Acta Odontologica Scandinavica最新文献

Objective: To identify caries experience in two groups of children and adolescents using longitudinal data from the Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa).

Material and methods: Data from two groups (10- and 20-year-olds), 165,365 individuals, were observed retrospectively for 10 years. Using a three-trajectory caries model (3-TCM), individuals were assigned according to their caries development as: high (15%), moderate (45%), or low (40%). Caries experience was expressed using the decayed and filled surfaces (DFS) and dfs indices. The specific affected caries (SaC) index and a point prevalence measurement at age 6 years (PP-6) were also analyzed.

Results: Over the observation period, significant differences were discovered between all three trajectories within the oldest group (20-year-olds). The mean DFS increase was significantly elevated for the high trajectory compared with the lower trajectories, 7.9 ± 10.2, 3.3 ± 2.9 and 0.2 ± 0.5 for the three trajectories respectively. In the youngest group (10-year-olds), the high trajectory combined with the SaC and PP-6 provided further information of those with the highest caries experience.

Conclusions: The 3-TCM identified individuals with high caries experience in the permanent dentition; but to properly elucidate caries experience in the primary and mixed dentitions, a combination with other indices was needed.

Objective: Assess the construct validity of Sense of Coherence (SOC) by testing a one- and a three-factor structure and associations with oral health indicators.

Method: In all, 9000 adults were randomly selected from a national population panel of 83,000 and 1,557 completed telephone interviews. SOC was measured using the 13-item Norwegian version of the original 29-item Orientation to Life questionnaire. Oral health was assessed as oral impacts on daily performances (OIDP), periodontal symptoms and attitudes towards oral health. Descriptive statistics and multivariable logistic regression analyses were conducted using Statistical Package for the Social Sciences (SPSS). Confirmatory factor analysis (CFA) was performed using the Lavaan package in R.

Results: Confirmatory factor analysis provided satisfactory fit to a modified one-factor model; comparative fit index (CFI) = 0.940, root mean squared error of approximation (RMSEA) = 0.062, Tucker-Lewis index (TLI) = 0.925. Factor loadings ranged from 0.360 to 0.798. Metric invariance was obtained across sexes. Adults having strong SOC were less likely to report oral impacts and periodontal symptoms, and more likely to report positive oral attitudes.

Conclusion: This study demonstrated construct validity of the Norwegian version of SOC 13 and that, in the presence of socio-demographic factors, SOC is an important contributor to oral health outcomes. SOC should be considered in oral health educational and promotional interventions among Norwegian adults.

Objective: To describe differences in the dental age of Finnish children with the mixed stage of dentition in relation to the treatment provided for the permanent maxillary canines.

Material and methods: This retrospective register-based study was based on 1,332 cross-sectional dental panoramic tomographs (DPTs) for children with a chronological age of 8.5-10.5 years together with longitudinal information on the eruption and treatment of 1,817 maxillary canines in the same children. The treatments were categorized into early (interceptive treatment and early headgear) and late treatment (orthodontic treatment and treatment for crowding) groups. Dental age was assessed by Demirjian's dental maturity method and grouped into delayed (≤ -1 year), normal (> -1 and < +1), and advanced (≥ +1 year) relative to children's chronological age. Results were performed using Pearson's chi-square test, Fisher's exact test, and multinominal logistic regression models.

Results: Normal dental age at the time of the DPT was detected most often in the children in all studied treatment groups. Delayed dental age was detected more often in the children in the early treatment group and advanced dental age in the late treatment group (p = 0.002). The mean dental age of the girls with early treated canine(s) lagged significantly behind that of the girls in the groups that received no treatment (-0.43 years, p = 0.004) or late treatment (-0.45 years, p = 0.026). Delayed dental age was detected in 28.1% of the interceptively treated canines, leading to an association between delayed dental age and interceptive treatment (odds ratio 3.99, 95% confidence interval 1.84-8.67).

Conclusions: Association was found between delayed dental age and interceptive treatment of a maxillary canine. Because of variations in dental age within the same age group, the timing of treatment plays a key role in order to achieve early treatment options for children's erupting maxillary canines.

Objectives: This study aimed to evaluate the association between obesity, periodontal status, and cathepsin S (CatS) levels in gingival crevicular fluid (GCF) and saliva and assess the impact of obesity on clinical and biochemical outcomes following nonsurgical periodontal therapy (NSPT).

Methods: A total of 52 participants were categorized into nonobese with periodontal health, obese with periodontal health, nonobese with periodontitis, and obese with periodontitis groups. Clinical, periodontal, and anthropometric measurements were recorded. CatS levels in GCF and saliva were quantified using an enzyme-linked immunosorbent assay. NSPT was performed in the periodontitis groups, and clinical and biochemical parameters were re-evaluated after 3 months.

Results: GCF and salivary CatS levels were highest in the obese periodontitis group and lowest in the nonobese periodontal health group (p < 0.001). Regression analysis revealed a significant positive association between body mass index (BMI), GCF, salivary CatS levels, and plaque index (p < 0.05). Significant positive correlations were observed between BMI and CatS levels, as well as between CatS levels and clinical periodontal parameters (p < 0.001). Following NSPT, both periodontitis groups exhibited significant clinical and biochemical improvement (p < 0.05). However, reductions in bleeding on probing, probing pocket depth, clinical attachment loss, and salivary CatS levels were significantly greater in the nonobese periodontitis group than in the obese group (p < 0.001).

Conclusion: Periodontitis and obesity are associated with elevated CatS levels in GCF and saliva. Obesity may negatively impact clinical responses to NSPT. CatS could serve as a potential biomarker linking obesity to periodontitis and NSPT outcomes.

Objective: To investigate whether low daily doses of fluoridated milk, as an adjunct to oral hygiene routines with fluoridated toothpaste, can prevent caries development in enamel and dentine in adolescents.

Material and methods: Adolescents (mean age 13 years) at three dental clinics in Sweden were enrolled to a randomised clinical trial (RCT) including baseline and 2-year follow-up examinations. The intervention group consumed milk supplemented with fluoride (0.75-1.0 mg) daily, while the control group consumed milk with water. Caries lesion development was assessed visually in line with the international caries detection and assessment system (ICDAS), except for proximal surfaces of premolars and molars which were assessed using a radiological classification system. Outcome measures were decayed, missing and filled surfaces (DMFS) increment, caries lesion arrest and progression.

Results: Eighty seven participants in the intervention group and 72 in the control group completed the study. The intervention reduced the incidence of DMFS increment for enamel lesions, but not for dentine lesions. The degree of caries lesion arrest in outer enamel was higher in the intervention group compared to the control group, whereas caries lesion progression was lower in the intervention group.

Conclusion: Fluoride exerts an effect on caries lesions in the outer enamel, and fluoridated milk thus can be beneficial to adolescents with such lesions.

Trial registration: Clinicaltrials.gov registration number NCT06684405.

Objective: This study examined caries experience and its association with demographic, socioeconomic, and psychometric factors among persons with severe psychiatric and/or substance use disorders.

Material and methods: A cross-sectional study was conducted among inpatients at the Division of Mental Health and Substance Use, University Hospital of Northern Norway. Clinical oral examinations assessed decayed (D), missing (M), and filled (F) teeth separately and combined (DMFT). A questionnaire assessed demographic and socioeconomical factors, as well as variables from several health domains, including oral health. Analyses included descriptive statistics, cross-tabulations, and regression models.

Results: The study included 136 adults (mean age 37.7 years, range 19-70, 60% men). Mean scores were decayed teeth (DT) = 4.6 standard deviation (SD = 4.8), filled teeth (FT) = 7.9 (SD = 5.3), missing teeth (MT) = 2.6 (SD = 4.4), and DMFT = 13.6 (SD = 7.8). About 80% had at least one decayed tooth; 45% had DT ≥ 4. Eight percent had fewer than 20 teeth. DT was significantly associated with age, substance use, and toothbrushing frequency. DMFT was associated with age and toothbrushing frequency.

Conclusions: Findings reveal substantial unmet dental care needs, underscoring the importance of tailored interventions within the dental healthcare system.

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.