Acta Odontologica Scandinavica最新文献

Objective: This study explores how 9- and 17-year-olds in Norway experience conscious sedation during dental treatment, examining its impact on treatment ease, perceived ability to refuse, and memory retention.

Material and methods: A cross-sectional electronic questionnaire was distributed to 13,013 children and adolescents (6,686 9-year-olds and 6,327 17-year-olds) in the Public Dental Service of Hordaland County, Norway, in 2019. Response rates were 65.6% for 9-year-olds and 52.2% for 17-year-olds. The survey included validated instruments for dental fear and nonvalidated items assessing subjective sedation experiences. Data were analyzed using descriptive statistics, chi-squared tests, and Mann-Whitney U-tests.

Results: Of the respondents, 13.6% (n = 596) of the 9-year-olds and 9.5% (n = 313) of the 17-year-olds reported having undergone dental treatment with conscious sedation. Among them, 67.4% felt sedation made treatment easier, while 8.5% found it difficult to refuse treatment under sedation. A total of 51.2% remembered the treatment, and memory retention was associated with higher levels of dental fear (p < 0.001).

Conclusion: While conscious sedation is perceived to facilitate dental treatment for many children, a large proportion retain memories of the treatment, particularly those with high dental fear. This highlights the importance of understanding children's subjective experiences to improve sedation practices.

Objective: To investigate the changes in alveolar bone thickness (ABT), the height of the enamel bone border-alveolar ridge apex (ABH), and alveolar bone area (ABA) of the labial and palatal sides of the maxillary incisor region after orthodontic treatment of adult bimaxillary protrusion.

Methods: Ninety-eight adult patients with bimaxillary protrusion who underwent orthodontic treatment in our hospital between November 2023 and November 2024 were clinically selected for retrospective study, and patient data were obtained from the medical record system, comparing the widths of the intercuspal space between the cuspids, the width of the space between the first premolar teeth, the width of the space between the second premolar teeth, the convexity of the anterior teeth (UI-SN, UI-NA), and the lip and palate of maxillary incisor region before and after treatment. ABT, ABH, and ABA changes.

Results: Comparison of intercuspal width and MP-SN levels before and after treatment in all patients showed no statistically significant differences (P > 0.05). The intercuspal width of the first premolar, intercuspal width of the second premolar, UI-SN and MP-SN were higher than those before treatment, and the difference was statistically significant (P < 0.05). The labial cervical, labial mid-root, and labial apical ABT levels of maxillary mesial incisors and lateral incisors were higher than those before treatment, and the palatal cervical, palatal mid-root, and palatal apical ABT levels were lower than those before treatment, and the difference was statistically significant (P < 0.05). There was no statistically significant difference in the comparison of labial ABH levels of mesial incisors and lateral incisors before and after treatment (P > 0.05); the levels of palatal ABH of mesial incisors and palatal ABH of lateral incisors were higher than those before treatment, and the levels of palatal ABA of mesial incisors and palatal ABH of lateral incisors were lower than those before treatment, and the difference was statistically significant (P < 0.05).

Conclusion: Orthodontic treatment is effective in adult patients with bimaxillary protrusion, but significant resorption of the alveolar bone on the palatal side of the incisal region occurs after treatment, reducing the amount of alveolar bone in the entire incisal region. Therefore, the long-term effects on periodontal tissues need to be paid attention to.

Objective: In vitro leakage studies suggest that temporary restorations only provide a short-term seal. However, it remains unclear whether the clinical outcome is impacted by the time elapsing between the completion of a root canal treatment (RCT) and the placement of a direct permanent coronal restoration. The aim was to investigate any time-dependent difference in frequencies of endodontic orthograde retreatment, apical surgery and extractions during the subsequent 5 years following root filling of first molars restored with a direct restoration depending on immediate or delayed time between completion of RCT and placement of a direct restoration.

Material and methods: Data from the Swedish Social Insurance Agency was collected. In 2009, 50,314 direct restorations were registered after RCT of the first molars in individuals aged 20 years or older. The teeth were divided into five time intervals depending on time from completion of root filling to placement of direct restoration for comparisons of frequencies of orthograde retreatment, apical surgery and extractions, during the following 5 years. The time interval categories were compared using Pearson's Chi-square test.

Results: No statistically significant time-dependent differences in registrations were found for orthograde retreatment (p = 0.089), with or without apical surgery (p = 0.161) and with or without extraction (p = 0.737).

Conclusion: The time elapsed from the completion of RCT and the placement of a direct restoration did not affect the 5-year outcome of the RCT.

Objective: To investigate factors associated with nurses' challenges in providing oral care to infection- sensitive patients.  Material and methods: A total of 114 nurses from four internal medicine wards and one oncology ward participated in the study. Data were collected using a questionnaire containing six items about challenges in providing oral care to patients. A multivariate linear regression model was used to analyze the association between explanatory variables and challenges in oral care.  Results: Practical nurses reported more challenges in evaluating patients' oral problems compared to registered nurses (B = 1.8, p ≤ 0.01). Nurses reporting fairly good or poor oral health reported more challenges in managing resisting patients than those who reported good oral health (B = 1.1, p < 0.05). Higher self- efficacy in Practical skills was associated with fewer challenges related to having a lack of knowledge about cleaning a patient's mouth (B= -0.9, p ≤ 0.01) and evaluating patients' oral problems (B = -0.5, p ≤ 0.01). Higher self-efficacy in Confidence to detect oral problems was associated with fewer challenges in managing resisting patients (B= -0.6, p ≤ 0.01) and evaluating patients' oral problems (B = -0.5, p ≤ 0.001).  Conclusions: Nursing education, self-perceived oral health, and self-efficacy were associated with  perceived challenges.

Objective: The use of virtual surgical planning (VSP) in orthognathic surgery is increasing. The aim of this study was to investigate which type of dentofacial deformity makes the surgeon choose VSP and if VSP influences the choice of surgical techniques. Furthermore, we sought to evaluate if use of VSP affects surgical time and blood loss during surgery.

Material and methods: Patients having undergone orthognathic surgery and registered in the Swedish quality registry for orthognathic surgery (NROK) between 2018 and 2019 were eligible for inclusion in this study. An evaluation of the usage of VSP was performed together with an analysis of operation time and bleeding during surgery. A total of 862 patients were evaluated.

Results: Out of the 862 patients who had orthognathic surgery, 224 were VSP cases. Patients diagnosed with maxillary retrusion (p = 0.0024), maxillary vertical hyperplasia (p < 0.001), mandibular protrusion (p = 0.0031), laterogenia (p < 0.001) or craniofacial deformity (p = 0.0033) were more often digitally planned. Patients who underwent VSP and bimaxillary surgery showed a tendency of reduced operating time andless bleeding during surgery; however, the results were inconclusive.

Conclusion: The present study shows that VSP was used more frequently in patients with maxillary retrusion, maxillary vertical hyperplasia, mandibular protrusion, laterogenia, and craniofacial deformity in comparison with other diagnoses. Alongside the findings that VSP cases had more diagnoses per patient and that a larger number of surgical procedures were performed in this group, this indicates a preference for using digital planning in more complex orthognathic cases.

Objective: The study aims to evaluate the course of implant treatment for congenitally missing lower -second premolars in patients referred to publicly funded specialist care over an 11-year period.

Material and methods: This retrospective, register-based cohort study selected patient data on dental implant treatment in the lower second premolar region from 2009 to 2019 (n = 146). After applying exclusion criteria, the final sample included 74 patients. Data on retained deciduous teeth, orthodontic treatment prior to implant placement, and implantation procedures were gathered from patient files. Results were presented using descriptive statistics, t-test, and Chi-square analyses (p < 0.05).

Results: The most common orthodontic treatment was space optimization before dental implant placement. Most retained deciduous teeth were extracted between ages 21 and 29, with a median of 6 months before implant placement. Bone grafting was performed at 23% of implant sites. The mean implant diameter was 4.0 mm, and the mean implant length was 9.6 mm. Good primary stability was achieved in all cases.

Conclusion: Individually planned orthodontic and surgical treatments are essential in managing congenitally missing lower premolars, particularly when implant placement is indicated. Early diagnosis and collaboration between dental specialists are key elements in the treatment. A multidisciplinary approach ensures optimal space for implant, bone preservation, and optimal implant alignment.

Objective: This study evaluated mandibular cortical thickness and morphological changes in chronic kidney disease (CKD) patients using cone beam computed tomography (CBCT) and their correlation with bone metabolism markers.

Methods: CKD patients were divided into CKD-I (eGFR (estimated glomerular filtration rate) < 30) and CKD-II (eGFR ≥ 30) groups, with healthy controls for comparison. Mental index (MI), antegonial index (AI), and panoramic mandibular index (PMI) were compared using Kruskal-Wallis test. Mandibular cortical index (MCI) classifications, lamina dura loss, and soft tissue calcifications were assessed using Fisher's test. Relationships between serum bone metabolism markers and radiomorphometric indices were analyzed by linear regression.

Results: The study included 94 CKD patients (56 CKD-I, 38 CKD-II) and 88 controls. MI and AI were significantly lower in CKD-I versus controls (p < 0.05). MCI class I was less prevalent in CKD-I (5.4%) than controls (35.2%) (p < 0.001). Lamina dura loss (p = 0.006) and soft tissue calcifications (p = 0.009) occurred more frequently in CKD groups. Elevated alkaline phosphatase was associated with reduced cortical thickness (p < 0.01).

Conclusions: Although findings should be interpreted considering the retrospective design's limitations, CBCT revealed significant bone abnormalities in CKD patients, with compromised bone quality and reduced mandibular cortical thickness, especially in advanced renal impairment, suggesting its value for pre-implant bone quality assessment in CKD patients.

Objective: Adolescents belong to the high-risk group of erosive tooth wear (ETW), but by contrast, they are reported to lack knowledge about this condition and its association with the intake of acidic beverages. This study aimed to survey the awareness of ETW and the consumption of beverages among a group of Finnish adolescents.

Material and methods: A survey was conducted using an online questionnaire for the students in two upper comprehensive schools in the province of Southwest Finland. The awareness of ETW and the consumption frequencies of 14 beverages according to gender and school grade were analysed using chi-square or Fisher's exact test. The associations of the awareness of ETW with gender, school grade and acidic beverage consumption were analysed by logistic regression.

Results: Most of the 230 respondents consumed acidic beverages more than once a week. The consumption of lemonades (OR [odds ratio] 2.79-3.05, p = 0.008-0.018, 95% CI 1.19-7.00) and energy drinks (OR 5.59, p = 0.0008, 95% CI 2.06-15.2) was more common among those who assumed that ETW is not preventable. However, 45-47% of the respondents have not received information about ETW or its prevention from dental care professionals.

Conclusion: The studied Finnish adolescents have a lack of knowledge about ETW and the acidic beverage consumption among them requires intervention.

Objective: The study aims to describe the oral status, oral health-related quality of life (OHRQoL), and oral-health behaviours of vulnerable adult migrants with complex health problems.

Methods: We conducted a descriptive cross-sectional study at the Section of Immigrant Medicine, Hvidovre Hospital, Denmark. We conducted clinical examinations to assess participants' number of teeth, caries, oral hygiene, and periodontal status. Participants also completed a questionnaire to evaluate OHRQoL, oral-health related behaviours (e.g. use of dental care system), and perceived barriers to access dental treatment and maintaining oral hygiene.

Results: We included 50 participants, with a mean age of 49.4 (SD 7.4) years, 82% of whom were women, and 40% were from the Middle East and North Africa. Regarding oral status, 28% of participants had a full dentition, 54% had decayed teeth, 12% had good oral hygiene, and 46% had periodontal disease. Regarding OHRQoL, 92% of participants reported that their oral health negatively impacted one or more daily activities. Around 40% of participants had visited the dentist in Denmark the previous year, and 95% reported the costs as a barrier to dental care.

Conclusions: There is a high prevalence of oral disease with a massive impact on the OHRQoL of this group of vulnerable migrants. Despite the need for essential dental treatments, participants rarely used the Danish dental care system. Our findings highlight the need for multi-sectoral interventions for this population.