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  • 1.
    Andersson-Wenckert, Ingrid
    et al.
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Sunnegårdh-Grönberg, Karin
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Flowable resin composite as a class II restorative in primary molars: A two-year clinical evaluation.2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 6, p. 334-340Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the clinical durability of flowable resin composite and resin-modified glass ionomer cement when used as class II restoratives in primary molars. MATERIAL AND METHODS: A total of 190 restorations were placed in 61 children, age in the range of 5-11 years. The restoratives, Tetric Flow, in combination with the adhesives, Excite or Prompt-L-Pop and Vitremer, were used in class II cavities in primary molars. An intra-individual study design was used and the restorations were evaluated by modified USPHS criteria over a 2-year period. RESULTS: 146 of the restorations could be evaluated at 2 years. The cumulative failure rate was 10.6% for Vitremer and 13.6% for Tetric Flow. No statistically significant differences were found in failure rates between different materials or between bonding systems. The main cause of failure for Tetric Flow was secondary caries and for Vitremer wear and dissolution. CONCLUSIONS: Vitremer and Tetric Flow showed no significant difference concerning clinical durability at 2 years when used as class II restoratives in primary molars. Both materials demonstrated acceptable clinical results.

  • 2.
    Bergendal, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Odontology. Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    McAllister, Anita
    Stecksen-Blicks, Christina
    Umeå University, Faculty of Medicine, Odontology. Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Orofacial dysfunction in ectodermal dysplasias measured using the Nordic Orofacial Test-Screening protocol2009In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, ISSN 1502-3850, Vol. 67, p. 377-381Article in journal (Refereed)
  • 3. Bessing, C
    et al.
    Molin, M
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    An in vivo study of glass ceramic (Dicor) inlays. Preliminary report.1990In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 48, no 5, p. 351-7Article in journal (Refereed)
    Abstract [en]

    For the purpose of evaluating the clinical quality of glass ceramic (Dicor) inlays 15 patients with 37 inlays were examined 1 to 22 months after placement. In addition to certain periodontal variables, the inlays were rated by two independent examiners using the California Dental Association (CDA) quality evaluation system. The results of the present study showed that dental plaque was seen less often on proximal surfaces with inlays than on homologous proximal surfaces. Three patients reported hypersensitivity of the dental pulp. The examination using the CDA criteria showed that 54% of the inlays had a slight color mismatch, and slightly roughened surfaces were occasionally seen (35.5%). In nearly 30% of the inlays there was visible evidence of ditching along the margins. At present, no judgement can be made about the longevity of ceramic inlays.

  • 4. Bruno-Ambrosius, Katarina
    et al.
    Yucel-Lindberg, Tülay
    Twetman, Svante
    Umeå University, Faculty of Medicine, Odontology. Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Salivary buffer capacity in relation to menarche and progesterone levels in saliva from adolescent girls: a longitudinal study.2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 5, p. 269-72Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the relationship between salivary buffer capacity and menarche, and to explore any association with levels of the sex hormone progesterone in stimulated whole saliva in adolescent girls. The material comprised 162 girls, 12 years of age at baseline in the 6th grade, who were followed for 3 years. Every 4th month, a stimulated whole saliva sample was collected, secretion rate and buffer capacity were determined, and information was gathered on menarche, ongoing menses, and caries increment. Once yearly, the salivary concentration of progesterone was determined with an enzyme immunoassay kit. The results showed a significantly impaired salivary buffer capacity over the years (P < 0.05). Low buffer capacity was significantly correlated with low secretion rate (r = 0.42; P< 0.001) and DMFT increment (r=0.20; P<0.05). Pre-menarche buffer capacity did not differ from the postmenarche scores. The concentration of progesterone in saliva increased with age but displayed no significant relationship to buffer capacity, flow rate, or caries increment. In conclusion, the findings of this study suggest that the salivary buffer capacity may be impaired over the adolescent years in females, but the reason remains unclear.

  • 5. Chiang, Huei-Min
    et al.
    Tranaeus, Sofia
    Sunnegårdh Grönberg, Karin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Caries as experienced by adult caries active patients: a qualitative study2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In the western world, increased oral health has resulted in a skewed occurrence of caries disease where relatively few individuals now account for most caries disease. This study examines how adults with recurrent caries activity experience caries disease and treatment.

    MATERIALS AND METHODS: The study is based on qualitative data from individual interviews, which were subjected to qualitative content analysis. The interviews were semi-structured and thematic and an interview guide was used that consisted of two main areas with open ended questions. Meaning units were condensed and labelled with a code which preserved the core content of the reduced text. Codes were assigned to different subcategories according to their similarities or differences. Subcategories formed categories which describe the manifest content of the text.

    RESULTS: The domain "experience with caries" consisted of four subcategories that formed the main category Caries - an unwelcomed acquaintance. The domain "experience with caries treatment" consisted of three subcategories that formed the category Caries treatment - pain for gain.

    CONCLUSION: Comprehensive non-operative treatment and close follow-ups should precede restorations; this would probably gain insight in how to avoid new cavities to a greater extent. If to be supportive, information and advice about self-care given to individuals with recurrent cavities should be delivered with respect to the patient's feelings about their experience of dental caries.

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  • 6. Dalton Bittencourt, DD
    et al.
    Ezecelevski, IG
    Reis, A
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Loguercio, AD
    An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions.2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 3, p. 173-178Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. In this intra-individual comparison (an 18-months' randomized, controlled prospective study), we evaluated the clinical performance of one self-etch and one "etch & rinse" adhesive in non-carious cervical lesions. METHODS. Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated. Seventy-eight restorations were placed; 39 with etch & rinse (Single-Bond) and 39 with self-etch (Adper Prompt). Both adhesives were combined with the microfilled resin composite Filtek-A110. The restorations were evaluated at baseline, 6, 12, and 18 months according to slightly modified USPHS criteria. Statistical differences between the adhesives was tested with McNemar's test and clinical degradation over time for each material with the Fisher exact test (a=0.05). RESULTS. Thirty pairs were evaluated at 12 and 18 months. Two self-etch restorations were lost after 18 months. Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months (p<0.05). Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration (p<0.05). CONCLUSIONS. Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions. The self-etch adhesive showed a faster progressive marginal degradation.

  • 7. Davidson, Thomas
    et al.
    Rohlin, Madeleine
    Hultin, Margareta
    Jemt, Torsten
    Nilner, Krister
    Sunnegårdh Grönberg, Karin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Tranaeus, Sofia
    Nilsson, Mats
    Reimbursement systems influence prosthodontic treatment of adult patients2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 6, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.

  • 8. Derand, Tore
    et al.
    Molin, Margareta
    Umeå University, Faculty of Medicine, Department of Odontology, Prosthetic Dentistry.
    Kvam, Ketil
    Bond strength of a composite luting agent to alumina ceramic surfaces.2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 4, p. 227-30Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to evaluate the shear bond strength (SBS) of a dental luting agent to alumina ceramics after different surface pretreatment. MATERIAL AND METHODS: Specimens (n=50) of pressed blocks (10 x 0 x 5 mm) of alumina ceramic (Procera AllCeram) were divided into untreated specimens (AF) as provided by the manufacturer and polished specimens (AP). Five groups of specimens (n=5 x 10) with different surface pretreatments were prepared. Groups 1 and 2: AF and AP without any pretreatment; Group 3: AF treated with silane, (AF-s); Group 4: AF treated with RF plasma spray (AF-RF); Group 5: AF treated with low fusing porcelain (AF-p) glass pearls. Composite cylinders (5 x 5 mm) were cemented to the test specimens with a resin luting agent. The specimens were loaded to failure in shear mode using a universal testing machine. Recorded loads were used to calculate SBS in MPa. The results were analyzed using one-way ANOVA and the Tukey HSD multiple comparison test at alpha = 0.05. Scanning electron microscopic micrographs (SEM) were used to characterize surfaces of interest. RESULTS: Polished surfaces had significantly lower SBS (p < 0.05) compared with untreated specimens (AP vs AF). Silanated, non-polished surfaces (AF-s) revealed lower SBS, even though the result was not significantly different from that of AF-s without silane treatment. Plasma treatment improved SBS by a factor of 2 (p<0.05) and treatment with low-fusing porcelain micro pearls increased SBS by a factor of 3 compared to untreated surfaces (p<0.05). The layer of glass pearls did not exceed 5 microm (SEM). CONCLUSIONS: Within the limitation of the conditions of this study, treatment of alumina oxide ceramic surfaces with a plasma spray coating or a low-fusing porcelain pearl layer significantly increased the SBS of a resin luting agent to the ceramic surface.

  • 9.
    Dijken, Jan W. V. van
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene. Umeå University, Faculty of Medicine, Department of Odontology.
    Sunnegårdh-Grönberg, Karin
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology. Umeå University, Faculty of Medicine, Department of Odontology.
    A two-year clinical evaluation of a new calcium aluminate cement in Class II cavities2003In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 61, no 4, p. 235-40Article in journal (Refereed)
    Abstract [en]

    A calcium aluminate cement (Doxa Certex, Uppsala, Sweden) has recently been developed intended for use as direct restorative filling material for posterior restorations. The material is inorganic and non-metallic and the main components are CaO, Al2O3, SiO2, and water. The aim of this study was to evaluate intra-individually the experimental calcium aluminate cement (CAC) and a resin composite (RC) in Class II restorations. Each of 57 participants received at least one pair of restorations of the same size, one CAC and one RC (Tetric Ceram). Sixty-one pairs were performed. The restorations were evaluated clinically, according to slightly modified USPHS criteria, at baseline, after 6 months, 1, and 2 years. One-hundred-and-twenty restorations were evaluated at 2 years. Postoperative sensitivity was reported for 5 restorations (2 RC, 3 CAC). Significantly better clinical durability was shown for RC. Five non-acceptable CAC restorations (8.2%) were observed at 6 months, 10 CAC (16.7%) and 2 RC (3.3%) at 12 months, and 11 CAC (18.3%) at 24 months. This resulted in a cumulative failure frequency of 43.3% for the CAC material and 3.3% for the RC material. Main reasons for failure for the CAC were partial material fracture (7), cusp fracture (5), and proximal chip fracture (6). The CAC showed a non-acceptable clinical failure rate for Class II restorations, probably caused by its difficult handling and low mechanical properties.

  • 10.
    Engström, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Petersson, Lars G.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Twetman, Svante
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Composition of the salivary microflora during habital consumption of fluoridated milk2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 3, p. 143-146Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the effect of habitual consumption of fluoridated milk on the composition of the salivary microflora. The study group comprised 20 healthy schoolchildren and young adults with a mean age of 13.6 years and the investigation had a randomized double-blind crossover design with a washout period of 1 month. After professional tooth-cleaning at baseline, the subjects were supplied with either fluoridated (250 mL, 5 ppm F) or non-fluoridated milk for one daily intake during a period of 4 weeks. Salivary samples were collected immediately before tooth-cleaning and after 1, 2, and 4 weeks, respectively. The samples were immediately cultivated for total viable counts, oral streptococci, mutans streptococci, lactobacilli, and actinomyces spp. Bacterial counts were logarithmically transformed before statistical evaluation using ANOVA. No significant alterations of the salivary microflora were found during any of the milk regimens compared with baseline. There was a slight reduction in the proportion of mutans streptococci after 2 and 4 weeks during consumption with fluoridated milk but the difference failed to reach statistical significance. In conclusion, this study was unable to disclose any significant alteration of the composition of the salivary microflora following daily intake of fluoridated milk.

  • 11.
    Felszeghy, Szabolcs
    et al.
    Department of Anatomy, Histology and Embryology, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
    Holló, Krisztina
    Department of Anatomy, Histology and Embryology, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
    Módis, Laszlo
    Department of Anatomy, Histology and Embryology, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
    Lammi, Mikko
    Department of Anatomy, University of Kuopio, Kuopio, Finland.
    Type X collagen in human enamel development: a possible role in mineralization.2000In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 58, no 4, p. 171-176, article id 11045371Article in journal (Refereed)
    Abstract [en]

    Although type X collagen is one of the key molecules in endochondral ossification, no data are available on whether it is present in dental structures when mineralization is proceeding. We therefore monitored the appearance of type X collagen in tooth germs of human samples ranging in gestational age from 17-week-old fetuses to 9-week-old newborn. Using immunohistochemistry, ELISA techniques, and Western blotting, we show that type X collagen is present in human tooth germ during enamel maturation. Intense immunohistochemical staining for collagen type X was observed in the enamel and in the apical parts of secretory ameloblast at the bell stage when the dentine and enamel matrix were already under formation. The odontoblasts, the dentine, and the pulp were not stained. In the early (9-week) postnatal stage, the staining for collagen type X in the enamel matrix was diminished, and only a very weak signal could be detected in the secretory ameloblasts. A positive reaction for collagen type X was also observed in ELISA assay of extracts obtained from human embryonic enamel and hypertrophic cartilage samples. The Western blot analysis of the enamel demonstrated that size of the molecule detected by MoAb X53 is characteristic of the type X collagen. This correlates well with our immunohistochemical findings. Based on these data, we propose that type X collagen is one of the candidate molecules present in the enamel matrix that might be involved in mineralization of the enamel.

  • 12. Flygare, Lennart
    et al.
    Hosoki, Hidehiko
    Petersson, Arne
    Rohlin, Madeleine
    Åkerman, Sigvard
    Bone volume in human temporomandibular autopsy joints with and without erosive changes1997In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 55, no 3, p. 167-172Article in journal (Refereed)
    Abstract [en]

    The aim was to compare the trabecular bone volume (TBV) and the total bone volume (TOBV) of human temporomandibular joints (TMJ) with erosive changes with those of joints without erosive changes. We examined 35 TMJ autopsy specimens from 19 individuals aged 66 88 years. Sagittal sections of the joints were analyzed microscopically for erosive hard-tissue changes. The TBV and the TOBV of the sections were assessed with the aid of computerized image analysis. A significant increase in trabecular and total bone volume was found in condyles with erosive changes (TBV = 21%, TOBV = 54%) as compared with condyles without erosive changes (TBV = 15%, TOBV = 40%). The trabecular bone volume of the temporal component was also increased (TBV = 24%) in joints with erosive changes in the condyle as compared with joints with unaffected condyles (TBV = 16%). The findings indicate that the relative bone mass may play a role in the development of erosive changes in the TMJ.

  • 13. Flygare, Lennart
    et al.
    Klinge, Björn
    Rohlin, Madeleine
    Åkerman, Sigvard
    Lanke, Jan
    Calcified cartilage zone and its dimensional relationship to the articular cartilage in the human temporomandibular joint of elderly individuals1993In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 51, no 3, p. 183-191Article in journal (Refereed)
    Abstract [en]

    The aim was to describe the appearance of the calcified cartilage zone (CCZ) and to determine its dimensional relationship to the articular cartilage thickness in the normal human temporomandibular joint. An autopsy material comprising 21 joints from 12 elderly individuals was examined microscopically. The appearance of the CCZ was examined, and the thickness of the CCZ and of the total articular cartilage was measured in 18 different positions in each joint. The CCZ was outlined by a flat or gently undulating tidemark and an irregular osteochondral junction. The cellularity of the CCZ varied extensively. The cells were numerous in the CCZ when the overlying articular cartilage displayed high cellularity. Statistical analysis of the measurements demonstrated a relationship (p < 0.001) between the thickness of the CCZ and of the articular cartilage. Our findings, both qualitative and quantitative, indicate a close relationship between the physiology of the CCZ and of the overlying articular cartilage.

  • 14. Flygare, Lennart
    et al.
    Rohlin, Madeleine
    Åkerman, Sigvard
    Macroscopic and microscopic findings of areas with radiologic erosions in human temporomandibular joints1992In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 50, no 2, p. 91-100Article in journal (Refereed)
    Abstract [en]

    The aim was to describe the macroscopic and microscopic findings of areas with radiologic erosions in the human temporomandibular joint. An autopsy material of 40 human joints, removed as blocks, was examined with tomography, and an erosion was found in 37 areas. A macroscopic and a microscopic examination focused on the presence of the calcified cartilage zone (CCZ) was performed in these areas. In the condyle 13 of 14 areas with a radiologic erosion showed denudation of bone macroscopically. Microscopically, these areas were covered by a thin fibrocellular tissue, and the CCZ was absent. In the temporal component, only 1 of the 23 areas showed bone exposure macroscopically. Microscopically, the soft tissue in these areas varied in thickness. The CCZ was missing in 13 of the 23 areas, even in some areas that appeared normal macroscopically and were microscopically covered by intact soft tissue. Thus, in areas with a radiologic erosion the macroscopic and microscopic appearance differed between the condyle and the temporal component. The nature of the findings is discussed.

  • 15. Flygare, Lennart
    et al.
    Rohlin, Madeleine
    Åkerman, Sigvard
    Microscopy and tomography of erosive changes in the temporomandibular joint. An autopsy study.1995In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 53, no 5, p. 297-303Article in journal (Refereed)
    Abstract [en]

    Thirty-nine temporomandibular joint autopsy specimens were examined by microscopy and tomography for erosive changes. We found two types of erosive changes, an extensive type with complete loss of cartilage and a local type with retained articular cartilage. On microscopic examination nearly twice as many temporal components as condyles were eroded. The erosions were generally more extensive in the condyle. Erosions in the condyle were evenly distributed. In the temporal component there was a slight predominance of erosions located to the lateral part of the tubercle. The radiologic investigation underestimated both the presence and the extent of the erosions. Positive predictive values and negative predictive values were 0.70 and 0.83, respectively, for erosions in the condyle and 0.91 and 0.68 for erosions in the temporal component. It is suggested that the initial event in osteoarthrosis of the TMJ can occur as a subarticular hard-tissue change. The need for more accurate diagnostic tools than radiography should be stressed.

  • 16. Franz, Alexander
    et al.
    Konradsson, Katarina
    Umeå University, Faculty of Medicine, Odontology.
    König, Franz
    Van Dijken, Jan
    Schedle, Andreas
    Cytotoxicity of a calcium aluminate cement in comparison with other dental cements and resin-based materials.2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 1, p. 1-8Article in journal (Refereed)
  • 17.
    Gu, Xiaolian
    et al.
    Umeå University, Faculty of Medicine, Medical Biosciences, Pathology.
    Bäckman, Birgitta
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Coates, Philip J
    Cullman, Inger
    Umeå University, Faculty of Medicine, Medical Biosciences, Pathology.
    Hellman, Urban
    Umeå University, Faculty of Medicine, Medical Biosciences, Medical and Clinical Genetics.
    Lind, Lisbet
    Umeå University, Faculty of Medicine, Medical Biosciences, Medical and Clinical Genetics.
    Nylander, Karin
    Umeå University, Faculty of Medicine, Medical Biosciences, Pathology.
    Exclusion of p63 as a candidate gene for autosomal-dominant amelogenesis imperfecta.2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 2, p. 111-114Article in journal (Refereed)
  • 18. Henningsson, Mikael
    Defensive characteristics in individuals with amalgam illness as measured by the percept-genetic method Defense Mechanism Test.1996In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, no 54, p. 176-181Article in journal (Refereed)
  • 19.
    Holgerson, Pernilla Lif
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Twetman, Svante
    Stecksen-Blicks, Christina
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Validation of an age-modified caries risk assessment program (Cariogram) in preschool children.2009In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 67, no 2, p. 106-112Article in journal (Refereed)
    Abstract [en]

    Objectives. (i) To validate caries risk profiles assessed with a computer program against actual caries development in preschool children, (ii) to study the possible impact of a preventive program on the risk profiles, and (iii) to compare the individual risk profiles longitudinally. Material and methods. Caries risk was assessed in 125 two-year-old children invited to participate in a 2-year caries-preventive trial with xylitol tablets. At 7 years of age, 103 were available for follow-up, 48 from the former intervention group and 55 from the control group. At baseline and after 5 years, 7 variables associated with caries were collected through clinical examinations and questionnaires, and scored and computed with a risk assessment program (Cariogram). Results. Children assessed as having a "low chance (0-20%) of avoiding caries" had significantly higher caries at 7 years of age compared to children with a lower risk in the control group (p<0.05) but not in the intervention group. Overall predictive accuracy and precision, however, were moderate in both groups. Less than half of the children remained in the same risk category at both ages, despite a largely unchanged consumption pattern of sugar. The majority of the children who changed category displayed a lowered risk at 7 years. The intervention program seemed to impair the predictive abilities of Cariogram. Conclusion. A modified Cariogram applied on preschool children was not particularly useful in identifying high caries risk patients in a low-caries community.

  • 20.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Wiesinger, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Research and Development, Västernorrland County Council, Umeå University, Umeå, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    The effect of supervised exercise on localized TMD pain and TMD pain associated with generalized pain2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 6-12Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate the effect of a supervised exercise program in patients with localized/regional temporomandibular disorder (TMD) pain and with TMD associated with generalized pain.

    Material and methods: Consecutively referred patients with localized/regional TMD pain (n = 56; 46 women and 10 men, mean age 44 years) and TMD associated with generalized pain (n = 21; 21 women, mean age 41 years) participated. Patients underwent a 10-session structured supervised exercise program over 10-20 weeks that included relaxation, and coordination and resistance training of the jaw and neck/shoulders. The outcomes were jaw pain intensity on the Numerical Rating Scale, endurance time for jaw opening and protrusion against resistance and chewing, and effect of pain on daily activities.

    Results: After the exercise program, a reduction in jaw pain was reported by the local (p = .001) and general (p = .011) pain groups. There were no significant differences in jaw pain intensity between the groups, before (p = .062) or after treatment (p =.121). Endurance time increased for both groups for jaw opening/protrusion (both p <. 001) and chewing (both p = .002). The effect of jaw pain on daily activities decreased after exercise compared to baseline for both the local (p < .001) and general (p = .008) pain groups.

    Conclusions: Supervised exercise can reduce TMD pain and increase capacity in patients with TMD. The results suggest that activation of the jaw motor system with exercise has a positive effect in patients with localized/regional TMD pain and TMD associated with generalized pain.

  • 21.
    Johansson, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Anderson-Weckert, Ingrid
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Hagenbjörk-Gustavsson, Annika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Department of Odontology, Dental Hygiene.
    Ozone air levels adjacent to a dental ozone gas delivery system2007In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 6, p. 324-330Article in journal (Refereed)
    Abstract [en]

    Objective. Ozone (O(3)) has been suggested as an anti-microbial treatment in dentistry, with an ozone gas delivery system introduced for the treatment of fissure and root caries. The aim of this study was to investigate the sealing capacity of the novel delivery system and its re-suction capacity during accidental displacement of the cup at different stages of ozone delivery. Material and methods. Ozone leakage was studied in vitro after application on a flat metal surface and on buccal and occlusal tooth surfaces. An ozone analyzer was used to measure ozone gas concentrations adjacent to the delivering cups when adapted to the target surfaces during and after 10-20 s application cycles. The measured levels were compared with the background concentrations in the room. Measurements were performed 1) after complete ozone application cycles, 2) within the cycle before the start of the suction period, and 3) after displacements of the cup during the cycles. Results. Ozone air values varied between 8 and 166 microg.m(-3) for the flat metal surface and between 0 and 108 microg.m(-3) for the tooth surfaces. Ozone leakage levels were 7.6 microg.m(-3) for the flat and 7.4 microg.m(-3) and 5.6 microg.m(-3) for the buccal and occlusal surfaces, respectively, and 5.2 microg.m(-3) and 9.8 microg.m(-3) for the premolar and molar surfaces, respectively. Cycles with displacement showed significantly higher leakage levels than continuous complete cycles (p=0.03). Conclusions. Ozone application cycles with displacements showed significantly higher leakage levels than continuous complete cycles. The largest ozone delivery cups showed the highest leakage values. A change in background levels was seen with similar change in adjacent ozone levels. The overall measured ozone leakage values were low after normally functioning delivery cycles and after repeated displacements. The delivery system can be considered safe.

  • 22.
    Jonsson, Anton
    et al.
    Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Periodontology, Public Dental Service at Eastmaninstitutet, Stockholm County Council, Stockholm, Sweden.
    Holmer, Jacob
    Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Kullman, Leif
    Division of Oral and Maxillofacial Radiology, Department of Dental Medicine Karolinska Institutet, Huddinge, Sweden.
    Eriksdotter, Maria
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden.
    Ahlqvist, Jan
    Umeå University, Faculty of Medicine, Department of Odontology.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology.
    Buhlin, Kåre
    Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Calcified carotid artery atheromas in individuals with cognitive dysfunction2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 4, p. 325-331Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this case-control study was to investigate whether cognitively impaired individuals have a higher burden of calcified carotid artery atheroma (CCAA) than controls without cognitive impairment.

    Material and methods: The study included 154 cases with Alzheimer’s disease (n = 52), mild cognitive impairment (n = 51), or subjective cognitive decline (n = 51) diagnosed at a university memory clinic. Seventy-six cognitively healthy controls were sampled through the Swedish population register. All participants underwent clinical oral and panoramic radiographic examinations. Two oral and maxillofacial radiologists performed blinded analyses of the panoramic radiographs for signs of CCAA, which was registered as absent or present and, if present, unilateral or bilateral. Consensus assessment was used for all statistical analyses.

    Results: CCAA was common (40%) in this middle-aged and older Swedish population. We found no differences in the prevalence of CCAA between cases and controls (40% vs. 42%).

    Conclusion: Cognitively impaired patients do not have a higher burden of CCAA than matched controls without cognitive impairment.

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  • 23. Jorkjend, Lars
    et al.
    Johansson, Anders
    Johansson, Ann-Katrin
    Bergenholtz, Axel
    Umeå University, Faculty of Medicine, Department of Odontology.
    Resting and stimulated whole salivary flow rates in Sjogren's syndromepatients over time: a diagnostic aid for subsidized dental care?2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 5, p. 264-268Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to evaluate Swedish and Norwegian criteria currently applied in the assessment of eligibility for subsidized dental care of Sjogren's syndrome (SS) patients. These criteria are partly based on a single salivary test showing a resting whole salivary secretion rate of less than or equal to0.1 mL/min. Thirty secondary Sjogren (SSS) patients (29 F and 1 M) participated for the duration of the study, in which resting (RWS) and stimulated (SWS) whole salivary flow rates were collected in the morning and afternoon, over 3 consecutive weeks, once per week, as well as at different times over a 5-year period. Twenty patients presented levels of RWS flow rates of less than or equal to 0.1 mL/min on one or more occasions over a 3-week period, while 8 of these also exceeded, on one or more occasions, the cut-off level of 0.1 mL/min, indicating that salivary flow rates varied over time. Six patients showed consistently low secretion rates of RWS as well as of SWS, estimated as less than or equal to0.1 mL/min and less than or equal to0.7 mL/min, respectively. Based on the results, salivary tests that are to be used as a diagnostic aid for SS diagnosis, and thus as a basis for inclusion within the subsidy net for dental care, must be taken on several occasions in order to more accurately give information about salivary gland function. In line with this, current regulations governing the eligibility of SS patients within subsidized dental care programs should be reviewed.

  • 24. Karlsson, S
    et al.
    Molin, M
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Myrvold, T
    Flexural strength of two electro-plated dental ceramics.1994In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 52, no 5, p. 290-3Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate the influence on flexural strength of electro-plating two dental porcelains, Vita Omega and Vita Omega 800. The porcelains were treated in accordance with the manufacturer's instructions, and the specimens were produced following the ISO 6872 standard for rectangular bars. Specimens were divided into three groups, of which none, one, or three of the surfaces were plated with a thin layer of gold. Flexural strength was tested with a three-point bending test. Ten specimens were tested for each combination of porcelain and plating, for a total of 60 test pieces. For both porcelains, a significantly higher flexural strength was found for the specimens furnished with a gold layer. The number of covered surfaces did not significantly influence the tested strength. This increase in strength is most likely due to decreased crack initiation and fracture propagation after the covering of random defects in the porcelain. A better stress distribution might also be anticipated and partly explain the results.

  • 25. Keller, Mette Kirstine
    et al.
    Hasslöf, Pamela
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Twetman, Svante
    Co-aggregation and growth inhibition of probiotic lactobacilli and clinical isolates of mutans streptococci: an in vitro study2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 5, p. 263-268Article in journal (Refereed)
    Abstract [en]

    Objective: Co-aggregation and growth inhibition abilities of probiotic bacteria may play a key role in their interference with the oral biofilm. The aim was to investigate the in vitro ability of selected commercial probiotic lactobacilli to co-aggregate and inhibit growth of oral mutans steptococci isolated from adults with contrasting levels of caries.

    Materials and methods: Mutans streptococci (MS) strains were isolated from caries-free (n = 3) and caries-susceptible (n = 5) young adults and processed with eight commercial probiotic lactobacilli strains. One laboratory reference strain (S. mutans Ingbritt) was selected as control. Co-aggregation was determined spectrophotometrically and growth inhibition was assessed with the agar overlay technique.

    Results: All probiotic lactobacilli showed an ability to co-aggregate with the isolated MS strains. Statistically significant differences (p < 0.05) were found between strains from different individuals when compared with the reference strain. The selected lactobacilli inhibited MS growth, but the ability varied between the strains and was clearly related to pH. No differences were observed between the different MS strains from caries-free and caries-susceptible individuals.

    Conclusions: The selected lactobacilli displayed co-aggregation activity and inhibited growth of clinical mutans streptococci. The growth inhibition was strain-specific and dependent on pH and cell concentration. The findings indicate that the outcome of lactobacilli-derived probiotic therapy might vary between individuals and depend on the specific strain used.

  • 26.
    Konradsson, Katarina
    et al.
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Effect of a novel ceramic filling material on plaque formation and marginal gingiva.2002In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 6, p. 370-374Article in journal (Refereed)
    Abstract [en]

    The aim of this clinical investigation was to evaluate a novel ceramic (CF) filling material (DoxaDent) compared to resin composite (RC) and enamel in regard to plaque formation and gingival inflammation. The CF material is inorganic, non-metallic, and contains calcium aluminate, silicate, and water. To make intra-individual comparisons possible, each participant had at least one set of three test surfaces: two Class V restorations with subgingival cervical margins (one of the novel CF material and one of a hybrid RC) and one non-filled enamel surface (E). The amounts of plaque, gingival crevicular fluid, and clinical signs of gingival inflammation were intra-individually compared in 20 sets of the three test surfaces. In a cross-sectional study (CSS), the effect of oral hygiene on plaque formation and gingivitis around the surfaces was evaluated. In a following 10-day experimental gingivitis study (EGS), plaque formation and the induction of gingivitis during refrain from oral hygiene was compared. In the CSS, no significant differences were found between the surfaces in terms of amount of plaque and degree of gingival inflammation. At the end of the EGS the restorative materials showed a significantly higher amount of plaque (CF versus E, P = 0.014; RC versus E, P = 0.034), but no significant differences were found in degree of gingival inflammation. In condusion, the ceramic filling material was comparable to RC regarding plaque formation and gingival inflammation with customary oral hygiene. With neglected oral hygiene, significantly less plaque growth and a non-significant tendency toward lower amounts of gingival crevicular fluid were observed on enamel surfaces.

  • 27.
    Lantto, Angelika
    et al.
    Department of Dental Medicine, Unit for Oral Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden; Tandvårdens Kompetenscentrum, County of Norrbotten, Luleå, Sweden.
    Lundqvist, Robert
    The Research and Innovation Unit, County of Norrbotten, Luleå, Sweden.
    Wårdh, Inger
    Department of Dental Medicine, Unit for Oral Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden; Academic Centre of Geriatric Dentistry, Stockholms Sjukhem, Stockholm, Sweden.
    Quality of life related to tooth loss and prosthetic replacements among persons with dependency and functional limitations2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 3, p. 173-180Article in journal (Refereed)
    Abstract [en]

    Objectives: To examine if tooth loss or treatment with different prosthetic replacements are associated with oral health-related or health-related quality of life (OHRQoL or HRQoL) among persons with dependency and functional limitations.

    Material and Methods: Comparisons between results of questionnaires and clinical data (number of teeth, Eichner index, presence, type, and condition of prosthetic replacements) from a population of 180 individuals with dependency and functional limitations sampled from the register of increased financial support in Norrbotten County, Sweden.

    Results: The associations between clinical variables and the questionnaire responses were weak overall, e.g. Spearman’s rho was 0.162 (p =.033) for correlation between number of teeth and GOHAI, 0.094 (p =.249) for number of teeth and OHIP, −0.070 (p =.356) for complete dentures and GOHAI, and −0.108 (p =.185) for complete dentures and OHIP.

    Conclusions: The weak associations between clinical variables and questionnaire results in the present study suggest that good results on measured QoL do not necessarily indicate good oral health. As we cannot expect this specific population to report oral disorders by themselves, regular check-ups are necessary.

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  • 28.
    Lif Holgerson, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Twetman, Svante
    Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers.2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 4, p. 233-238Article in journal (Refereed)
    Abstract [en]

    Abstract. The aim was to investigate the effect of high and low amounts of xylitol on the interdental plaque-pH, directly and after sucrose challenge in schoolchildren with a habitual consumption. The study group consisted of 11 healthy children (10-15 years) with low caries risk and the experiment had a single-blind crossover (Latin square) design. After a 2-week run-in period with a daily 4.0 g xylitol intake, the children were subjected to single-dose exposures of chewing gums with i) paraffin (CTR; no xylitol), ii) low dose xylitol (LX; 2.0g xylitol), and iii) high dose xylitol (HX; 6.0g xylitol) in a randomised order separated by a wash-out period of one week. Samples of chewing-stimulated whole saliva were collected prior to and after the experimental period for determination of bacterial counts. The outcome measures were in situ plaque-pH (micro-touch method) and area under the curve (AUC) above pH 6.0. The AUC was significantly greater (p<0.05) in the HX group compared to the LX and control groups during the first 5 minutes after chewing. After a 10% sucrose rinse, the interdental plaque-pH dropped in all groups but the HX regimen displayed significantly less reduction 0-5 min after chewing (p<0.05). No significant alterations of the total viable counts or mutans streptococci levels in saliva were disclosed during the 4-week experimental period. The present results suggested that a high single dose of xylitol had a short and limited beneficial effect on interdental plaque-pH in habitual xylitol consumers while a low single dose, resembling a normal chewing gum use, did not differ from the control.

  • 29.
    Lindberg, A
    et al.
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Peutzfeldt, A
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Curing depths of a universal hybrid and a flowable resin composite cured with quartz tungsten halogen and light-emitting diode units.2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 2, p. 97-101Article in journal (Refereed)
    Abstract [en]

    This in vitro study evaluated curing depths of a universal hybrid resin composite with two viscosities (Tetric Ceram and Tetric Flow) after curing with 6 different quartz tungsten halogen and light-emitting diode curing units. Irradiance (light intensity) of the curing units varied between 200 and 700 mW/cm2. The curing units were used for standard, soft-start, or pulse curing. Curing times were 20 and 40 s for standard curing, 3 + 10 s and 3 + 30 s for pulse curing, and 40 s for soft-start. Resin composite specimens, 5 in each group, with a diameter of 4 mm and a height of 6 mm, were made in brass molds and cured from one side at a distance of 6 mm. After 2 weeks, the specimens were ground longitudinally half through the specimen. Curing depth was then determined by measurement of Wallace hardness for each half millimeter starting at 0.5 mm from the top surface. For all curing units and for both resin composites an increased curing time led to statistically significantly higher depth of cure (P < 0.0005). Tetric Flow showed a statistically significantly higher depth of cure than Tetric Ceram (P < 0.0005). All curing units cured more than 2.0 mm of both composites from a distance of 6 mm at 20 s curing time. The value for 40 s was 3.0 mm. The composite closer to the surface than the depth of cure value was equally well cured with all curing units investigated. There was a significant linear correlation between the determined irradiance of the curing units and the depths of cure obtained (20s: r = 0.89, P < 0.025; 40 s: r = 0.91, P < 0.01).

  • 30.
    Lindberg, A
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    van Dijken, JWV
    Horstedt, P
    Interfacial adaptation of a Class II polyacid-modified resin composite/resin composite laminate restoration in vivo.2000In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 58, no 2, p. 77-84Article in journal (Refereed)
    Abstract [en]

    The aim of this in vivo study was to evaluate the interfacial adaptation of Class II resin composite open sandwich restorations with a polyacid-modified resin composite as a stress-absorbing layer (PMRC/RC). Twenty Class II box-shaped, enamel-bordered cavities were prepared in 10 premolars scheduled to be extracted for orthodontic reasons. An open PMRC/RC sandwich restoration was placed in 1 of the cavities of each tooth. The first layer, PMRC, in the proximal box extended to the periphery in the cervical part of the cavity. The following RC layers were placed with a horizontally incremental technique. The PMRC was excluded from the control cavity. The teeth were extracted after 1 month and the interfacial adaptation of the restorations was studied with quantitative scanning electron microscope analysis using a replicate technique. Gap-free interfacial adaptation was observed for the PMRC/RC and RC restorations in cervical enamel in 97% and 73%, respectively (P = 0.006). The gap-free scores for dentin were 87% and 64%, respectively (P = 0.022). Excellent interfacial adaptation was observed in both groups for the occlusal enamel 99% and 100%, respectively. The adaptation to occlusal enamel for the direct resin composite restorations was significantly better than to dentin or cervical enamel. A higher frequency of enamel fractures was observed parallel to the cervical margins compared to the occlusal. No dentin fractures were observed in the experimental groups. The PMRC/RC sandwich technique showed a statistically significant improved interfacial adaptation to dentin and cervical enamel in Class II enamel-bordered cavities. The clinical significance of the differences has to be evaluated.

  • 31.
    Lindquist, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Isehed, Catrine
    Department of Periodontology, Public Dental Health County Council of Gävleborg, Gävle County Hospital, Gävle, Sweden; Center for Research and Development, Uppsala University/Region Gävleborg, Uppsala, Sweden.
    Lie, Anita
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lundberg, Pernilla
    Umeå University, Faculty of Medicine, Department of Odontology.
    Enamel matrix derivative does not affect osteoclast formation or bone resorption in cultures of mouse bone marrow macrophages or human monocytes2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 487-493Article in journal (Refereed)
    Abstract [en]

    Objective: Enamel matrix derivative (EMD) is widely used under the brand name Emdogain® to promote periodontal regeneration in surgical treatment of periodontitis and peri-implantitis. The molecular mechanisms are unclear, but it has been proposed that EMD has stimulatory effects on the root cementum and periodontal ligament cells. Since dental implants lack these structures, we hypothesized that EMD-induced bone gain involve interactions with osteoclast precursor cells, with consequent inhibitory effect on osteoclast formation and/or activity. The aim was to evaluate this hypothesis.

    Material and methods: Primary mouse bone marrow macrophages (BMMs) and human peripheral blood monocytes were cultured in the presence of receptor activator nuclear factor-κB ligand (RANKL) to stimulate osteoclast formation. A purified Emdogain® fraction was added to the cell cultures and the effect on number and size of newly formed osteoclasts were evaluated. In cultures on natural bone slices, bioanalytical methods were used to assay osteoclast number and bone resorption.

    Results: EMD had a negative effect on osteoclastogenesis in mouse cultures on plastic surface, whereas addition of EMD to osteoclast precursor cells on bone substrate did not affect osteoclast formation or bone resorption.

    Conclusions: The results on natural bone matrix contradict a direct effect of EMD on osteoclast precursor cells.

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  • 32.
    Lundberg, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology.
    Morhed-Hultvall, ML
    Twetman, Svante
    Mutans streptococci colonization and longitudinal caries detection with laser fluorescence in fissures of newly erupted 1st permanent molars.2007In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 4, p. 189-193Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To longitudinally apply a laser fluorescence (LF) device (DIAGNOdent) in newly erupted 1st permanent molars over a 3-year period and to relate the findings to mutans streptococci (MS) colonization, fissure morphology, and caries development. MATERIAL AND METHODS: The material consisted of 101 consecutive 5 to 6-year-old children attending a Public Dental Clinic and who volunteered after ethical approval and informed consent had been given. Only fully erupted molars with clinically sound fissures were included. At baseline, the fissures were subjectively categorized as "shallow" or "deep", and, prior to the LF readings, a plaque sample was collected and cultivated for MS using a chair-side kit. The registrations were repeated annually and the microbial samplings after 2 years. The total drop-out rate was 12%. RESULTS: The mean LF values increased significantly (p<0.05) with increasing age from 8.2 to 12.4 in the teeth that remained sound. Thirty-five teeth were decayed or filled during the follow-up and their mean LF values increased from 13.4 to 40.7. The LF readings were significantly higher in molars with "deep" fissures (p<0.05) at all visits. MS colonization at baseline was associated with an increased risk for caries (OR = 11.6, p<0.05) and significantly elevated LF readings. Baseline LF readings > or =12 were not diagnostic for dentin caries or fillings over the study period (sensitivity 0.57; specificity 0.86). CONCLUSION: LF readings could be used to some extent to monitor fissure morphology and caries development in fissures of newly permanent molars over time, but elevated initial values were not predictive for caries development.

  • 33. Lundegren, Nina
    et al.
    Sohrabi, Melvin M.
    Molin Thorén, Margareta
    Umeå University, Faculty of Medicine, Department of Odontology.
    Akerman, Sigvard
    Prosthetic dental restorations in Swedish samples: prevalence and agreement between self-report, clinical findings, and influence on quality of life2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 4, p. 296-302Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations. Material and methods: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi(2) test. Results: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20-39 years compared to 4.9 for the age group 65-89 years. Conclusion: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations.

  • 34.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Parvaneh, Hasti
    Lobbezoo, Frank
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, Corine Mirjam
    Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic.

    Material and methods: Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.

    Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83–0.94), whereas specificity was low (0.41–0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96).

    Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.

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  • 35.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, Corine M.
    Lobbezo, Frank
    Yekkalam, Negin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Vallin, Simon
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    The association between myofascial orofacial pain with and without referral and widespread pain2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 481-486Article in journal (Refereed)
    Abstract [en]

    Objectives: Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain.

    Materials and methods: Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20–69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain.

    Results: Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62–9.05 and OR 11.62 95% CI 5.18–27.88, respectively).

    Conclusion: These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.

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  • 36.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Österlund, Catharina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ilgunas, Aurelija
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 387-393Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Dental students have been identified as a group with high risks of developing both temporomandibular disorders (TMD) and psychosocial conditions. Our primary aim was to evaluate the cross-sectional prevalence of TMD diagnoses, as defined in the Diagnostic Criteria (DC)/TMD, among dental students. The secondary aim was to evaluate the prevalence and association of behavioural and psychosocial factors in relation to DC/TMD diagnoses.

    MATERIALS AND METHODS: The study was conducted among undergraduate dental students during the second semester of their third year at the Department of Odontology, Medical Faculty, Umeå University, Sweden. Three consecutive cohorts were recruited during August in 2013, 2014, 2015. In total, 54 students were included and examined according the DC/TMD procedure.

    RESULTS AND CONCLUSIONS: The prevalence of any DC/TMD diagnosis was 30%. The most prevalent TMD diagnosis was myalgia. Individuals with a TMD-pain diagnosis (i.e. myalgia or arthralgia) reported significantly higher pain intensity levels according to the Graded Chronic Pain Scale (GCPS) as compared to individuals without TMD-pain (Fisher's exact test p < .001, two-sided). In addition, individuals with any TMD scored significantly higher jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20, p < .001) and oral parafunctions according to the Oral Behavior Checklist (OBC, p = .005) as compared to individuals without TMD. The psychosocial factors evaluated did not differ between individual with or without a TMD diagnosis. The majority of the dental students reported symptoms that are already identified as risk factors for developing TMD and pain conditions. However, longitudinal data are needed to evaluate how this evolves over time.

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  • 37.
    Malmberg, Leona
    et al.
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Benavente Hansson, Catherine
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Grönqvist, Johan
    The Endodontic Specialist Clinic, The Public Dental Health Service of Västerbotten County, Umeå, Sweden.
    Brundin, Malin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Björkner, Annika Elisabeth
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Endodontic operative field asepsis: a comparison between general dentists and specialists2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 8, p. 603-608Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to evaluate the establishment of an aseptic endodontic operative field in general dentistry by assessing general dentists’ ability to reduce the amount of contamination to a non-cultivable level, and to compare the operative field asepsis at a general dentistry clinic with that at an endodontic specialist clinic.

    Materials and Methods: A total of 353 teeth were included in the study (153 in general dentistry, 200 at the specialist clinic). After isolation, control samples were taken, the operative fields disinfected with 30% hydrogen peroxide (1 min) followed by 5% iodine tincture or.5% chlorhexidine solution. Samples were collected from the access cavity area and buccal area, placed in a fluid thioglycolate medium, incubated (37°, 7 d), evaluated for growth/non-growth.

    Results: Significantly more contamination was observed at the general dentistry clinic (31.6%, 95/301), than at the endodontic specialist clinic (7.0%, 27/386) (p <.001). In general dentistry, significantly more positive samples were collected in the buccal area than in the occlusal area. Significantly more positive samples were collected when the chlorhexidine protocol had been used, both in general dentistry (p <.001) and at the specialist clinic (p =.028).

    Conclusions: The result from this study shows insufficient endodontic aseptic control in general dentistry. At the specialist clinic, both disinfection protocols were able to reduce the amount of microorganisms to a non-cultivable level. The observed difference between the protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as confounding factors may have contributed to the result.

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  • 38.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Huang, Karolina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Zohouri, Dorriz
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Dentists working conditions: factors associated with perceived workload2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 4, p. 296-301Article in journal (Refereed)
    Abstract [en]

    Background: Dentists are often exposed to occupational health hazards such as stress, high workload, and ergonomic and mental strain. However, there are limited studies focussing on occupational health and factors associated with working conditions. The aim of this study was to identify possible gender differences and factors associated with a high workload.

    Method: The study population comprised of 187 dentists (123 women and 64 men) who had been working between 5 and 12 years. All participants completed a questionnaire regarding perceived workload and different working conditions. In the logistic regression analyses, gender and employment (employee or employer/manger), influence over work, social support, ergonomics, and working hours were used as independent covariates.

    Results: Poor satisfaction with ergonomic conditions and low influence on the work situation were reported by 40 and 47% of the participants, respectively. Female dentists were more often employees, reported lower influence over work situation, and more often worked part-time compared to male dentists. Those who reported a high workload significantly more often experienced that they had low influence over work, low levels of social support, and were not satisfied with ergonomic working conditions.

    Conclusion: Dentists with low influence over work, low levels of social support, and who were unsatisfied with the ergonomic conditions reported higher levels of workload. The dentists experienced a similar workload, regardless of employment and gender. Preventive actions at the workplace in order to maintain a moderate workload promote both individual and organizational measures, to minimize the risk of poor occupational health.

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  • 39.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Risk factors associated with incidence and persistence of frequent headaches2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 788-794Article in journal (Refereed)
    Abstract [en]

    Abstract Objective. Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. Materials and methods. The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. Results. The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). Conclusions. The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.

  • 40.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Incidence and prevalence of myofascial pain in the jaw-face region: a one-year prospective study on dental students2008In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 66, no 2, p. 113-121Article in journal (Refereed)
    Abstract [en]

    Objective. The aims of this study were to examine the 1-year period prevalence, incidence, and course of myofascial pain in the jaw-face region, and to analyze whether female gender, dental occlusion, and oral parafunctions have any influence on these signs and symptoms. Material aad methods. The study population comprised 308 dental students examined at the start of their dentistry course and re-examined after 1 year. Case histories were collected using a questionnaire. The clinical examination included palpation sites of muscles, a submaximal clenching test, measurements of maximal mandibular mobility, and classification of morphological and functional dental occlusion. Results. The 1-year period prevalence of frequent myofascial symptoms was 19%. The incidence of myofascial pain, according to the Research Diagnostic Criteria for TemporoMandibular Disorders (RDC/TMD), was 4%. The female students presented an almost 4-fold incidence rate of myofascial symptoms compared to the male students. Non-symptomatic subjects were found among those without awareness of bruxism and with simultanious bilateral contact in the retruded contact position (RCP), and among those with a stable intercuspal position (ICP). Variations in morphological occlusion did not show any relation to myofascial symptoms, nor did contact patterns in eccentric positions. Conclusions. Female dental students were more prone to developing frequent myofascial pain and to perceiving local muscle soreness than were male students during a 1-year period. Both self-reported bruxism and registered mandibular instability in ICP showed association with the 1-year period prevalence of myofascial signs and symptoms in the jaw-face region.

  • 41.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Incidence and prevalence of temporomandibular joint pain and dysfunction: a one-year prospective study of university students2007In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 2, p. 119-127Article in journal (Refereed)
    Abstract [en]

    Objective. The aims of this study were to investigate the incidence and recovery of temporomandibular joint (TMJ) pain and dysfunction during a 1-year period, and to examine factors associated with TMJ signs and symptoms.

    Material and Methods. The study population comprised 371 dental students examined at the start of education, out of which 308 were re-examined after 1 year. Case histories were collected with the aid of a questionnaire.

    The cinical examination involved TMJ mobility, TMJ pain, TMJ sounds, morhological and functional dental occlusion.

    Results. The 1-year incidence of TMJ signs and/or symptoms was 12%, with no statistically significant difference between men and women. Reported TMJ sounds (10%) and clinically registered TMJ pain (8%) reached the highest incidence rates. Approximately a quarter of those who had TMJ signs and/or symptoms at baseline had recovered at follow-up. Subjects with a non-symptomatic TMJ were significantly more often found among men and among those with bilateral contacts in centric relation, a normal transverse inter-maxillary relationship, and a stabile manadibular position in centric occlusion.

    Conclusion. The 1-year incidence of TMJ pain and/or dysfunction was high among 1st-year univerisity students. The persistence of signs and symptoms during the observation period was related to gender, while incidence and disappearance of symptoms were not. Dental occlusion was not rejected as a possible concurrent factor in relation to TMJ pain and/or dysfunction among university students.

  • 42.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 5, p. 289-299Article in journal (Refereed)
    Abstract [en]

    This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

  • 43.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Bergman, B
    Marklund, S L
    Schütz, A
    Skerfving, S
    Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man.1990In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 48, no 3, p. 189-202Article in journal (Refereed)
    Abstract [en]

    In 10 healthy persons all amalgam fillings were replaced with gold inlays. Blood and urinary levels were measured on 10 occasions during a 4-month period before and a 12-month period after amalgam removal. These variables were also measured three times in 10 healthy controls. A strong statistically significant relation was found between plasma mercury values and both the total number of amalgam surfaces (r = 0.71, p = 0.0006) and the total surface area of the fillings (r = 0.73, p = 0.0004). In the immediate postremoval phase plasma mercury rose three- to four-fold, whereas the urinary and erythrocyte mercury rose about 50%. These peak values declined to the preremoval level at about 1 month. Twelve months after the removal the plasma and urinary mercury levels were significantly reduced to 50% and 25%, respectively, of the initial values for the experimental group. Apart from the significantly lower plasma selenium values 5 and 10 days after removal no significant differences were found with regard to plasma selenium or erythrocyte glutathione peroxidase either within or between the experimental and the control groups. A large number of supplementary biochemical analyses did not show any influence on organ functions or any differences between the groups before or after the amalgam removal. Amalgam fillings considerably contributed to the plasma and urinary mercury levels.

  • 44.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Bergman, B
    Marklund, S L
    Schütz, A
    Skerfving, S
    The influence of dental amalgam placement on mercury, selenium, and glutathione peroxidase in man.1990In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 48, no 4, p. 287-95Article in journal (Refereed)
    Abstract [en]

    Amalgam restorations were inserted in eight healthy persons, previously unprovided with dental restorations, who had several severe carious lesions. The mean number of surfaces restored were 16.1 (range, 11 to 22). The total mean calculated amount of mercury inserted was 2.9 g (range, 1.5 to 4.3 g). Blood and urinary levels were measured on seven occasions during a 4-month period before and a 3-month period after amalgam placement. One and 3 months after placement, the P-mercury mean values were almost equal to the preplacement values (3.3 nmol/l). After placement U-mercury increased continuously; 3 months after placement a statistically significantly higher (p less than 0.05) mean U-mercury value (0.58 nmol/mmol creatinine) was found compared with the mean preplacement value (0.34 nmol/mmol creatinine). No statistically significant correlation was found between the P- and U-mercury concentrations and the total number of amalgam surfaces. Selenium levels in plasma and urine and erythrocyte glutathione peroxidase showed no systematic change of pattern. The results show that the insertion of amalgam fillings contributed to the U-mercury concentration, but apparently even more extensive amalgam therapy and/or longer exposure periods are needed to affect the P-mercury concentration. No negative effects on the P- and U-selenium or the erythrocyte glutathione peroxidase levels could be found during the 3 months immediately after an extensive amalgam placement. The supplementary blood and urine analyses were not influenced by the insertion of amalgam fillings.

  • 45.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Karlsson, S
    A 3-year clinical follow-up study of a ceramic (Optec) inlay system.1996In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 54, no 3, p. 145-9Article in journal (Refereed)
    Abstract [en]

    To evaluate the clinical quality of ceramic (Optec) inlays, the inlay production of 10 dentists, served by 3 dental laboratories, was examined independently by 2 calibrated examiners. Of the 57 patients with 205 inlays participating in the first examination, 47 patients with 145 remaining inlays participated in the 3-year follow-up reexamination. For 14 of the participants in the reexamination, altogether 21 inlays had fractured. The mean time in service before fracture was 26.4 months (range, 12-53 months). The inlays were rated using the California Dental Association (CDA) quality evaluation system. This examination showed that the mismatch of color had increased from the first examination to the reexamination and registered slightly roughened surfaces. As to anatomic form, a reduced number of inlays did not receive an excellent CDA rating at the reexamination. Visible evidence of ditching along the margin had increased by almost 50%, and an apparent discoloration of the margin between the restoration and the tooth structure was seen in 73% of the reexamined inlays, compared with 7% at the first examination.

  • 46.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Karlsson, S
    A clinical evaluation of the Optec inlay system.1992In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 50, no 4, p. 227-33Article in journal (Refereed)
    Abstract [en]

    To evaluate the clinical quality of ceramic (Optec) inlays, the inlay production of 10 dentists, served by 3 dental laboratories, was examined independently by 2 calibrated examiners. A total of 57 patients with 205 inlays (mean age, 8.1 months) were examined 1 to 32 months after placement by means of using a slightly modified form of the California Dental Association criteria. Periodontal variables such as plaque index, gingival index, and margin index were also recorded. Eight patients reported postoperative but not persistent hypersensitivity in relation to the Optec therapy. No differences between Optec proximal surfaces and homologous control surfaces were seen with regard to plaque or bleeding on probing. The examination using the CDA criteria showed that 59% of the inlays had a slight color mismatch. Slightly roughened surfaces were most common (86%). As to anatomic form and margin integrity, 24% and 67%, respectively, of the inlays were rated excellent. A difference between the dentist with regard to the clinical quality of the inlay treatment procedure was seen. The present results cannot allow a definitive judgement with regard to the long-term clinical quality of the Optec inlay system but will serve as a base for further studies.

  • 47.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Karlsson, S
    The fit of gold inlays and three ceramic inlay systems. A clinical and in vitro study.1993In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 51, no 4, p. 201-6Article in journal (Refereed)
    Abstract [en]

    Four inlay systems--gold, Cerec, Mirage, and Empress inlays--were evaluated for their adaptation to stone die and clinically to the tooth by means of a replica technique. Twenty inlays of each system were placed on premolars and molars in the lower jaw. A microscope was used to measure the adaptation at the approximal margin, at the inner axial wall, and at the occlusal cavosurface area. An overall better fit was observed for the gold inlays than for the ceramic inlays. When the different measuring locations were compared, a better fit was found for the occlusal area. The greatest discrepancies were recorded for the Cerec inlays, whereas the Mirage and Empress inlays were comparable.

  • 48.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Marklund, S L
    Bergman, B
    Nilsson, B
    Mercury, selenium, and glutathione peroxidase in dental personnel.1989In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 47, no 6, p. 383-90Article in journal (Refereed)
    Abstract [en]

    Eighteen persons, dentists and nurses, with urinary mercury levels higher than the group median value of all dental personnel in the country of Västerbotten were compared with a group consisting of 15 persons with low urinary mercury levels working in the same clinics. A statistically significant difference between the high urinary mercury group and the low urinary mercury group could be seen in the plasma mercury level. In each group a statistically significant relation could be seen between the plasma mercury level and the total number of amalgam surfaces. The two groups did not differ with regard to the levels of plasma selenium and erythrocyte glutathione peroxidase, and no correlation between these two variables and the plasma mercury levels could be found. To evaluate organ functions, a large number of supplementary analyses were performed. These analyses did not indicate any influence on organ functions. Although the persons in the present study were occupationally exposed to mercury, none of the biologic variables analyzed seemed to be affected. Even among dental personnel who handle amalgam professionally the number of amalgam surfaces is a major contributory factor to the P-mercury level.

  • 49. Nordenram, Gunilla
    et al.
    Davidson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Norlund, Anders
    Rohlin, Madeleine
    Sunnegårdh-Grönberg, Karin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Tranæus, Sofia
    Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 937-951Article in journal (Refereed)
    Abstract [en]

    Objective: To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation.

    Background: Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function.

    Materials and methods: The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded.

    Results: The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation.

    Conclusions: In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.

  • 50. Norlén, P
    et al.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Birkhed, D
    Impact of medical and life-style factors on number of teeth in 68-year-old men in southern Sweden1996In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 54, no 1, p. 66-74Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the impact of general health and life-style factors on the number of remaining teeth in 68-year-old men living in the city of Malmö, Sweden. The study included 483 men (participation rate, 78%). Poor self-assessed health, frequent medical attendance, diabetes, and oral dryness were related to fewer remaining teeth. Number of teeth was negatively correlated to concentrations of triglycerides and alkaline phosphatases in serum and to glucose in blood but positively correlated to serum urea. Various dietary variables including consumption of sucrose-containing products and nutritional quality were not related either to number of teeth or to prevalence of edentulousness. Smoking and high consumption of coffee or alcohol were associated with fewer remaining teeth. Multiple logistic regression analyses showed that social class, frequency of dental attendance, smoking, and serum concentrations of triglycerides and urea had an independent effect on number of teeth.

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