Acta Odontologica Scandinavica最新文献

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.

Objective: As overtreatment has gained attention and is a threat to sustainable healthcare, the objective of this study is to investigate Norwegian private practice dentists' conceptions of overtreatment.  Material and Methods: Six private practice dentists were interviewed. Interviews were transcribed verbatim and analyzed by thematic analysis in a six-step process including coding and identifying main- and sub-themes.

Results: The main themes identified were conceptions of overtreatment, internal factors, and external conditions of importance for overtreatment. Norwegian private practice dentists are familiar with the concept overtreatment and provide several examples of overtreatment. Although they see overtreatment as a problem, they express that the boundaries of what is considered necessary or professionally justified treatment have changed over time - particularly towards aesthetic and cosmetic treatment. Overtreatment is considered to be less problematic if the patients are informed and consent. The participants point to several internal factors and external conditions furthering overtreatment: professional status and prestige, general social trends, social media, demographic changes, overcapacity, and the expansion of commercial chains. The dentists in the interviews demonstrated that they are aware of their power, but also acknowledge their responsibility.  Conclusion: Private practice dentists in Norway are aware of overtreatment and their drivers. They acknowledge their power to promote overtreatment, but also that this gives them responsibility. This raises important issues about dentists' professional accountability and integrity.

Objective: To explore experiences of caries prevention in adult patients with recurrent cavities among experienced dentists.  Method: Five focus group discussions consisting of seven men and nine women, 38-61 years of age, and with working experience as dentists between 5 and 35 years, were conducted. The participants represented Public Dental Health Service clinics and private practitioners. Qualitative content analysis was used to analyze data.  Results: The participants emphasized the importance of effective communication and patient engagement in caries prevention. They described their experiences as an endless trail, making fillings. They expressed their inability to take necessary responsibility and being stuck in the dental care system due to various circumstances. The understanding of caries was contradictory, and an inadequate mandate to control time to fulfill their preventive work was evident. They felt responsible to do the best for their patients, but how to share responsibility with colleagues and patients and having enough time for this seemed difficult and unclear. These problems did not motivate to further education in cariology.

Conclusion: The findings underscore the urgent need for improvement in preventive caries treatment and the necessity of allocating sufficient time for dentists to engage in this crucial aspect of their work.

Objective: The aims of this article are (1) to evaluate the association between oral health-related quality of life (OHRQoL) and self-perceived job readiness and (2) to investigate changes in self-perceived job readiness following an oral health promotion intervention.

Materials and methods: The first aim was elucidated in a cross-sectional design, and the second through a prospective intervention study. A survey was administered among 273 unemployed vulnerable people in Copenhagen, Denmark. Participants were randomised to either control or intervention in 2018, and follow-up was conducted 7-15 months later. The intervention entailed support for dental care. OHRQoL was measured by the Oral Health Impact Profile (OHIP-14), and self-perceived job readiness was measured using the Employability Indicator Project (BIP) questionnaire.

Results: The sample reported a high mean OHIP-14 score at baseline (26.9, SD 15.6) and poor OHRQoL was significantly associated with low self-perceived job readiness (rs = -0.15, p = 0.02). The control group reported better job readiness at follow-up compared to the intervention group. However, the effect sizes were small in both groups and no clear pattern was observed.

Conclusions: The results indicate that OHRQoL is linked to self-perceived job readiness. However, the oral health promotion applied in this study did not lead to better self-perceived job readiness. Further research is needed on the effect of oral health promotion interventions on job readiness within socially vulnerable groups.

Introduction: Third molars (M3) remaining impacted in Class II malocclusion characterised with sagittal mandibular deficiency is a high probability. The null hypothesis of this study is that mesioangular M3s changes position through the eruption way in Class II malocclusion treatment requiring moderate anchorage with four first premolars extraction. The aim of this study is to reconsider the decision to surgically extract impacted third molars in four premolars extraction treatment of Class II malocclusion.

Material and methods: The materials consisted of the pre-treatment and post-treatment lateral cephalograms and orthopantomographs of 30 individuals with skeletal and dental Class II malocclusion with a mean chronological age of 13.48 years, who were treated by the same clinician (H.G.) with four first premolar extractions via the straight wire technique at the Ankara University Faculty of Dentistry Department of Orthodontics, Ankara, Turkey. The sagittal position of the upper and lower incisors and molars, M3 position and M3 space were evaluated with the paired-t test; the relationship between the sagittal position of the upper and lower incisors and molars and the change in M3 position were evaluated with correlation analysis.  Results: The study found the retroclination and mesial movement of the upper incisors and molars, and an increase in the M3 space by the fixed orthodontic treatment. An insignificant steepening of both the upper right M3 position and the lower right M3 position was found. A statistically significant increase in the lower right and left side M3 spaces was found. Positive correlations between lower right M3 angulation and the sagittal position of the lower incisors and first molars were found.

Conclusion: Improvement in the mesioangulation of the M3s and an increase in the M3 space were achieved in this study. Based on the findings, it is useful to review the decision for prophylactic surgical extraction of the M3s before orthodontic treatment in such cases, taking into account the risks of postoperative complications.

The often poor oral health status of socioeconomically vulnerable adults is widely recognised. Nevertheless, research on it is scarce. To address this gap, this exploratory pilot study aimed to report on the prevalence of untreated caries and its clinical odontogenic consequences, as well as the associated Oral Health Related Quality of Life (OHRQoL) in a marginalised adult Dutch population. The Dutch department of Médecins du Monde (Doctors of the World) included socioeconomically vulnerable (low socioeconomic position [SEP]) adults in the Netherlands through community organisations. The validated Deprivation in Primary Care Questionnaire (DiPCare-Q) was translated in Dutch and used to characterise the SEP of the population. To document untreated caries and severe odontogenic consequences, the DMFT (Decayed, Missing, Filled Permanent Teeth) and PUFA (Pulpal, Fistula, Ulceration, Abscess) index were used. The validated Dutch Oral Health Impact Profile questionnaire (OHIP-14) was used to document the impact of these issues on OHRQoL. Data analysis was conducted in SPSS® (Statistical Package for the Social Sciences) statistics (Kruskal-Wallis, Mann-Whitney-U-test) and STATA software. Data from 59 adult participants were analysed. The prevalence of untreated caries (DT ≥ 1) was 65.5%, 57.9% of which experienced severe odontogenic consequences (DT+PUFA). The prevalence of severe odontogenic consequences (PUFA ≥ 1) was 45.5%. The mean OHIP-14 score of 17.7 ± 13.4 (25th-75th percentile: 6-26) illustrated that untreated caries may have impact on OHRQoL. Individuals who experienced any severe odontogenic consequences from untreated caries reported significantly higher OHIP-14 scores (mean ± s.d.: 21.8 ± 14.8 vs.11.1 ± 7.2). The untreated caries and severe odontogenic consequences seen in a large number of the socioeconomically vulnerable adult participants seemed to have an impact on OHRQoL. These findings emphasise the urgency of including these adults in the professional oral health system for treatment and prevention, and may emphasise the necessity of improving the socioeconomic circumstances of this population. Further exploration of the exact barriers and facilitators to oral healthcare access for socioeconomically vulnerable adults is necessary.

Objective: This research investigated the oral health status of Dutch primary school children aged 10-12 years in Utrecht and its association with demographic characteristics, lifestyle factors, general psychosocial health, and dental treatment, to guide targeted interventions to improve children's oral and overall well-being.

Materials and methods: A cross-sectional survey was conducted at 49 primary schools in Utrecht in 2017 and 42 schools in 2019. The questionnaire covered background characteristics (7 questions), psychosocial health (14 questions), nutrition and exercise (20 questions), school and leisure time (26 questions), home situation (23 questions), and oral health (4 questions). Associations were analyzed using multivariate logistic regression.

Results: Data from 5,426 children were analyzed. Prior to the survey, 11% did not visit a dentist, 23% had a toothache, 22% had a cavity filled, and 8% had a tooth extracted. Independent predictors for increased odds of oral health problems were migration background, poor general health, drinking more than two glasses of soft drinks per day, having ever drunk alcohol, having fear of failure, experiencing problems at home and/or coming from average or low socioeconomic position group. Factors associated with increased odds of dental treatment, such as cavity filled and tooth extracted, were migration background, fear of failure and home problems.

Conclusions: These findings emphasize the need for targeted prevention to improve the oral health of children with a migration background, average or low socioeconomic position and/or with poorer general and psychosocial health, unhealthy diets and problems in the home situation, within a community-based and transdisciplinary approach.

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of two different loading methods in implant-supported removable prostheses (partial dentures and full-maxillary dentures).

Methods: As of August 2023, three electronic databases and nine oral implant-related journals had been searched. Only randomised controlled trials (RCTs) that compare immediate loading with conventional loading in implant-supported removable prostheses were included. The primary outcome was the implant survival rate. At the same time, a meta-analysis of bone-level changes was performed. Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to evaluate the risk of bias in the included trials.

Results: A total of 16 RCTs were included, including 543 participants with 1595 implants. The included trials compared immediate loading and conventional loading in implant-supported removable prostheses. Regarding implants as the statistical unit, the immediate loading group had a statistically significant lower survival rate (RR = 0.950; 95% confidence interval [CI], (0.926, 0.974); P = 0.027; I² = 47%). When patients were regarded as statistical units, a statistically significant lower survival rate was also observed in the immediate loading group (RR = 0.929; 95% CI, (0.897, 0.961); P = 0.590; I² = 0%). When we analysed the bone level changes, a statistically significant decrease was observed in bone level in the immediate loading group compared with the conventional loading group (weighted mean difference [WMD] = -0.127; 95% CI, (-0.195, -0.059); P < 0.00001).

Conclusion: Lower implant survival rates and a decrease in marginal bone level was observed compared to immediate loading with conventional loading.