Acta Odontologica Scandinavica最新文献

Objective: Third molar extraction is a common procedure with occasional complications. This study aimed to determine the incidence and types of complications in challenging lower third molar extractions and to identify complication risk factors in tertiary hospital patients.

Material and methods: A retrospective cohort study was conducted on 354 patients who underwent unilateral lower third molar extraction during a 2-year period in 2018-2019 at Helsinki University Hospital. The outcome was the presence of a complication, and patient-related and operation-related variables served as determinants. Statistical analyses included Mann-Whitney U and Chi-squared tests, and binary logistic regression.

Results: Complications occurred in 16.7% of patients. The most common complication was local infection (7.6%), followed by nerve injury (5.6%). The complication risk was 3.7-fold (95% confidence interval (CI) 1.97-6.77, p < 0.001) higher in extractions defined as demanding than in routine operative extraction. If the third molar was acutely infected, the complication risk increased 2.0-fold (95% CI 1.08-3.75, p = 0.027).

Conclusions: Due to the high rate of complications in challenging extractions, scheduling a follow-up visit is important, and risk factors must be considered properly, especially in demanding extractions and in acutely infected third molars.

Objective: Temporomandibular joint (TMJ) arthritis is a common finding in juvenile idiopathic arthritis (JIA) patients. TMJ arthritis can cause significant disturbances in TMJ function and growth without treatment. Our aim was to evaluate the effectiveness of medical treatments used to manage TMJ arthritis and how to evaluate the outcome of the treatment. Furthermore, this study aimed to ascertain the prevalence of TMJ arthritis in JIA patients and investigate the potential impact of specific factors.

Material and methods: Between 2015 and 2019, a total of 194 JIA patients who received treatment at the Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Finland were included in the study. We retrospectively screened the patient records and imaging studies to find out how many patients had TMJ arthritis and what medication was used to treat it.

Results: Maximal incisal mouth opening (MIO) increased significantly with patients whose TMJ arthritis was successfully treated with intra-articular corticosteroid injection (IACI). Almost all patients with TMJ arthritis were treated with an IACI at some point during their treatment. Overall, 99 patients (51%) had been diagnosed with TMJ arthritis. No statistical difference was found between the prevalence of TMJ arthritis and different JIA subtypes, JIA onset time, gender, or immunological factors.

Conclusion: MIO is an easy way to evaluate the treatment outcome and possible disease activation of TMJ arthritis. The prevalence of TMJ arthritis is high among JIA patients. In our study, we could not find any parameters that predict TMJ arthritis, and despite systemic medication, TMJ arthritis might occur.

Objectives: This study aims to explore the identification of older people in need of dental consultation, with a Simplified Oral Indicator (SOI) used by home care nurses (HCNs) and with the Geriatric Oral Health Assessment Index (GOHAI-NL) completed by older people themselves, compared with the Oral Health Assessment Tool (OHAT-NL), performed by dental hygienists.

Methods: The HCNs completed SOI based on their professional view, knowledge and experience; scores red/orange/green were given to older people for oral health and oral hygiene. Older people completed the GOHAI-NL and dental hygienists completed the OHAT-NL.

Results: Data from 141 older people were analysed. Sensitivity and specificity of SOI -OHAT-NL were low (0.45 and 0.64, respectively); SOI scored only few older people as 'red', while only 11 older people did not need a dental referral according to the OHAT-NL. OHAT-NL and GOHAI-NL correlation was significant, but low (r = -0.226, p = 0.012).

Conclusion: Simplified Oral Indicator is currently not sensitive enough to identify older people in need of dental consultation. Additional education to HCNs and/or adjusting SOI may be needed. The GOHAI-NL seems not useful in dental triage.

Introduction: The impact of dental anxiety is profound. At the same time, dental anxiety is sometimes difficult to detect. Therefore, a patient-reported outcome measure is needed. The Modified Dental Anxiety Scale (MDAS) is a short, internationally used self-assessment questionnaire for screening of dental anxiety.

Aim: To cross-culturally adapt the original English MDAS to Swedish (MDAS-S), and to validate it in a Swedish setting.

Materials and methods: The adaptation was conducted in accordance with recommended guidelines. Field testing was performed both among adults presenting for their regular dental check-ups and among adults diagnosed by a psychologist as dentally phobic.

Results: The MDAS-S was formed during the adaptation procedure. Field testing included 246 adults presenting for their regular dental check-ups and 7 adults diagnosed with dental phobia. The MDAS-S score was significantly higher (p < 0.001) in the dentally phobic group than in the regular dental check-up group. Reliability was good with Cronbach's Alpha values between 0.880 to 0.909. Test-retest of 37 individuals showed an excellent Intraclass Correlation Coefficient of 0.956. Confirmatory factor analysis (CFA) finds support for a two-factor model although with 78% shared variance between the factors.

Conclusions: The MDAS-S demonstrates good reliability and appears valid as a screening tool for dental anxiety among Swedish adults.

Aim: To analyse the risk factors contributing to the prevalence of periodontitis among clusters of patients with diabetes and to examine the clustering patterns of clinical blood biochemical indicators.

Materials and methods: Data regarding clinical blood biochemical indicators and periodontitis prevalence among 1804 patients with diabetes were sourced from the National Health and Nutrition Examination Survey (NHANES) database spanning 2009 to 2014. A clinical prediction model for periodontitis risk in patients with diabetes was constructed via the XGBoost machine learning method. Furthermore, the relationships between diabetes patient clusters and periodontitis prevalence were investigated through consistent consensus clustering analysis.

Results: Seventeen clinical blood biochemical indicators emerged as superior predictors of periodontitis in patients with diabetes. Patients with diabetes were subsequently categorized into two subtypes: Cluster A presented a slightly lower periodontitis prevalence (74.80%), whereas Cluster B presented a higher prevalence risk (83.68%). Differences between the two groups were considered statistically significant at a p value of ≤0.05. There was marked variability in the associations of different cluster characteristics with periodontitis prevalence.

Conclusions: Machine learning combined with consensus clustering analysis revealed a greater prevalence of periodontitis among patients with diabetes mellitus in Cluster B. This cluster was characterized by a smoking habit, a lower education level, a higher income-to-poverty ratio, and higher levels of albumin (ALB g/L) and alanine aminotransferase (ALT U/L).

Objective: The aims of this study were to assess the accuracy of Cameriere's and Demirjian's methods in Finnish children, and compare the findings with those of the Turkish children according to dental age.

Material and methods: Dental panoramic tomography (DPT) of children (482 Finnish, 423 Turkish) aged between 5 and 15 years were evaluated. Comparison of mean difference between estimated and chronological age was evaluated. The difference between two means was analysed using paired t-test at 95% confidence interval (CI). Pearson correlation coefficients were used to estimate the correlation between chronological and estimated ages.  Results: Demirjian's method resulted in overestimation in all age groups except for 8-year-old girls. Dental age, however, was found to be underestimated with Cameriere's method in all age groups but 6-year-old girls and boys. In Northern Finnish children, Demirjian's method was more suitable for boys while Cameriere's method led to better estimation in girls. When comparing Finnish and Turkish children, differences between dental ages and chronological ages differed significantly in 10-year-old boys and 8-year-old girls with both methods.  Conclusion: Dental age of Turkish children seems higher than that of Finnish children. There is a significant difference between chronological and dental ages in both populations assessed by both methods.

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Introduction and objective: Agenesis of one or more teeth is common among patients who are referred for orthodontic treatment. The most common treatments are orthodontic space closure (SC) and implant replacement (IR), which are widely studied, but the experiences of patients receiving these treatments have received little attention. The aim of this qualitative study is to explore how treatments to address missing maxillary lateral incisors (MMLIs) are experienced by individuals who are treated using either orthodontic SC or IR.

Materials and methods: This study is conducted in Sweden and based on semi-structured interviews with 13 individuals who have completed treatment, either orthodontic SC (n = 7) or IR (n = 6), to address the lack of one or two maxillary lateral incisors. Data were analysed in accordance with the grounded theory approach.

Results: Findings were classified into the main category of being different during treatment and into three associated sub-categories. The first category, that is being different due to missing teeth, refers to when a person experiences being different because of the anterior spacing The second category, that is being different due to fixed appliance, refers to when the appliance itself makes a person different. The two first categories exemplify being different in terms of appearance. The third identified category, that is being different due to treatment appointments, refers to the need to spend time differently because of having appointments at the clinic for treatment.

Conclusion: Patients MMLIs consider their treatment to start at the time of diagnosis. They experience feelings of being different irrespective of whether the type of treatment is orthodontic SC or IR. The experience of being different differs in timing and causes depending on the treatment method.

After a tooth extraction, a dry socket is a common problem that can cause excruciating pain and prevent healing. Antiseptic dressings have historically been the mainstay of treatments for this illness in order to lower bacteria and accelerate healing. Alveogyl is a medicated dressing composed of butamben, iodoform, and eugenol is conventionally used to manage the pain associated with dry socket. The purpose of this study is to assess how well laser therapy treats alveolitis symptoms. The idea that laser therapy is an excellent tool for treating alveolitis is what motivated this meta-analysis. This systematic review aims to evaluate the effects of Level Laser Therapy (LLT) in the treatment of dry socket.  Methods: A literature search was done on PubMed, Lilacs, Web of Science, Scopus, and Cochrane using the keywords entered, and papers published between January 2000 and September 2023 were taken into consideration. The terms "laser" and "dry socket" have been merged using the Boolean conjunction AND; the results show that 65 studies could be identified using the three search engines. Only five were selected to create the current systematic study and metanalysis. The meta-analysis demonstrated that laser therapy is superior to the traditional Alvogyl treatment in managing alveolitis symptoms, especially in pain reduction. The overall effect demonstrated a mean difference of -2.01 (95% CI: -2.43 to -1.59) on the third day of treatment, with a p < 0.05, indicating statistical significance.  Conclusion: The quantitative analysis showed that Low-Level Laser Therapy demonstrated promising potential in managing alveolitis symptoms, particularly in terms of pain reduction, when compared to traditional treatments like Alvogyl. Despite the results indicating a statistically significant reduction in pain, the evidence does not conclusively establish laser therapy as a complete substitute for conventional therapies. Further high-quality studies with larger sample sizes and standardized protocols are required to confirm its long-term efficacy and to assess its broader applicability in clinical settings.

Objectives: This study aimed to investigate factors associated with nurses' self-efficacy in oral care among infection-sensitive patients in a university hospital.

Material and methods: All the nurses working in five wards of internal medicine and one department of oncology at Oulu University Hospital, Finland (n = 114) were recruited. Data were collected with a questionnaire containing 10 self-efficacy items (scored 0 to 10) and nine knowledge items (five-point Likert scale) that were validated in an earlier pilot study. Factor analysis was performed for the self-efficacy scale and a mean score was calculated for the knowledge scale. A multivariate linear regression model was used to analyze the association between explanatory variables and self-efficacy factor scores.

Results: Factor analysis revealed self-efficacy factors: Practical skills, Self-confidence in taking care of patients' oral hygiene, and Confidence in detecting oral problems (factor scores varied between 4.9 and 8.8). A higher mean score for the knowledge scale was positively associated with the factor Practical skills (B = 0.5, p < 0.05). Longer working experience was associated with higher factor scores in Self-confidence in taking care of patients` oral hygiene and Confidence in detecting oral problems.

Conclusions: Better oral health-related knowledge and longer working experience were positively associated with oral health-related self-efficacy.