Den Norske tannlaegeforenings tidende最新文献

Case histories of patients referred to a university clinic for evaluation/treatment with implants were studied, regarding recommended and actually performed treatment. Patient reactions after treatment with conventional methods were also recorded. Three main groups attended: 1) Elderly, unsatisfied complete denture wearers. 2) Patients with few remaining teeth and an aversion against removable dentures. 3) Young patients with single teeth missing in an otherwise healthy dentition. Fifty-seven per cent of edentulous patients were recommended correction/replacement of their conventional full denture. Three out of four followed the recommendation. For jaws with a severely reduced dentition conventional prosthetic alternatives were advocated in 80 per cent of the cases. Corresponding treatment was carried out in 57 per cent of the cases, prosthetic appliances differing substantially from the suggested alternative in 26 per cent, and 17 per cent received no prosthetic treatment. Only few jaws required single tooth replacements. Every second patient who had this complete denture corrected or remade, considered implant therapy then superfluous. All complicated cases with extensive tooth loss were treated to the patients satisfaction, without using implant support, provided the treatment was referred to a colleague with specialist training. Forty per cent of similar cases remitted to their general practitioner did not receive any prosthetic treatment at all.

This article reviews the present status on the prevalence and distribution of periodontal diseases in the population. The relationship between periodontal diseases and tooth loss is described. Epidemiological data have limitations when they are used to describe treatment needs in the population. Some of these limitations are discussed.

It is likely that dental personnel have little knowledge about Alzheimer's disease (AD), the most common of the degenerative diseases. The number of patients with AD will increase in the future, due to an increasing number of the aged. The number of AD-patients in need of dental treatment will also increase because of a continually higher number of remaining teeth among the elderly. To meet this category of patients, it is of importance to increase the knowledge of AD. The criteria for the diagnosis of AD may be summarized as loss of intellectual accomplishment, loss of memory, slowly progressive course of the disease and either loss of abstract thinking, loss of judgement, loss of higher cortical functions or personality disturbances. The prevalence of senile dementia in Oslo has been estimated to 72% in nursing homes and 11% for the population living at home for the age group <75 years. Among these, between 50 and 70 percent suffer from AD. The etiology of AD is unknown, but the two most accepted hypotheses are the genetic and the toxic. Epidemiological and molecular biological evidence points to the possible involvement of aluminum in the aetiopathogenesis of Alzheimer's disease.

Dental and periodontal status and treatment needs were among the parameters assessed and related to the use of oral health services of 25- and 40-year olds in the community of Balsfjord, Northern Norway. The 25-year olds were found to have an average of 27.3 teeth. 13.6 DMFT and no deep periodontal pockets (greater than 5.5 mm). The oldest group had an average of 20.2 teeth. Twenty per cent wore a full denture in one or both jaws, and deep periodontal pockets were found in 6% of remaining sextants in those with only one full denture. The effect of oral health care use and social status were found to be different in the two age-groups. In the 25-year olds, frequent dental health care use was found to have a significant negative effect on both caries experience and periodontal pockets when adjusted for sex and educational background. The findings may indicate a possibility of accumulation of false positive diagnoses with overtreatment as a consequence. This may be the main explanation of this negative effect on the dental status. The level of education appeared to have a significant positive influence on the oral health in the 40-year olds. However, the use of oral health care services showed no significant effect in this group.

Sixty-two ceramic implants (Frialit) were installed in 53 patients with agenesia or loss of single teeth due to traumata or infection. Sixty-three per cent of the implants were operated in immediately after tooth extraction, whereas the rest were installed in a healed bony alveolar ridge. Eighty-five per cent of the implants were replacements for maxillary incisors. The average observation period was 4 years. During this period 10 implants were removed due to lack of osseointegration. Seven of these implants were lost in the healing period, the remaining 3 were removed after installation of the suprastructure. Eighty-four percent of the implants were successful after 4 years. Trauma in the maxillary region have caused fracture of the implants in 5 patients. Such incidents create therapeutic problems difficult to solve satisfactorily.

Regeneration of lost tooth support has been the illusive goal of periodontal surgery for more than 100 years. Important progress was made in the nineteen-seventies when it was found that (1) periodontally involved root surfaces can be detoxified by mechanical and chemical means, (2) demineralized bone and dentin matrices have an osteoinductive potential, and (3) application of citric acid or tetracycline to the root surface during reconstructive surgery enhances attachment of granulation tissue and new collagen fibers. While experimental studies in animals have reported 100% connective tissue regeneration, clinical results have been less spectacular. More recently, improvements have included the introduction of membrane materials to guide tissue regeneration. Currently, resorbable membrane materials, osteinductive graft materials, and a variety of biologic response modifiers are being examined for their potential as adjuncts to periodontal regenerative procedures.

This article gives a review of autotransplantation of teeth. From being a method of rather poor prognosis, autotransplantation has developed to be a safe treatment procedure. Scientific criteria for selecting patients, donor teeth, surgical procedures and postoperative care has contributed to this. The surgical procedure and the endodontic treatment are discussed. The degree of root development is of importance. Complications may be extern root resorption and ankylosis because of damage to the periodontium.