Acta Odontologica Scandinavica最新文献

Objective: This study aimed to clarify the perceptibility of periapical foreign materials in imaging compared with histopathology. We hypothesized that dentoalveolar imaging is sufficient to detect periapical foreign bodies.

Material and methods: Radiological and histopathological records of patients diagnosed with periapical granuloma or radicular cyst from 2000 to 2013 were evaluated retrospectively. Patients with histologically verified foreign bodies were included in the study and their pathological samples and radiological images were reviewed. The outcome variable was radiologically detectable foreign material. The predictor variables were histopathological diagnosis, type of inflammation, type and number of foreign bodies, imaging modality, and site of foreign material.

Results: Compared to the histopathological diagnosis of foreign bodies as the gold standard, the level of radiologic detectability was mild. Histologically verified foreign material could be detected by imaging in 32/59 (53.5%) patients. Histological diagnosis, type of inflammation, type or number of foreign bodies, imaging modality or site of foreign material had no association with radiological detectability (p > 0.05).

Conclusions: According to our results, histopathology is a more accurate diagnostic tool than radiology in periapical foreign bodies or foreign body reactions. Clinicians should keep in mind the limitations of imaging when setting the diagnosis and planning treatment.

Objective: The aim was to evaluate the establishment of an aseptic endodontic operative field in general dentistry by assessing general dentists' ability to reduce the amount of contamination to a non-cultivable level, and to compare the operative field asepsis at a general dentistry clinic with that at an endodontic specialist clinic.

Materials and methods: A total of 353 teeth were included in the study (153 in general dentistry, 200 at the specialist clinic). After isolation, control samples were taken, the operative fields disinfected with 30% hydrogen peroxide (1 min) followed by 5% iodine tincture or .5% chlorhexidine solution. Samples were collected from the access cavity area and buccal area, placed in a fluid thioglycolate medium, incubated (37°, 7 d), evaluated for growth/non-growth.

Results: Significantly more contamination was observed at the general dentistry clinic (31.6%, 95/301), than at the endodontic specialist clinic (7.0%, 27/386) (p <.001). In general dentistry, significantly more positive samples were collected in the buccal area than in the occlusal area. Significantly more positive samples were collected when the chlorhexidine protocol had been used, both in general dentistry (p <.001) and at the specialist clinic (p =.028).

Conclusions: The result from this study shows insufficient endodontic aseptic control in general dentistry. At the specialist clinic, both disinfection protocols were able to reduce the amount of microorganisms to a non-cultivable level. The observed difference between the protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as confounding factors may have contributed to the result.

Objective: To describe the prevalence of the developmental abnormalities involved in Dental Anomaly Patterns (DAP) and investigate their co-occurrence in an age cohort of children with late mixed dentition.

Material and methods: Retrospective, register-based study focused on 1315 panoramic radiographs of children aged 8.5-10.5 years. The features examined were absent teeth, peg-shaped maxillary lateral incisor, delayed dental age, infraocclusion of primary molars, transposition and distal angulation of unerupted mandibular second premolar.

Results: Feature involved in DAP was detected in 29.8% of the children, most common being infraocclusion of primary molars (17.5%), followed by absent teeth (8.4%), delayed dental age (7.6%), distal angulation of unerupted mandibular second premolar (7.3%), peg-shaped maxillary lateral incisor (2.4%) and transposition (0.5%). Two DAP features occurred together in 4.7% of children, while three occurred in 0.7%. Infraocclusion (p=.040) and absent teeth (p=.001) occurred more commonly in girls. Phenotypic variations in maxillary lateral incisor more often occurred together (p=.004). Absent teeth, peg-shaped maxillary lateral incisor and delayed dental age more often occurred together (p<.01) as did transposition and absent teeth (p=.016).

Conclusion: Almost third of the children had dental developmental abnormalities involved in DAP. Absent teeth, peg-shaped lateral incisors and delayed dental age more often occurred together.

Background: Cryotherapy using ice chips has been successfully used to prevent chemotherapy-induced oral mucositis. Although effective, concerns have been raised that the low temperatures that are obtained in the oral mucosa during cooling may be potentially harmful to taste and smell perception. Thus, this study aimed to investigate whether intraoral cooling permanently affects taste and smell perception.

Subjects and methods: Twenty subjects inserted an ounce of ice chips and moved the ice around in the mouth to cool as large a part of the oral mucosa as possible. Cooling continued for 60 min. At baseline (T0 - minutes), and following 15, 30, 45, and 60 min of cooling, taste and smell perception were registered, using the Numeric Rating Scale. The same procedures were repeated 15 min (T75 - minutes) after completion of cooling. Taste and smell were evaluated using four different solutions and a fragrance, respectively.

Results: A statistically significant difference was seen for taste perception with Sodium chloride, Sucrose, and Quinine at all the follow-up time points tested as compared to baseline (p < .05). Citric acid and smell perception proved to be significantly different from baseline following 30 min of cooling. When the same assessments were carried out 15 min following completion of cooling, i.e. T75, all taste and smell perceptions had recovered to some extent. For taste perception, however, a statistically significant difference was still seen for all solutions tested as compared to baseline (p < .01).

Conclusion: In healthy individuals, intraoral cooling with IC leads to a temporary reduction in taste and smell perception, with a tendency to return to baseline values.

Objectives: The aims were (1) to study the association between dental anxiety (DA) and temporomandibular disorders (TMDs) and whether subgroups formed differ in psychological symptoms and pain sensitivity in the Northern Finland Birth Cohort 1966 and (2) to confirm the factor structure of the Hopkins Symptom Checklist-25 assessing psychological symptoms.

Materials and methods: Data were acquired using questionnaires and clinical examinations at age 46 years (n = 1889). Dental anxiety was assessed with Modified Dental Anxiety Scale (MDAS). Pain-related TMD (myalgia, arthralgia) were assessed according to modified diagnostic criteria for temporomandibular disorders. Pressure pain threshold and tolerance were measured with an algometer. Explanatory factor analysis revealed three factors, named 'depression', 'anxiety' and 'distress'.

Results: Those with high DA and myalgia and/or arthralgia reported higher depression (mean = 1.52), anxiety (mean = 1.61) and distress (mean = 2.06) scores, and lower pressure pain threshold (mean = 496 kPa) and tolerance (mean = 741 kPa) values than those with only DA (1.22; 1.56; 1.84; 613; 875), TMD (1.21; 1.39; 1.83; 600; 908) or neither (1.12; 1.29; 1.58; 707; 1006), respectively.

Conclusions: Patients with DA and/or myalgia/arthralgia have similar profiles regarding pain sensitivity and psychological symptoms, the burden being highest among those with DA and a TMD diagnosis.

Objectives: To compare self-rated orthodontic pain (OP) and whole salivary alpha-amylase (αA) and cortisol levels (CL) during early stages of fixed orthodontic and clear aligner therapy (CAT).

Methods: In groups 1 and 2, malocclusions were treated using fixed orthodontic appliances and CAT, respectively. In Group-3, individuals had normal occlusion and had never undergone orthodontic therapy. Self-rated OP was assessed using the visual-analogue-scale at baseline (T0); after 24-hours (T1) of appliance activation; and after 30 days (T2). Unstimulated whole saliva was collected and αA and CL were measured using enzyme-linked immunosorbent assay. p < .01 was considered statistically significant.

Results: Twenty-four (Group-1), 24(Group-2) and 25 (Group-3) patients were included. In groups 1 and 2, participants had Class-I malocclusion with anterior-crowding in both arches. At baseline (T0) none of the participants reported pain on mastication. In groups 1 (p < .01) and 2 (p < .01), OP was higher at T1 than T2. In groups 1 and 2, αA and CL were higher at T1 (p < .01) than T0 and T2. At T1 and T2, salivary αA and CL were higher in groups 1 (p < .01) and 2 (p < .01) than Group-3. In groups 1 and 2, a significant correlation was recorded between OP and αA (p < .01) and CL (p < .01) at T1 interval.

Conclusion: Self-rated OP and salivary αA and CL during the early stages of fixed OT and CAT are similar. Whole salivary αA and CL and OP and are high during the first 24 hours of fixed OT and CAT activation.

Objectives: This study evaluates the agreement of data on dental caries between electronic dental records and data retrieved from the national SKaPa-registry (Swedish Quality Registry for caries and periodontal disease), with special reference to e/M in deft/DMFT.

Methods: In a random sample of 500 6- and 12-year-old children having received dental care in 2014 in the county region of Värmland, Sweden, the diagnostic accuracy of data in electronic dental records with corresponding data obtained from the SKaPa-registry was compared by using Cohen's Kappa and Intraclass correlation coefficient (ICC).

Results: For dft/DFT the Kappa was 0.95, and ICC 0.98 (total population). For deft/DMFT in the total population the Kappa was 0.80 and ICC 0.96. For 6-year-olds (deft) the Kappa was 0.89 and ICC 0.99 and for 12-year-olds (DMFT) the Kappa was 0.70, and ICC 0.83. The corresponding figures for Kappa and ICC when excluding individuals without caries (deft/DMFT = 0) were: Total population 0.63 and 0.94; 6-year-olds 0.79 and 0.99; 12-year-olds 0.42 and 0.68.

Conclusion: Agreement between data in the dental records and SKaPa was very high for dft/DFT confirming that transfer from the dental records to the SKaPa-registry is safe and correct. As the accuracy of deft/DMFT was considerably lower than for dft/DFT we advise against using deft/DMFT data from SKaPa for research purposes at this point.

Objectives: To investigate the measures that were taken to limit the risk of COVID-19 contagion, how the risk of adverse effects on patient treatment outcomes was mitigated in orthodontic practices in Finland during the COVID-19 pandemic, and how these measures affected the course of orthodontic treatment.

Materials and methods: In January 2021, an online questionnaire was sent by email to the members of the Orthodontic Division of the Finnish Dental Association Apollonia (n = 361). An additional inquiry was sent to the chief dental officers of 15 health centers.

Results: A total of 99 clinically active members (39.8%) responded to the questionnaire. Of them, 97.0% had made changes in their practices, e.g. using additional protective gear such as visors (82.8%), incorporating preoperative mouthwashes (70.7%), and limiting the use of turbines (68.7%) and ultrasonics (47.5%). Two in three respondents reported temporary lockdowns (mean 1.9 months, range 0.3-5.0 months), during which some occlusions slightly regressed (30.2%) and some relapsed to a previous stage of treatment (9.5%). During this study, 59.6% of respondents reported that some treatments were still behind schedule. One in three respondents had used teleorthodontics because of the pandemic.

Conclusions: Preventive measures and changes in treatment procedures were implemented according to the local COVID-19 situation. Some treatments were prolonged, e.g. because of lockdowns or patient's fear of contracting COVID-19 whilst receiving treatment. New methods like teleorthodontics were introduced for coping with the increased workload.

Objective: This cross-sectional study evaluated the number and characteristics of third molars extracted in a single visit in primary care and their associations with patient's age and sex and operator's experience.

Materials and methods: The data included all appointments where routine and surgical extractions of third molars were performed in 2016 in primary care of the City of Helsinki. Statistics included χ² and Mann-Whitney U tests, and binomial logistic regression.

Results: In total of 10,894 appointments, the number of extracted third molars was 12,728, yielding an average of 1.2 third molars per visit. Mean age of patients (55% women, 45% men) at extraction was 32.2 years (range 12 - 97 years). Most appointments (83.7%, n = 9,118) comprised extraction of one, 15.8% two, 0.4% three, and 0.1% four third molars. Number of teeth extracted at a time did not differ by sex. Increasing age was associated with a reduction in the likelihood of several third molar extractions in a visit (OR 0.96; 95% confidence interval (CI) 0.96-0.97). Multiple third molars were extracted significantly more likely if the operator was experienced (OR 2.32; 95%CI 1.90-2.84). Multiple extractions were also associated with the mandible, operative extractions, unerupted teeth and caries.

Conclusions: Third molars were typically extracted one at a time. In health care units, it is appropriate to consider extraction of several third molars in a single visit, if need for extraction of other third molars exist. Concentrating the extractions of younger patients on experienced operators would reduce the number of patients' visits.

Objective: The aim of this in-vitro study was to investigate the tactile assessment ability at the implant impression-taking stage.

Methods: Thirty clinicians (18 novices, 12 experts) were included for a tactile fit assessment by using a used/new probe (tip diameter 100 µm/20 µm). Six implant replicas and related impression copings of two internal connection implant systems were used, each with a perfect fit (0 µm) and defined vertical micro gaps of 8, 24, 55, 110 and 220 µm at the interface. Statistical analysis was performed using descriptive methods and non-parametric tests with a focus on specificity (ability to detect perfect fit), sensitivity (ability to detect misfit), and predictive values. P-values <5% were considered statistically significant.

Results: The tactile assessment showed a mean total sensitivity for the Straumann and Nobel Biocare systems of 83% and 80% with a used probe, and 91% and 92% with a new probe, respectively. The mean total specificities were 33% and 20% with a used probe and 17% and 3% with a new probe, respectively. No statistical significance was observed between novice and expert clinicians concerning their tactile assessment ability.

Conclusions: The ability to detect a perfect fit (specificity) with a probe was very poor for both implant systems and impaired with the use of a new probe. The use of a new probe improved the gap detection ability (sensitivity) significantly at the expense of the specificity. A combination of additional chairside techniques with training and calibration could improve clinicians' ability to correctly assess the fit/misfit at the implant-abutment interface.