Acta Odontologica Scandinavica最新文献

Objective: This study aimed to compare time-dependent changes in fractal dimension (FD) and periapical index (PAI) values of periapical trabecular bone in the lesion areas following single- and multi-visit end-odontic treatments using different intracanal medicaments.

Material and methods: Data from 62 mandibular molars treated between March and December 2023 were analyzed and assigned to three groups: Group 1, multi-visit treatment with calcium hydroxide [Ca(OH)₂] (n = 20); Group 2, multi-visit treatment with chlorhexidine (CHX) gel (n = 21); and Group 3, single-visit treat-ment without medicament (n = 21). Follow-up data were collected until December 2024. Three periapical radiographs, baseline, 6-months, and 12 months after treatment, were evaluated. Fractal analysis was per-formed on a region of interest (ROI) near the infected root apex, and periapical healing was also assessed using PAI scores. PAI scores were compared using the Kruskal-Wallis test; FD values and their correlation with PAI were analyzed by two-way analysis of variance (ANOVA) and Spearman's test. Categorical variables were compared using the chi-square and Fisher-Freeman-Halton tests.

Results: PAI scores significantly decreased in all groups at 6 and 12 months compared with baseline (p < 0.001), with no intergroup differences (p > 0.05). FD values significantly increased over time in all groups (p < 0.001). The magnitude of FD change and gender-related differences were not significant (p > 0.05). No correlation was observed between PAI and FD values (p > 0.05).

Conclusions: Single- and multi-visit endodontic treatments resulted in similar periapical healing out-comes. The type of intracanal medicament did not influence FD or PAI values. Fractal analysis is a valuable, noninvasive tool for assessing periapical bone healing over time.

Objective: The objective of this study was to examine inequalities in access to subsidized dental care according to household income before, during and after the COVID-19 lockdown in Norway.  Material and methods: Our data encompassed all individuals aged 20 years and above (n = 3,977,747). The data were analyzed using a linear probability model. The outcome variable was whether an individual had received subsidized dental care, and the main independent variable was net household income. Analyses were carried out with and without the following control variables: gender, age (fixed effects), level of education, immigrant background and place of residence (fixed effects for county). Inequalities were measured using concentration indices.  Results: The proportion of adults who received subsidized dental care was 3.10% before lockdown, 0.47% during lockdown and 2.15% after lockdown. The concentration indices were small. The unstandardized concentration indices (without control variables included) were: 0.04 before, 0.002 during and 0.04 after lockdown. The standardized concentration indices (with control variables included) were: 0.02 before, -0.007 during and 0.02 after lockdown. We carried out several supplementary analyses. They all supported our main findings.

Conclusion: The lockdown did not lead to inequalities in access to subsidized dental care in Norway according to income.

Objective: The purpose of this study was to investigate the effect of resveratrol in a rat model of experimental periodontitis by assessing alveolar bone loss along with catalase and glutathione peroxidase mRNA expression and enzymatic activity in gingival tissue.

Material and methods: Experimental periodontitis was induced in 34 male Sprague-Dawley rats by placing silk ligatures bilaterally around mandibular first molars. Then the animals were randomly divided into two groups: placebo (n = 17) and resveratrol (n = 17). The placebo group received a placebo solution, while the resveratrol group received 10 mg/kg resveratrol daily via oral gavage for 30 days. Alveolar bone loss was measured on microscopic photographs of stained tissue sections. Gingival enzyme activity levels were determined by enzyme-specific reactions and mRNA levels were assessed using semiquantitative real-time polymerase chain reaction (PCR).

Results: Systemic resveratrol administration significantly reduced alveolar bone loss (440.87 ± 142.24 μm) compared to the placebo group (897.06 ± 383.59 μm) (p < 0.001). Catalase and glutathione peroxidase activities were also significantly higher in the resveratrol group (p < 0.001).

Conclusions: Resveratrol appears to be effective in reducing alveolar bone loss in experimental periodontitis, potentially through its antioxidant properties. These findings suggest that resveratrol may offer clinical benefit as an adjunct to periodontal therapy.

Objective: Many studies have shown a link between inflammation and increased morbidity and mortality. We evaluated the association between baseline periodontitis, medication purchases, and mortality in a 35-year follow-up.  Materials and methods: The sample and data are from a long-term follow-up of a random sample, from the greater region of Stockholm, Sweden, 1985 to 2017. The sample comprised 1,643 participants, initially clinically examined in 1985, and found to either have (n = 286) or not have (n = 1,357) periodontitis. Swedish national population and patient registers from 1985 to 2017 were used for analyses. Descriptive statistics, Chi2-test, Kaplan-Meier and Coxs proportional hazard regression models were used in the analyses. The outcome variable in the Kaplan-Meier and Cox's regression analyses was time to death.  Results: Periodontitis at baseline showed a positive association with all-cause and, particularly, with cancer-specific mortality and a poorer survival distribution. In addition, having lost two or more teeth at the age of 30-40 years, a higher dental calculus or gingival index at baseline, were identified as risk factors for overall mortality among the participants. In addition, alimentary tract and metabolism medications, systemic hormones, and antineoplastic and immunomodulating agents were associated with higher mortality risk.  Conclusion: This study found that periodontitis diagnosed 35 years earlier was associated with an earlier death when compared with the then periodontally healthy participants.

Rheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by chronic inflammation,  primarily targeting joints. When it affects the temporomandibular joint (TMJ), it can significantly diminish the quality of life for individuals. Despite the increasing recognition of disorders involving TMJ and the importance of the stomatognathic system, there is a limited number of studies on masticatory muscle activity of TMJ in patients with RA and the changes in the function of these keychewing muscles. The objective of this study was to conduct a comprehensive systematic review of existing evidence concerning the functioning of major chewing muscles in patients with RA, specifically focusing on parameters such as chewing force. Findings from existing research indicate that RA patients exhibit higher prevalence of bone changes in the TMJ, including erosion, flattening, sclerosis, and osteophytes. These alterations are typically diagnosed through cone-beam computed tomography (CBCT). Results demonstrate that individuals with RA are more likely to experience bone changes in TMJ structures compared to those without RA. By synthesizing available data, this review aims to provide insights that can inform clinical management strategies and potentially improve outcomes for patients grappling with RA-related TMJ involvement. This article aims to review TMJ disorder in RA patients.

Objective: The objective was to assess the radiographic and periodontal status among obese patients with and without type-2 diabetes and systemically-healthy subjects.

Methods: Participants were divided into four groups: (a) Non-diabetic obese patients; (b) Type-2 diabetic obese patients; and (c) self-reported systemically healthy controls. Demographic data, daily oral hygiene maintenance protocols and education status (ES) were collected using a questionnaire. Information regarding family history of diabetes mellitus and obesity was recorded. Hemoglobin A1c (HbA1c) levels and body mass index (BMI) were recorded. Plaque index (PI), bleeding-on-probing (BoP), probing depth (PD), clinical attachment loss (CAL), marginal bone loss (MBL) and number of missing teeth (MT) were recorded. Group comparisons were done, and the correlation between BMI, HbA1c and periodontal parameters was assessed using linear regression models. Level of significance was set at P < 0.05.  Results: Sixty-three individuals (21 non-diabetic obese, 22 type-2 diabetic obese and 20 systemically healthy controls) were included. Percentages of sites that demonstrated plaque (P < 0.05) and BoP (P < 0.05), and scores of CAL (P < 0.05), PD (P < 0.05), MBL (P < 0.05) and MT (P < 0.05) were higher among non-diabetic obese and type-2 diabetic obese patients than controls. There was no difference in these parameters among type-2 diabetic and non-diabetic obese patients. There was a significant correlation between HbA1c (P < 0.05) and BMI (P < 0.05) and PD in type-2 diabetic and non-diabetic obese patients. There was no correlation between HbA1c and BMI in all groups.  Conclusions: Periodontal tissue destruction is more pronounced in obese individuals, irrespective of diabetic status. This suggests that excess adiposity plays a central role in periodontal breakdown, regardless of diabetic status.

Background: This study compared the efficacy of a bioflavonoid-enriched herbal mouthwash versus 0.12% and 0.2% chlorhexidine (CHX) in reducing peri-implant inflammation and subgingival Porphyromonas gingivalis (P. gingivalis) carriage among patients with peri-implantitis.

Methods: In all, 67 individuals diagnosed with peri-implantitis were enrolled. Demographic and implant-related data were retrieved, and subgingival biofilm samples were analysed for P. gingivalis. All patients underwent non-surgical mechanical debridement (MD) and were then randomised into three groups: test group (bioflavonoid mouthwash, n = 22), control group 1 (0.12% CHX, n = 23), and control group 2 (0.2% CHX, n = 22). Participants rinsed with 15 ml of the assigned solution twice daily for 90 days. Clinical parameters, including modified plaque index (mPI), modified bleeding index (mBI), probing depth (PD), and crestal bone loss, were recorded at baseline and after 90 days. Statistical significance was set at P < 0.05.

Results: Significant reductions in mPI, mBI, and PD were observed across all groups compared with baseline (P < 0.05). The follow-up scores for these parameters were significantly lower in the test group compared with both CHX groups (P < 0.05). At baseline, P. gingivalis was detected in 79.1% of participants. After 90 days, P. gingivalis carriage was lower in the test group (13.6%) compared with control group 1 (50.0%) and control group 2 (54.5%).

Conclusion: Prescription of a bioflavonoid-enriched herbal mouthwash following MD is more effective in reducing peri-implant inflammation and subgingival P. gingivalis compared with 0.12% and 0.2% CHX rinses.

Objective: The aim of this study was to compare the effects of different fixed lingual retainers (LRs) on tooth mobility after orthodontic treatment at the 10-month follow-up.  Methods: 72 patients were allocated to three different LR groups (Ortho FlexTech® chain, Bond-A-Braid®, Penta-One®). Additionally, 20 non-treated people were included as a control group. The mobility of six mandibular anterior teeth was measured using a Periotest® device at each time points (before application of LR [T0], immediately after application of LR [T1] and 10 months after [T2] the application of the LR), and at only one time (T0) for the control group.

Results: The mobility value was significantly lower at T1 and T2 compared to that at T0 (P < 0.05); yet, there were no differences at T1 and T2 in all LR groups (P > 0.05). No significant differences in mobility between the T0-T1, T0-T2, and T1-T2 time points were observed across the LR groups (P > 0.05). The mobility of teeth 33 and 43 decreased over time across all study groups (P < 0.05).  Conclusions: Mobility decreased immediately after LR application, but did not change during the 10-month follow-up in the treatment groups. The observed decrease in mobility of canines over time, in contrast to other teeth, suggests a relationship between root size and mobility.

Trial registration: The current clinical trial was recorded at clinicaltrials.gov, NCT06284499, 08/02/2024, retrospectively registered.

Objective: The purpose of statutory oral health care services based on the Health Care Act (implemented 01 May 2011) and Decree (implemented 06 April 2011) is to provide equal services nationwide for all children. The aim of this register-based study was to explore the implementation and content (multiprofessional co-operation, absenteeism and the need for family's special support) of statutory oral health examinations and screenings among a group of Finnish preschool children.

Materials and methods: The study group consisted of the medical records of Finnish children in the City of Oulu from three different age groups (born in 2014-2018, n = 2,023-2,456). In this pilot study, data on dental examinations/screenings and missed appointments and their reasons of 206 randomly selected preschool-aged were collected from patient records in oral and public child health clinics during March 2022 to July 2022. Referrals within oral health care, along with the occupations of those referred to, were registered. Chi-squared or Fisher's Exact Test was used to evaluate differences between three age groups.  Results: Across different age groups, 8.7% - 21.4% of children dropped out of statutory oral health care services. Dentists performed only a small proportion of oral health examinations for preschool-aged children (3.1%). Co-operation between oral health professionals was scarce. They rarely solved the reasons for missed appointments of dental care visits (5.1%). No referrals to Child Protection Services were made from oral health care.  Conclusion: In this group of preschool children, implementation of Health Care Act and Decree was only partially completed. Absenteeism from statutory oral health care, addressing the need for Child Protection Services, and lack of multiprofessional co-operation seem to be causes for concern. Further research and attention to this topic is necessary.