Acta Odontologica Scandinavica最新文献

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.

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.