0.002).

Conclusions: Significantly increased OSA-related risk factors among overweight/obese children and adolescents and among those who had a parental/self-report of loud snoring were found.