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  • 101.
    Belibasakis, Georgios N
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology. Umeå University, Faculty of Medicine, Odontology, Oral Microbiology.
    Johansson, Anders
    Umeå University, Faculty of Medicine, Odontology, Periodontology.
    Wang, Y
    Chen, C
    Kalfas, S
    Lerner, Ulf
    Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology.
    The cytolethal distending toxin induces receptor activator of NF-κB ligand expression in human gingival fibroblasts and periodontal ligament cells2005In: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 73, no 1, p. 342-351Article in journal (Refereed)
    Abstract [en]

    Actinobacillus actinomycetemcomitans is associated with localized aggressive periodontitis, a disease characterized by rapid loss of the alveolar bone surrounding the teeth. Receptor activator of NF-kappaB Ligand (RANKL) and osteoprotegerin (OPG) are two molecules that regulate osteoclast formation and bone resorption. RANKL induces osteoclast differentiation and activation, whereas OPG blocks this process by acting as a decoy receptor for RANKL. The purpose of this study was to investigate the effect of A. actinomycetemcomitans on the expression of RANKL and OPG in human gingival fibroblasts and periodontal ligament cells. RANKL mRNA expression was induced in both cell types challenged by A. actinomycetemcomitans extract, whereas OPG mRNA expression remained unaffected. Cell surface RANKL protein was also induced by A. actinomycetemcomitans, whereas there was no change in OPG protein secretion. A cytolethal distending toxin (Cdt) gene-knockout strain of A. actinomycetemcomitans did not induce RANKL expression, in contrast to its wild-type strain. Purified Cdt from Haemophilus ducreyi alone, or in combination with extract from the A. actinomycetemcomitans cdt mutant strain, induced RANKL expression. Pretreatment of A. actinomycetemcomitans wild-type extract with Cdt antiserum abolished RANKL expression. In conclusion, A. actinomycetemcomitans induces RANKL expression in periodontal connective tissue cells. Cdt is crucial for this induction and may therefore be involved in the pathological bone resorption during the process of localized aggressive periodontitis.

  • 102.
    Belibasakis, Georgios N
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral Microbiology. Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology.
    Johansson, Anders
    Umeå University, Faculty of Medicine, Odontology, Periodontology.
    Wang, Y
    Chen, C
    Lagergård, T
    Kalfas, S
    Lerner, Ulf
    Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology.
    Cytokine responses of human gingival fibroblasts to Actinobacillus actinomycetemcomitans cytolethal distending toxin2005In: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 30, no 2, p. 56-63Article in journal (Refereed)
    Abstract [en]

    Actinobacillus actinomycetemcomitans is implicated in the pathogenesis of localized aggressive periodontitis, and has the capacity to express a cytolethal distending toxin (Cdt). Gingival fibroblasts (GF) are resident cells of the periodontium, which can express several osteolytic cytokines. The aims of this study were a) to investigate the role of Cdt in A. actinomycetemcomitans-induced expression of osteolytic cytokines and their cognate receptors in GF and b) to determine if the previously demonstrated induction of receptor activator of NFkappaB ligand (RANKL) by A. actinomycetemcomitans is mediated by these pro-inflammatory cytokines or by prostaglandin E(2) (PGE(2)). A. actinomycetemcomitans clearly induced interleukin (IL)-6, IL-1beta, and to a minimal extent, tumor necrosis factor (TNF)-alpha mRNA expression. At the protein level, IL-6 but not IL-1beta or TNF-alpha expression was stimulated. The mRNA expression of the different receptor subtypes recognizing IL-6, IL-1beta and TNF-alpha was not affected. A cdt-knockout strain of A. actinomycetemcomitans had similar effects on cytokine and cytokine receptor mRNA expression, compared to its parental wild-type strain. Purified Cdt stimulated IL-6, but not IL-1beta or TNF-alpha protein biosynthesis. Antibodies neutralizing IL-6, IL-1 or TNF-alpha, and the PGE(2) synthesis inhibitor indomethacin, did not affect A. actinomycetemcomitans-induced RANKL expression. In conclusion, a) A. actinomycetemcomitans induces IL-6 production in GF by a mechanism largely independent of its Cdt and b) A. actinomycetemcomitans-induced RANKL expression in GF occurs independently of IL-1, IL-6, TNF-alpha, or PGE(2).

  • 103.
    Belibasakis, Georgios N
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral Cell Biology. Umeå University, Faculty of Medicine, Odontology, Oral Microbiology.
    Mattsson, Anna
    Umeå University, Faculty of Medicine, Odontology, Periodontology.
    Wang, Ying
    Chen, Casey
    Johansson, Anders
    Umeå University, Faculty of Medicine, Odontology, Periodontology.
    Cell cycle arrest of human gingival fibroblasts and periodontal ligament cells by Actinobacillus actinomycetemcomitans: involvement of the cytolethal distending toxin2004In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 112, no 10, p. 674-685Article in journal (Refereed)
    Abstract [en]

    The cytolethal distending toxin (Cdt) is produced by several Gram-negative bacterial species and causes growth arrest and morphological alterations in mammalian cells. Actinobacillus actinomycetemcomitans, which is involved in the pathogenesis of localized aggressive periodontitis, also produces a Cdt that affects periodontal connective tissue cells. The aim of this study was to investigate in which phase of the cell cycle these cells are arrested and enlarged when challenged with A. actinomycetemcomitans, and to evaluate the involvement of its Cdt. Human gingival fibroblasts and periodontal ligament cells were challenged with A. actinomycetemcomitans extract, or with purified Cdt, and cell cycle analysis was performed by propidium iodide staining and flow cytometry. Cells exposed to an A. actinomycetemcomitans wild-type strain, or to purified Cdt, were arrested in both G1 and G2/M phases, and appeared enlarged compared to the corresponding controls. The cellular enlargement occurred in both G1 and G2/M arrested cells. In contrast, cells exposed to an A. actinomycetemcomitans cdt-knockout mutant strain showed cell cycle phase distribution and size similar to the controls. In conclusion, A. actinomycetemcomitans causes a combined G1 and G2/M growth arrest and enlargement in periodontal connective tissue cells, which is attributed to its Cdt.

  • 104. Belibasakis, GN
    et al.
    Bostanci, N
    Hashim, A
    Johansson, Anders
    Umeå University, Faculty of Medicine, Odontology, Periodontology.
    Aduse-Opoku, J
    Curtis, MA
    Hughes, FJ
    Regulation of RANKL and OPG gene expression in human gingival fibroblasts and periodontal ligament cells by Porphyromonas gingivalis: a putative role of the Arg-gingipains2007In: Microbial Pathogenesis, ISSN 0882-4010, E-ISSN 1096-1208, Vol. 43, no 1, p. 46-53Article in journal (Refereed)
    Abstract [en]

    Porphyromonas gingivalis is highly implicated in the pathogenesis of periodontitis, which is characterized by the destruction of periodontal connective tissues and the supporting alveolar bone. Receptor Activator of NF-kappaB Ligand (RANKL) stimulates bone resorption, whereas osteoprotegerin (OPG) blocks its action, and this bi-molecular system is implicated in periodontitis. The aim of this work was (a) to investigate the regulation of RANKL and OPG gene expression in human periodontal ligament (PDL) cells and gingival fibroblasts (GF), in response to P. gingivalis culture supernatants, by quantitative real-time PCR and (b) to attempt to identify putative virulence factors involved in this process. The results indicated that P. gingivalis induced RANKL and reduced OPG mRNA expression by the studied cells, resulting in an increased RANKL/OPG expression ratio. Heat-inactivation of P. gingivalis resulted in significant reduction of RANKL mRNA expression. A Lys-gingipain mutant strain did not affect, whereas an Arg-gingipain mutant strain further enhanced RANKL mRNA expression, compared to their parental wild-type strain. In conclusion, P. gingivalis up-regulates the RANKL/OPG expression ratio in GF and PDL cells, denoting an enhanced osteoclastogenic potential by the cells. The component mainly responsible for RANKL induction appears to be proteinaceous, and it may be regulated by the Arg-gingipains.

  • 105. Benetou, V
    et al.
    Orfanos, P
    Pettersson-Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Bergström, Ulrica
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Berrino, F
    Tumino, R
    Borch, K B
    Lund, E
    Peeters, P H M
    Grote, V
    Li, K
    Altzibar, J M
    Key, T
    Boeing, H
    von Ruesten, A
    Norat, T
    Wark, P A
    Riboli, E
    Trichopoulou, A
    Mediterranean diet and incidence of hip fractures in a European cohort2013In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 24, no 5, p. 1587-1598Article in journal (Refereed)
    Abstract [en]

    Prevention of hip fractures is of critical public health importance. In a cohort of adults from eight European countries, evidence was found that increased adherence to Mediterranean diet, measured by a 10-unit dietary score, is associated with reduced hip fracture incidence, particularly among men. INTRODUCTION: Evidence on the role of dietary patterns on hip fracture incidence is scarce. We explored the association of adherence to Mediterranean diet (MD) with hip fracture incidence in a cohort from eight European countries. METHODS: A total of 188,795 eligible participants (48,814 men and 139,981 women) in the European Prospective Investigation into Cancer and nutrition study with mean age 48.6 years (±10.8) were followed for a median of 9 years, and 802 incident hip fractures were recorded. Diet was assessed at baseline through validated dietary instruments. Adherence to MD was evaluated by a MD score (MDs), on a 10-point scale, in which monounsaturated were substituted with unsaturated lipids. Association with hip fracture incidence was assessed through Cox regression with adjustment for potential confounders. RESULTS: Increased adherence to MD was associated with a 7 % decrease in hip fracture incidence [hazard ratio (HR) per 1-unit increase in the MDs 0.93; 95 % confidence interval (95 % CI) = 0.89-0.98]. This association was more evident among men and somewhat stronger among older individuals. Using increments close to one standard deviation of daily intake, in the overall sample, high vegetable (HR = 0.86; 95 % CI = 0.79-0.94) and high fruit (HR = 0.89; 95 % CI = 0.82-0.97) intake was associated with decreased hip fracture incidence, whereas high meat intake (HR = 1.18; 95 % CI = 1.06-1.31) with increased incidence. Excessive ethanol consumption (HR high versus moderate = 1.74; 95 % CI = 1.32-2.31) was also a risk factor. CONCLUSIONS: In a prospective study of adults, increased adherence to MD appears to protect against hip fracture occurrence, particularly among men.

  • 106. Benetou, V
    et al.
    Orfanos, P
    Zylis, D
    Sieri, S
    Contiero, P
    Tumino, R
    Giurdanella, M C
    Peeters, P H M
    Linseisen, J
    Nieters, A
    Boeing, H
    Weikert, C
    Pettersson, U
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Bueno-de-Mesquita, H B
    Dorronsoro, M
    Boffetta, P
    Trichopoulou, A
    Diet and hip fractures among elderly Europeans in the EPIC cohort2011In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 65, no 1, p. 132-139Article in journal (Refereed)
    Abstract [en]

    In a prospective study of the elderly, diet, including consumption of dairy products, alcohol and vitamin D, did not appear to play a major role in hip fracture incidence. There is however, weak and statistically non-significant evidence that vegetable and fish consumption and intake of polyunsaturated lipids may have a beneficial, whereas saturated lipid intake a detrimental effect.

  • 107.
    Bengtsson, Py
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Carlsson, Klara
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Treatment Results after Intra-articular Injection of Corticosteroids in Patients with TMJ Arthritis2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Arthritis is a common disease affecting the temporomandibular joint. The inflammation causes local pain and decreased function of the masticatory system. Temporomandibular joint arthritis can result from mechanical overloading, general autoimmune disease or individual susceptibility. The aim of this study was to investigate objective and subjective treatment results after intra-articular injection of corticosteroids in patients with temporomandibular joint arthritis. The hypothesis was that treatment with intra-articular injection of corticosteroids relieves clinical signs and subjective symptoms and no difference between objective and subjective treatment outcome was anticipated.

    An outcome assessment study with consecutive sample was performed. Objective and subjective data was registered from 70 subjects treated with intra-articular injection of corticosteroids. Statistics were analyzed in SPSS. Subgroup analysis was performed to evaluate and distinguish confounding variables such as sex, age, autoimmune disease (general), previous physical trauma and hard tissue changes.

    Maximum mouth opening capacity was increased by 8.7% after treatment demonstrating an objective improvement. Subjects with an initial impaired maximum mouth opening capacity <40 mm showed a greater increase compared to those within the normal range. Subjective assessment at follow-up presented a self-reported improvement in 77% of the subjects. The routines regarding follow-up were found to be inconsistent and subjective assessments scales were missing in about 50% of the cases.

    Objective and subjective improvement was observed after intra-articular injection of corticosteroids. This confirms the present treatment recommendations that intra-articular injection is an effective method in relieving signs and symptoms of temporomandibular joint arthritis.

  • 108.
    Bengtzboe, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Öskog, Stina
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Surgical Treatment of Peri-implantitis: Treatment Results -a pilot study2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Peri-implantitis is an infectious disease and one of the treatment methods involves surgical debridement of the infected area. The aim of this pilot study was to investigate treatment outcome after surgical treatment of peri-implantitis in humans. Outcome measures were reduction in pocket probing depth (PPD) and bleeding on probing and/or suppuration (BOP/Sup). Eight patients, with a total amount of 28 implants, who were diagnosed with peri-implantitis were surgically treated with a non regenerative surgical method including debridement and removal of granulation tissue combined with osteoplasty. Oral hygiene instructions were given and after 6 to 18 months a clinical re-examination was performed by two dental students at Umeå University. PPD and BOP/Sup data at the re-examination were retrospectively compared to baseline data.

    The results of the study showed a reduction in mean PPD and BOP/Sup after surgery at patient level. A significant reduction in mean PPD was shown (p <0.05), while the reduction in BOP/Sup was not significant. At patient level, the mean reduction in mean PPD was 1.6 mm and in BOP/Sup 26%. Results varied among patients, suggesting that treatment outcome is influenced by several different factors. Tendencies that risk factors such as smoking and poor oral hygiene may have affected the treatment result were noted. In conclusion, our study shows that surgical therapy may be a beneficial treatment method for peri-implantitis in terms of reduction of PPD and BOP/Sup.

  • 109. Benteke, M
    et al.
    Berntsson, L
    Broman, U
    Enfeldt, K
    Sköld-Larsson, K
    Twetman, S
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Population- vs. risk-based applications of fissure sealants in first permanent molars: a 13-year follow-up.2006In: Oral health & preventive dentistry, Vol. 4, no 151-156Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate and compare the long-term outcome of a population-based and a risk-based strategy of applying fissure sealants in newly erupted first permanent molars. DESIGN AND SETTING: Retrospective cohort study in primary dental care. MATERIALS AND METHODS: Four hundred and ninety-six subjects from two cohorts were included. In group P (n = 236), routine applications of fissure sealants were conducted while sealants were placed on the basis of subjective criteria in Group R (n = 260). Data of applications, maintenance, decay, restorations, extractions, and cumulative time of applications from six to 19 years were extracted from the dental records and bite-wing radiographs by two of the authors simultaneously. The main outcome measures were the total caries prevalence at the age of 19 years as well as the fate of each sealed and non-sealed occlusal surface. RESULTS: In group P, 87.7% of all first permanent molars were sealed compared with 20.2% in group R. There was no statistically significant difference concerningthe total DFT at 19 years of age between the groups (mean 3.5 +/- 3.8 vs. 3.7 +/- 3.4). Considering the occlusal surfaces of the first permanent molars only, a statistically significant treatment effect was demonstrated in group P with an odds ratio of 4.6 (95% CI: 3.0 - 6.7; p < 0.05). The absolute risk reduction was 36.3% and the number needed to treat was 2.8. In Group R, no statistically significant treatment effect was disclosed (OR = 1.3; 95% CI: 0.9 - 1.7; risk reduction 5.5%). CONCLUSION: This 13-year follow-up showed that population-based applications of fissure sealants in first permanent molars shortly after eruption showed a statistically significant treatment effect on the occlusal surfaces at the age of 19 years, which was in contrast to findings from a cohort in which sealants were applied on the basis of an individual risk-based strategy. There were, however, no significant differences concerning the total caries experience between the two cohorts

  • 110.
    Berg, Veronica
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    Högbacka, Ulrika
    Bäckman, Nils
    Persson, Maurits
    Swallowing and inhaling foreign objects during treatment2004In: Tandläkartidningen, Vol. 96, no 7, p. 58-64Article in journal (Refereed)
    Abstract [sv]

    Three hundred dentists in private and 300 dentists in public dentistry were asked to fill in a questionnaire on the incidents of patients swallowing and inhaling objects during treatment. The response rate was 81%. The incident information provided in the questionnaire was compared to reports sent to the Socialstyrelsen (National Board of Health and Welfare), according to lex Maria for the period 1992-2002.

    Approximately one quarter of the dentists questioned reported an experience of a patient swallowing or inhaling a foreign object during the last 10 years, with a similar incidence seen between private and public dentistry. About two thirds of the situations reported occurred in treatments related to prosthetic dentistry. However, a marked difference between dentists in private and public service was found in the number of reported incidents to the Socialstyrelsen. The questionnaire showed that dentists lacked information and training in the handling of situations of swallowing and aspiration. The study concluded that official reports on swallowing and aspiration of foreign objects during dental treatment do not reflect the true incidence of occasions and highlighted the need for education and training of dentists in how to handle such situations.

  • 111.
    Bergdahl, Jan
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Mårell, Lena
    Umeå University, Faculty of Medicine, Department of Odontology.
    Bergdahl, Maud
    Umeå University, Faculty of Medicine, Department of Odontology.
    Perris, Hjördis
    Psychobiological personality dimensions in two environmental-illness patient groups2005In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 9, no 4, p. 251-256Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the psychobiological personality dimensions in two subgroups of patients with environmental illness (EI). Fifty-nine patients, 34 women and 25 men (aged 32-69 years), were referred for symptoms allegedly caused by abnormal sensitivity to either dental fillings (DF; n=26) or electromagnetic fields (EMF; n=33). For the evaluation of personality, the Swedish 238-item version of the Temperament and Character Inventory (TCI) was used. Compared with a control group, the EMF group scored higher on the temperament dimension Persistence. The DF group scored higher on the TCI subscales Harm Avoidance (fatigability and asthenia) and Self-Directedness (self-acceptance). Women scored higher than men did on the Novelty Seeking and Reward Dependence (RD) dimensions in the DF group and on RD in the control group, indicating an inherited gender difference. No differences were found between men and women in the EMF group. Our results indicate that the high level of persistence found in the EMF group and the high level of fatigability and asthenia in combination with high self-acceptance found in the DF group represent vulnerable personalities. No significant differences were found between the two patient groups, indicating that these groups are quite similar regarding personality. This vulnerability can be expressed as various mental and somatic symptoms, which can be interpreted as El symptoms by the affected individual.

  • 112. Bergdahl, M
    et al.
    Bergdahl, J
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Depressive symptoms in individuals with idiopathic subjective dry mouth1997In: Journal of Oral Pathology & Medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, Vol. 26, no 10, p. 448-450Article in journal (Refereed)
    Abstract [en]

    It has been known for many centuries that there is a relationship between saliva flow rate and emotional status. The significance of psychological processes in the subjective sensation of a dry mouth has been discussed earlier, and this study deals with the presence of depressive symptoms in individuals with idiopathic subjective sensation of a dry mouth. Depressive symptoms in 94 healthy subjects with normal flow rates for unstimulated and stimulated whole saliva but with a subjective sensation of a dry mouth were assessed by the Beck Depression Inventory (BDI) and compared with healthy age- and gender-matched controls. The subjects with a subjective dry mouth condition were significantly more depressive and also had a significantly higher frequency of depressive symptoms. Depression was found in 21.3% of the individuals with a subjective dry mouth sensation and in 3.2% of the controls. The results of this study indicate that, in some cases, subjective dry mouth may be of psychological origin.

  • 113.
    Bergdahl, M
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hedström, L
    Metronidazole for the prevention of dry socket after removal of partially impacted mandibular third molar: a randomised controlled trial2004In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 42, no 6, p. 555-558Article in journal (Refereed)
    Abstract [en]

    We randomised 119 patients who had been referred for removal of partially impacted mandibular third molars to be given either metronidazole 1600 mg or placebo as a single dose 45 min before operation. Ten of the fifty-nine patients who were given metronidazole and 13 of the 60 given placebo developed dry sockets. Two variables were significantly associated with the development of a dry socket: pericoronitis and oral contraceptives.

  • 114.
    Bergendal, Birgitta
    Umeå University, Faculty of Medicine, Odontology.
    Oligodontia and ectodermal dysplasia: on signs, symptoms, genetics and outcomes of dental treatment2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this thesis was to broaden our knowledge of the signs and symptoms, genetics, and outcomes of dental implant treatment in individuals with oligodontia or ectodermal dysplasia.

    Article I is a population-based study in three Swedish counties of 162 individuals with oligodontia, which was a prevalence of 0.09%. The intent was to explore ways for dentists to assess symptoms from other ectodermal structures than teeth through a clinical interview and chair-side analyses. Thirty per cent had low salivary secretion rates while only 11% with no known syndrome reported symptoms from hair, nails, or sweat glands. These are, together with teeth, the ectodermal structures on which it is proposed that a clinical diagnosis of ectodermal dysplasia (ED) be based.

    Article II screened 93 probands with oligodontia for mutations in six genes known to cause oligodontia and hypohidrotic ED. Sequence alterations predicted to be damaging or potentially damaging were revealed in the AXIN2, MSX1, PAX9, and EDARADD genes in 14 (15%) of the probands. All mutations but one were novel. For the first time, EDARADD mutations were shown to cause isolated oligodontia. No individual who had reported ectodermal symptoms from hair, nails, or sweat glands had a mutation.

    Article III assessed orofacial function in individuals with different types of EDs using the Nordic Orofacial Test-Screening (NOT-S) protocol. Individuals with ED scored significantly higher in orofacial dysfunction than a healthy reference sample, especially in the Chewing and swallowing, Dryness of the mouth, and Speech domains.

    Article IV surveyed treatment outcome of dental implants in Swedish children up to age 16 years. In a 20-year period, only 26 patients were treated, 5 of whom had hypohidrotic ED and anodontia of the mandible. Individuals with ED had 64% failed implants compared to 6% among subjects with teeth missing due to trauma or agenesis.

    The main conclusions of this thesis were that (i) a check of whether one or more permanent incisors are missing will identify 65% of individuals with oligodontia and 84% of individuals missing nine teeth or more, (ii) evaluation of salivary secretion is indicated in children with oligodontia, (iii) a majority of individuals with oligodontia did not report other abnormal ectodermal organ function besides teeth, (iv) no clinical indicator discriminated between individuals with and without mutations in the tested genes, and more unidentified genes are involved in tooth morphogenesis, (v) EDARADD mutations are associated with isolated oligodontia, (vi) evaluation of orofacial function is indicated in individuals with ED, and many individuals with ED would benefit from orofacial skills training, (vii) dental implant placement is a rare treatment modality in children, (viii) individuals with hypohidrotic ED seem to present special challenges due to structural as well as direct effects of the mutations on bone, which seem to compromise osseointegration, (ix) central registers on signs and symptoms in individuals with rare disorders would help establish prevalences of various diagnoses and define treatment needs, and (x) quality registers for monitoring treatment outcomes of dental implants would promote early detection of risks and side-effects in individuals with rare disorders.

  • 115.
    Bergendal, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Pediatric Dentistry.
    Ekman, Agneta
    Nilsson, Peter
    Implant failure in young children with ectodermal dysplasia: a retrospective evaluation of use and outcome of dental implant treatment in children in Sweden2008In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 23, no 3, p. 520-524Article in journal (Refereed)
    Abstract [en]

    Purpose: This study surveyed dental implant treatment in children up to age 16 years in Sweden between 1985 and 2005, with special reference to young children with ectodermal dysplasia (ED) and anodontia in the lower jaw.

    Materials and Methods: A questionnaire was sent to Swedish specialist clinics in oral and maxillofacial surgery and prosthetic dentistry. Also, the teams who had treated children with ED were asked to submit their records for these children for a discussion on reasons for implant failure.

    Results: Six out of 30 specialist centers (20%) in Sweden had treated 26 children with dental implants between 1985 and 2005. Twenty-one patients had received 33 implants to replace teeth missing from nonsyndromic agenesis or trauma at ages 14 or 15 years; 2 (6.1%) of these implants were lost. Five children with ED received 14 implants at 5 to 12 years of age; 9 (64.3%) of these implants were lost before loading.

    Conclusions: Dental implant placement has been a rarely used treatment modality in Swedish children less than 16 years old in the last 20 years. The failure rate in children treated because of tooth agenesis was only slightly higher than that reported for adult individuals, whereas in young children with ED and anodontia in the mandible, implants seemed to present special challenges, and the failure rate was very high. The small jaw size and peroperative conditions, rather than ED per se, were thought to be the main risk factors. Centralizing implant operations in young children with ED and monitoring outcomes in implant registers are strongly advocated. Int J Oral Maxillofacial Implants 2008;23:520–524

  • 116. Bergendal, Birgitta
    et al.
    Klar, Joakim
    Stecksén-Blicks, Christina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Norderyd, Johanna
    Dahl, Niklas
    Isolated oligodontia associated with mutations in EDARADD, AXIN2, MSX1, and PAX9 genes2011In: American Journal of Medical Genetics. Part A, ISSN 1552-4825, E-ISSN 1552-4833, Vol. 155, no 7, p. 1616-1622Article in journal (Refereed)
    Abstract [en]

    Oligodontia is defined as the congenital lack of six or more permanent teeth, excluding third molars. Oligodontia as well as hypodontia (lack of one or more permanent teeth) are highly heritable conditions associated with mutations in the AXIN2, MSX1, PAX9, EDA, and EDAR genes. Here we define the prevalence of mutations in the AXIN2, MSX1, PAX9, EDA, and EDAR genes, and the novel candidate gene EDARADD in a cohort of 93 Swedish probands with non-syndromic, isolated oligodontia. Mutation screening was performed using denaturing gradient gel electrophoresis and DNA sequence analysis. Analyses of the coding sequences of the six genes showed sequence alterations predicted to be damaging or potentially damaging in ten of 93 probands (10.8%). Mutations were identified in the EDARADD (n = 1), AXIN2 (n = 3), MSX1 (n = 2), and PAX9 (n = 4) genes, respectively. None of the 10 probands with mutations had other self-reported symptoms from ectodermal tissues. The oral parameters were similar when comparing individuals with and without mutations but a family history of oligodontia was three times more frequent for probands with mutations. EDARADD mutations have previously been reported in a few families segregating hypohidrotic ectodermal dysplasia and this is, to our knowledge, the first report of an EDARADD mutation associated with isolated oligodontia.

  • 117.
    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)
  • 118. Bergius, Marianne
    et al.
    Kiliaridis, Stavros
    Marklund, Marie
    Umeå University, Faculty of Medicine, Odontology, Ortodontics.
    Mohlin, Bengt
    Ortodonti i relation till oral funktion2007In: Tandläkartidningen, Vol. 99, no 2, p. 52-59Article, review/survey (Other (popular science, discussion, etc.))
    Abstract [sv]

    The association between the activity of masticatory muscles and craniofacial development has been studied in man as well as in animals. The common finding of these investigations is that the muscles closing the mandible influence the transversal closing the mandible inflkuence the transversal and the vertical dimensions of the craniofacial skeleton. The loading of the facial bones due to masticatory muscle function may stimulate sutural growth and increase bone apposition, leading in turn to an increase of the transversal growth of the maxilla and broader bone bases for the dental arches. The big functional demands of the masticatory muscles are often associated with anterior growth rotation pattern and well-developed angular, coronoid, and condylar processes in the mandible. Individuals with disabilities have an increased prevalence of malocclusion and poor oral function. Behavioural problems and deviating orofacial growth and function will complicate the orthodontic treatment. But with behavioural and various treatment modifications, we can give those patients a well adopted orthodontic treatment. That may favour the facial appearance, achieving a better mouth closure and improve the posibilities to eat and speak. The development and critical evaluation of treatment methods aiming towards normalizing craniofacial and occlusal development is essential. Modified functional appliances such as the ”mandibular repositioning appliance” (MRA) has in placebo controlled studies been shown to reduce periods of respiratory arrest and snoring in patients with mild apnea. This method may also be an alternative in more severe cases where patients do not accept treatment with continous overpressured air (CPAP). Sucessful treatment of sleep apnea must be based on a close cooperation of dentists with knowledge in this field and doctors at sleep apnea clinics. Effects and side effects of treatment must be supervised during long periods.

  • 119.
    Berglin, Ewa
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Carlsson, Jan
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Effect of hydrogen sulfide on the mutagenicity of hydrogen peroxide in Salmonella typhimurium strain TA1021986In: Mutation research, ISSN 0027-5107, E-ISSN 1873-135X, Vol. 175, no 1, p. 5-9Article in journal (Refereed)
  • 120.
    Berglin, Ewa
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Edlund, Maj-Britt K.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Nyberg, Göran K.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Carlsson, Jan
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Potentiation by L-cysteine of the bactericidal effect of hydrogen peroxide in Escherichia coli1982In: Journal of Bacteriology, ISSN 0021-9193, E-ISSN 1098-5530, Vol. 152, no 1, p. 81-88Article in journal (Refereed)
    Abstract [en]

    Under anaerobic conditions an exponentially growing culture of Escherichia coli K-12 was exposed to hydrogen peroxide in the presence of various compounds. Hydrogen peroxide (0.1 mM) together with 0.1 mM L-cysteine or L-cystine killed the organisms more rapidly than 10 mM hydrogen peroxide alone. The exposure of E. coli to hydrogen peroxide in the presence of L-cysteine inhibited some of the catalase. This inhibition, however, could not fully explain the 100-fold increase in hydrogen peroxide sensitivity of the organism in the presence of L-cysteine. Of other compounds tested only some thiols potentiated the bactericidal effect of hydrogen peroxide. These thiols were effective, however, only at concentrations significantly higher than 0.1 mM. The effect of L-cysteine and L-cystine could be annihilated by the metal ion chelating agent 2,2'-bipyridyl. DNA breakage in E. coli K-12 was demonstrated under conditions where the organisms were killed by hydrogen peroxide.

  • 121.
    Berglin, Ewa H.
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Carlsson, Jan
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Microbiology.
    Potentiation by sulfide of hydrogen peroxide-induced killing of Escherichia coli1985In: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 49, no 3, p. 538-543Article in journal (Refereed)
    Abstract [en]

    L-Cysteine potentiates 100-fold the hydrogen peroxide-induced killing of a growing culture of Escherichia coli K-12 (Berglin et al., J. Bacteriol. 152:81-88). In the present study it is shown that hydrogen sulfide is formed from L-cysteine and that sodium sulfide could substitute for L-cysteine in the potentiation of hydrogen peroxide-induced killing of E. coli K-12. Addition of an amino acid, L-leucine, L-valine, or L-alanine, to an L-cysteine-containing medium with a growing culture of E. coli K-12 inhibited hydrogen sulfide formation and the potentiation of hydrogen peroxide-induced killing. These amino acids did not inhibit hydrogen sulfide formation from L-cysteine by a cell extract, and they did not inhibit the potentiation by sulfide of hydrogen peroxide-induced killing. This indicated that the amino acids protected the culture from L-cysteine-potentiated, hydrogen peroxide-induced killing by inhibiting the transport of L-cysteine into the cell. The potentiation by sodium sulfide of hydrogen peroxide-induced killing was abolished by the metal ion chelator 2,2'-bipyridyl. This indicated that metal ions, in addition to sulfide, were involved in the killing. Toxic effects of hydrogen peroxide are often presumed to be mediated by hydroxyl radicals formed in iron-catalyzed reactions. It was demonstrated that iron sulfide was more efficient than ferrous iron in catalyzing the formation of hydroxyl radicals from hydrogen peroxide. It was suggested that hydrogen sulfide formed in polymicrobial infections may play an important role in the host defense by potentiating the antimicrobial effect of hydrogen peroxide produced by phagocytic cells.

  • 122. Berglund, A
    et al.
    Molin, M
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Mercury levels in plasma and urine after removal of all amalgam restorations: the effect of using rubber dams.1997In: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 13, no 5, p. 297-304Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the present study was to determine whether removal of all amalgam restorations might significantly affect mercury levels in plasma and urine and whether the use of rubber dams might reduce patient exposure to mercury during amalgam removal. METHODS: All amalgam restorations were removed from 18 subjects during a single treatment session in which a rubber dam was used and from 10 subjects when a rubber dam was not used. All amalgam restorations were removed by the same dentist using high-speed cutting, water coolant, and high-volume evacuation. The levels of mercury in plasma and urine were analyzed both before and during the subsequent twelve months after amalgam removal. In order to determine whether removal of all amalgam restorations might cause an exposure large enough to significantly increase the mercury levels in two indicator media for mercury exposure, i.e., plasma and urine, and to determine if the removal might cause a significant decrease in the mercury levels found over time, the one-tailed, paired Students' t-test was used. For each individual, the pre-removal levels were compared with both the levels found in plasma on d 1 and in urine on d 10, and also with the levels found 1 y after removal. Furthermore, in order to examine whether the use of rubber dams had any effect on the mercury levels found after removal, the changes in the mercury levels found were compared between the groups using the Wilcoxon-Mann-Whitney rank sum test. RESULTS: After removal of all amalgam restorations, only the non-rubber dam group showed significant increases in the mercury levels found in plasma (p = 0.012) and urine (p = 0.037). However, one year later, the mercury levels in plasma and urine had sunk significantly below the pre-removal levels for both groups. When the changes in the mercury levels found were compared between the groups, the non-rubber dam group showed a significantly higher increase of mercury in plasma than the rubber dam group the day after removal (p = 0.0010). Compared to the pre-removal mercury levels in plasma and urine, the levels found 1 y after removal of all amalgam restorations were on average 52 +/- 23% (range 4-89%) lower in plasma and 76 +/- 21% (range 20-94%) lower in urine. SIGNIFICANCE: The study showed that dental amalgam had a statistically significant impact on the mercury levels found in plasma and urine in the patients tested, and that the use of a rubber dam during removal of all amalgam restorations significantly reduced the peak of mercury in plasma following removal.

  • 123. Berglund, A
    et al.
    Molin, M
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Mercury vapor release from dental amalgam in patients with symptoms allegedly caused by amalgam fillings.1996In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 104, no 1, p. 56-63Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine whether a group of patients with symptoms, self-related to their amalgam restorations, experienced an exposure to mercury vapor from their amalgam restorations that reached the range at which subtle symptoms have been reported in the literature. Furthermore, the aim was to determine whether the mercury exposure for these patients was significantly higher than for controls with no reported health complaints. The symptom group consisted of 10 consecutively selected patients from a larger group, referred by their physicians for investigation into any correlation between subjective symptoms and amalgam restorations. The control group consisted of 8 persons with no reported health complaints. The intra-oral release of mercury vapor was measured between 7:45 a.m. and 9:00 p.m. at intervals of 30-45 min, following a standardized schedule. The mercury levels in plasma, erythrocytes, and urine were also determined. The calculated daily uptake of inhaled mercury vapor, released from the amalgam restorations, was less than 5% of the daily uptake calculated at the lower concentration range given by the WHO (1991), at which subtle symptoms have been found in particularly sensitive individuals. The symptom group had neither a higher estimated daily uptake of inhaled mercury vapor, nor a higher mercury concentration in blood and urine than in the control group. The study provides no scientific support for the belief that the symptoms of the patients examined originated from an enhanced mercury release from their amalgam restorations.

  • 124.
    Berglund, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Branting-Ekenbäck, C
    Ohlson, M
    En översikt över chairside CAD/CAM-system i Sverige. Garanteras patientsäkerheten genom CE-märkningen av utrustning och material?2013Report (Other academic)
    Abstract [sv]

    Inom odontologin har Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) blivit allt vanligare, främst på tandtekniska laboratorier, men tekniken blir också vanligare på tandläkarklinikerna, s.k. chairside CAD/CAM. Chairside CAD/CAM innebär att tandläkaren efter preparationen av en tand framställer tandersättningen i tre steg. I första steget används en intraoral scanner istället för den traditionella avtryckstagningen (Mörmann et al., 2002; Beuer et al., 2008; Hehn, 2001). Man kan även scanna modeller och avtryck, vilket kan vara bra om patienten har svårt att gapa eller har hög salivproduktion, då scannrarna är känsliga för fuktiga miljöer (Kachalia et al., 2010). Det digitala avtrycket överförs till datorn, där uppgifterna bearbetas och en modell av tänderna skapas i 3D. I det andra steget designar tandläkaren tandersättningen på 3D-modellen. Här bestämmer tandläkaren kusphöjd, kontakter approximalt, utsträckning mot preparationsgränsen och utseende på tandersättningen. I det tredje steget fräses tandersättningen fram ur ett keramblock i en fräsmaskin. Ofta målas kronan här för att karaktärisera den och ge den ett mer tandlikt utseende innan den bränns i ugn. Med större möjligheter att själv kunna sköta hela processen fram till färdig tandkonstruktion måste tandläkaren fundera över hur kvaliteten och säkerheten hos de färdiga produkterna kan säkerställas. Färdiga tandtekniska arbeten räknas som specialanpassade medicintekniska produkter och ska inte CE-märkas men de material som ingår i arbetet är oftast CE-märkta. Lag (1993:584) om medicintekniska produkter och Läkemedelsverkets föreskrifter (LVFS 2003:11) om medicintekniska produkter innehåller krav på att medicintekniska produkter som släpps ut på marknaden ska vara lämpliga och säkra för sina användningsområden genom att krav ställs som ska leda till att allvarliga avvikelser, olyckor och tillbud på grund av produkterna så långt som möjligt ska kunna undvikas. Avvikelser inkluderar här både funktionsfel och misstänkta biverkningar. Innan ett tandtekniskt laboratorium får börja leverera tandtekniska arbeten till tandläkare måste ett antal krav vara uppfyllda för att bl.a. säkerställa säkerheten hos dessa produkter för patienterna. Laboratoriet ska vara registrerat hos Läkemedelsverket och vid registreringen måste man intyga att man har en tillverkningsverksamhet som uppfyller de krav för specialanpassade medicintekniska produkter som ställs i LVFS 2003:11. Medicintekniska produkter ska konstrueras och tillverkas på ett sådant sätt att de inte äventyrar patienternas kliniska tillstånd eller säkerhet, användarnas eller i förekommande fall andra personers hälsa och säkerhet, när de används under avsedda förhållanden och för sitt avsedda ändamål. Riskerna med att använda produkterna ska vara acceptabla med tanke på fördelarna för patienten och förenliga med en hög hälso-och säkerhetsnivå. Detta innefattar omfattande krav både på produkt och tillverkningsprocess. Det finns en del oklarheter rörande hur det regelverk som styr framställningen av tandtekniska arbeten tillämpas för arbeten tillverkade med chairside CAD/CAM.

  • 125.
    Berglund, Anders
    et al.
    Umeå University, Faculty of Medicine, Odontology, Dental Technology/Dental Materials Science.
    Hulterström, Anna Karin
    Umeå University, Faculty of Medicine, Odontology, Dental Technology/Dental Materials Science.
    Gruffman, Ewa
    Umeå University, Faculty of Medicine, Odontology, Dental Materials Science.
    van Dijken, Jan
    Umeå University, Faculty of Medicine, Odontology, Dental Hygiene.
    Dimensional change of a calcium aluminate cement for posterior restorations in aqueous and dry media.2006In: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 22, no 5, p. 470-476Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: A calcium aluminate cement has recently been developed, with claims of being an alternative to dental amalgam and resin composites in posterior cavities. However, its' mechanical properties are not well evaluated and the aim of the study was therefore, to evaluate its' dimensional stability over time. METHODS: The dimensional changes of the cement, Doxadent, and two composite resins, Esthet-X and InTen-S, were tested during 360 d. The specimens were stored at 37+/-1 degrees C either in 100% air humidity (dry) or immersed in distilled water (wet), except for the first 24h when all specimens were stored at 100% air humidity and 37+/-1 degrees C. RESULTS: During the first 24h, Doxadent decreased in volume with 0.04%, while InTen-S and Esthet-X decreased with 1.60 and 1.75%, respectively. From d 1-360, the dry Doxadent specimens increased in volume with 2.0% and in weight with 5.5%, while the corresponding increase for the wet specimens were 4.1 and 6.3%, respectively. The volume of both composites increased 0.8% or less in dry and wet conditions, while the increase in weight for InTen-S was 1.2% for the wet specimens and 0.6% for the dry. The corresponding figures for Esthet-X were 0.7 and 0.2%. SIGNIFICANCE: Doxadent was less dimensionally stable than the composites tested. Doxadent increased 2 times more in volume immersed in water than in 100% air humidity, while the increase in weight was almost similar. The clinical implications of the results found in the present study are uncertain. A material that continues to absorb water during prolonged periods and continues to react is questionable for clinical use.

  • 126.
    Berglund, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Konradsson, Katarina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Biverkningar av dentala implantat i titan och zirkoniumdioxid: en systematisk översikt av vetenskapliga studier2014Report (Other academic)
    Abstract [sv]

    Dentala implantat har använts som stöd för kronor och broar sedan 1930-talet och under mitten av 1960-talet behandlades den första patienten med implantat i titan. Behandlingen har blivit allt vanligare och idag opereras cirka 50-60 000 implantatfixturer per år in på cirka 20 000 patienter. De flesta implantat som används idag är framställda i titan men implantat av zirkoniumdioxid blir allt vanligare. Zirkoniumdioxid anses vara ett lovande material för dentala implantat då det, i likhet med titan, anses biokompatibelt och har goda mekaniska egenskaper. Materialet har också en estetisk fördel och efterfrågas av patienter som vill undvika konstruktioner av titan.

    Syftet med denna systematiska översikt är att utreda om det finns ett vetenskapligt underlag som ger stöd för att det finns skillnader mellan dentala implantat av titan och zirkoniumdioxid, när det gäller typ och frekvens av biverkningar. Slutsatserna är att:

    • Det finns ett otillräckligt vetenskapligt underlag för att uttala sig om huruvida det finns skillnader i risk för biverkningar mellan de två fixturmaterialen, då det saknas studier.
    • Den identifierade kunskapsluckan påvisar behovet av kontrollerade studier (RCT) med dentala implantat av olika material där biverkningar ingår som ett utfallsmått.

    I kliniken kommer valet av implantatmaterial i stället att baseras på andra dokumenterade egenskaper hos dessa produkter, och på tandläkarens beprövade erfarenhet.

  • 127.
    Berglund, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Holopainen, Laura
    Umeå University, Faculty of Medicine, Department of Odontology.
    Analysis of Drop-outs in a 2-year Follow-up of individuals exposed to Whiplash Trauma2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Most studies that investigate the relationship between temporomandibular disorders (TMD) and whiplash are cross-sectional, but in order to identify risk factors prospective studies are needed. The reliability of prospective studies is dependent on representative follow-up groups. The prospective study “ProNeck” investigated possible risk factors for devolvement of TMD following a whiplash trauma by comparing cases to controls within one month following whiplash trauma and after two years. The aim of the present study was to investigate whether dropouts from “ProNeck” differed in baseline symptoms from individuals attending the two-year follow-up. A second aim was to reduce number of dropouts by offering a short-version follow-up questionnaire.

    In total, baseline data from 217 cases and controls who participated in the two-year follow-up was compared with baseline data from 65 drop-outs. Parameters analysed were gender, age, Neck Disability Index, intensity of jaw and neck pain on the Numerical Rating Scale, screening questions on jaw pain and dysfunction, depression and physical symptoms. The short follow-up questionnaire containing five key questions was sent to 13 participants who did not attend the two-year follow-up.

    No significant difference for any of the analysed parameters was found when comparing baseline data between individuals that participated in the two-year follow-up and dropouts. For the shortened follow-up questionnaire, only one individual completed the questionnaire.

    The results of the dropout analysis strengthen the reliability and value of the prospective study "ProNeck". The low response-rate of the short-follow up questionnaire indicates that there is little gain trying to reduce dropouts in prospective studies by offering short-version questionnaires.

  • 128. Bergman, B
    et al.
    Marklund, Susanna
    Umeå University, Faculty of Medicine, Odontology.
    Nilson, H
    Hedlund, S O
    An intraindividual clinical comparison of 2 metal-ceramic systems.1999In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 12, no 5, p. 444-7Article in journal (Refereed)
    Abstract [en]

    PURPOSE: It has been questioned whether the surface and color of the ceramic and the metal-ceramic bond strength of a titanium-ceramic system are comparable to those of a conventional noble alloy-ceramic system. It was therefore the aim of this study to carry out an intraindividual clinical comparison between crowns fabricated according to the Procera system (titanium copings veneered with a low-fusing ceramic) and noble-alloy copings veneered with a medium-fusing ceramic. MATERIALS AND METHODS: Twenty-one crown pairs were fabricated for eighteen patients; three of the patients were each provided with two crown pairs. After 2 years nineteen crown pairs in sixteen patients could be compared. Clinical examinations were performed by two calibrated dentists who are long experienced in prosthetic dentistry. The crowns were rated according to the California Dental Association system. In addition, Bleeding Index and Margin Index were evaluated. RESULTS: After 2 years the quality of surface and color of the ceramic material seemed to have deteriorated more in titanium-ceramic crowns than in conventional metal-ceramic crowns, although the difference was not statistically significant. Regarding anatomic form, margin integrity, Bleeding Index, and Margin Index the differences between the two crown systems were small. CONCLUSION: The low-fusing ceramics have been subject to improvements during the last few years. Their bond strength to titanium seems to be comparable to that of conventional metal-ceramic systems. However, in the long run one problem may be the surface and color stability of low-fusing ceramics. To make extended long-term comparisons between the two metal-ceramic systems possible the present patient material will be followed for a longer period than the current 2 years.

  • 129.
    Bergman, Bo
    Umeå University, Faculty of Medicine, Department of Odontology.
    The distribution and concentration of zinc and the effects of zinc deficiency in the mammalian body: some experiments in mice and rats with special reference to mandibular condyle and some other skeletal tissues1970Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis constitutes a summary of the following series of studies:

    I Autoradiographic studies on the distribution of zinc-65 in mice. In collaboration with Rune Söremark. The Journal of Nutrition 94,6, 1968.

    II Comparative study of distribution of injected zinc 65 in the mandibularcondyle and other tissues in rat as determined by gammascintillation. Acta Radiologica, Therapy Physics Biology 1970. Preprint.

    III Concentration of zinc in some hard and soft tissues of rat determinedby neutron activation analysis. Acta Radiologica, TherapyPhysics Biology 1970. Preprint.

    IV The distribution of 65Zn in the endochondral growth sites of themandibular condyle and the proximal end of the tibia in youngrats.—An autoradiographic and gamma scintillation study. OdontologiskRevy, 1970. Preprint.

    V Morphologic and autoradiographic observations on the effect ofzinc deficiency on endochondral growth sites in the white rat. Incollaboration with Ulf Friberg, Stefan Lohmander and TorstenÖberg. Odontologisk Revy, 1970. Preprint.

    VI The zinc concentration in hard and soft tissues of the rat. Theinfluence of zinc deficient feeding. Acta odontologica Scandinavica,1970. Preprint.

    These studies will be referred to in the following by the appropriate Roman numerals.

  • 130.
    Bergman, Maud
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Chemical and thermodynamic studies of dental gold alloys with special reference to homogenization, electrochemical corrosion and cluster formation1976Doctoral thesis, comprehensive summary (Other academic)
  • 131.
    Bergqvist, Hanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ljungqvist, Josefine
    Umeå University, Faculty of Medicine, Department of Odontology.
    Adhesion of S. mutans and of S. sanguinis to Superhydrophobic Alkyl Ketene Dimer Nano-surface A Pilot Study2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In the oral cavity, inflammatory processes are caused by bacterial adhesion to non-shedding surfaces. If these surfaces could be modified to prohibit bacterial adhesion, inflammation could be prevented. In this study, bacterial adhesion to a superhydrophobic alkyl ketene dimer (AKD) surface was tested. The AKD-surface, produced by spraying an aerosol onto an existing surface (e.g. a dental prosthesis), has been shown to have largely enhanced hydrophobic characteristics, thus potentially repellant of bacteria.

     

    In this study, bacterial adhesion onto the AKD-surface produced on glass was compared to bacterial adhesion onto surfaces of glass, polyethylenterephthalat-plastic, titanium and biological surfaces, i.e. enamel and dentin. Streptococcus mutans and Streptococcus sanguinis were labeled with fluorescent antibodies, fluorescein isothiocyanate (FITC), and applied to the different surfaces in four tests; control and three different tests where the surfaces were pretreated with blocking buffer, non-secretor saliva and secretor saliva. The areas where bacteria had adhered were quantified and compared. The tooth surface had to be excluded from the study because of optical interference with the FITC labeled bacteria. The AKD-surface was damaged during the experiments and could only be included in the control.

     

    Overall, S. sanguinis adhered to a larger extent compared to S. mutans, with some exceptions. More bacteria adhered after pretreatment with non-secretor saliva compared to secretor saliva. It was concluded that the AKD-surface was unsuitable for use in the oral cavity. Further studies on anti-adhesive coatings that can prevent inflammation in the oral cavity are welcome.

     

  • 132.
    Bergström, Maja
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Al-Dory, Hala
    Umeå University, Faculty of Medicine, Department of Odontology.
    Virtual Surgical Planning in Orthognathic Surgery, Mandibular Reconstruction, and Dental Implant Treatment2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Virtual surgical planning (VSP) has the potential to make the work process of oral and maxillofacial surgery more efficient both in terms of performance and cost. 

    This study aims to investigate how VSP is used among oral and maxillofacial surgery clinics in Sweden, and to analyse VSP with regard to accuracy, healing, patient communication, and overall operative time. 

    A questionnaire was sent to all (n = 34) oral and maxillofacial surgery clinics in Sweden, concerning their knowledge and practice of VSP. A literature review was also carried out to compare the results from clinics in Sweden with the general view. 

    94 % of the oral and maxillofacial surgery clinics participated in the study, and all respondents affirmed knowledge of VSP. While 65 % recognise a need for VSP in their work, only 42 % utilise it. The main obstacles reported were economy, training, and availability. This was in high accordance with the literature review. The review also concluded that VSP increased accuracy, reduced planning time, decreased blood loss, and lowered the need for reoperations. 

    The presented study shows that VSP is beneficial both pre- and intra-operatively in orthognathic surgery, mandibular reconstruction and implant placement. Accuracy, planning, and patient communication are improved with VSP, both according to studies and questionnaire respondents. However, healing, overall operative time, and cost-benefit did not show strong evidence of improvement with VSP, which might explain the contrasted responses in the questionnaire on these subjects.

  • 133.
    Bernhold Brechter, Anna
    Umeå University, Faculty of Medicine, Odontology.
    Kinins: important regulators in inflammation induced bone resorption2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Inflammatory processes in, or in close vicinity of, the skeleton often lead to loss of bone tissue. Different cytokines have been shown to be involved as stimulators of inflammatory induced osteoclastic bone resorption. During inflammatory processes also the kallikrein-kinin system is activated, leading to production of kinins that can cause pain, vasodilation and increased permeability of vessels. Kinins can also induce bone resorption in vitro. All cytokines and kinins that stimulate bone resorption stimulate in parallell prostaglandin synthesis, and prostaglandins, per se, have also been shown to induce bone resorption.

    The aim of this project was to increase the knowledge about the mechanisms involved in the interactions between different inflammatory mediators (i.e. kinins, cytokines and prostaglandins) suggested to be involved in the pathogenesis of inflammatory bone resorbing diseases.

    Human osteoblasts (MG-63) are equipped with both kinin B1 and B2 receptors linked to prostaglandin release and the stimulation of prostaglandin release are likely mediated via separate molecular mechanisms (Paper I). Activation of B1 or B2 receptors causes synergistic stimulation of PGE2 synthesis induced by either interleukin-1b (IL-1b) or tumour necrosis factor-a (TNF-a) (Paper II). The molecular mechanism involves increased expression of cyclooxygenase-2 (COX-2) and results in synergistic potentiation of receptor activator of NF-kB ligand (RANKL) protein expression. The synergistic interaction is dependent on the activation of NF-kB and the mitogen-activated protein kinases (MAPK) p38 and JNK (Paper II). The synergistic increase in RANKL expression might be an explanation why kinins potentiate IL-1b induced bone resorption, a mechanism likely to be important in inflammation induced bone resorption in diseases such as periodontal disease and rheumatoid arthritis.

    The synergism between kinins and IL-1b or TNF-a might also be dependent on regulation of kinin receptors, since both IL-1b and TNF-a markedly upregulated B1 and B2 receptors, both at the mRNA level and protein level (Paper III). This upregulation is not further potentiated by the kinins, and different kinin receptor agonists do not regulate the receptors for IL-1b or TNF-a, in MG-63 cells. No other cytokines known to stimulate bone resorption regulates the expressions of B1 and B2 receptors. The IL-1b- or TNF-a-induced enhancements of B1 and B2 receptor expressions involve activation of NF-kB and MAPK. The enhancement of kinin receptors may also be an important mechanism in the synergistic interactions between the two pro-inflammatory cytokines and kinins (paper III). IL-4 and IL-13 are two cytokines that have been shown to inhibit bone resorption. We have shown that COX-2 and both B1 and B2 receptors are down-regulated by IL-4 and IL-13, via a ‘signal transducer and activator of transcription6’ (STAT6) dependent pathway, which might be an important regulatory mechanism in inflammation induced bone resorption (paper IV).

    In conclusion, the mechanisms behind the synergistic potentiation of prostaglandin formation and increased bone resorption caused by co-stimulation with kinins and IL-1b or TNF-a seem to involve both potentiation of COX-2 and subsequently increased levels of RANKL, as well as upregulation of B1 and B2 kinin receptors. Interestingly, IL-4 and IL-13 decreased the expressions of COX-2 and both B1 and B2 receptors. These events might be important in the regulation of inflammation induced bone resorption in diseases such as periodontitis and rheumatoid arthritis.

  • 134.
    Bernhold Brechter, Anna
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    Lerner, Ulf H.
    Umeå University, Faculty of Medicine, Odontology.
    Characterization of bradykinin receptors in a human osteoblastic cell line2002In: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 103, no 1, p. 39-51Article in journal (Refereed)
  • 135.
    Bernhold Brechter, Anna
    et al.
    Umeå University, Faculty of Medicine, Odontology.
    Lerner, Ulf H.
    IL-4 and IL-13 inhibit cytokine-induced enhancements of COX-2 and kinin receptor expression: effects important for their inhibition of the synergistic stimulation of PGE2 formation caused by co-treatment with cytokines and kininsManuscript (Other academic)
  • 136. 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.

  • 137. Bhoo-Pathy, Nirmala
    et al.
    Peeters, Petra H. M.
    Uiterwaal, Cuno S. P. M.
    Bueno-de-Mesquita, H. Bas
    Bulgiba, Awang M.
    Bech, Bodil Hammer
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Perquier, Florence
    Teucher, Birgit
    Kaaks, Rudolf
    Schuetze, Madlen
    Boeing, Heiner
    Lagiou, Pagona
    Orfanos, Philippos
    Trichopoulou, Antonia
    Agnoli, Claudia
    Mattiello, Amalia
    Palli, Domenico
    Tumino, Rosario
    Sacerdote, Carlotta
    van Duijnhoven, Franzel J. B.
    Braaten, Tonje
    Lund, Eiliv
    Skeie, Guri
    Redondo, Maria-Luisa
    Buckland, Genevieve
    Sanchez Perez, Maria Jose
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Amiano, Pilar
    Wirfalt, Elisabet
    Wallstrom, Peter
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Wareham, Nick
    Allen, Naomi E.
    Key, Timothy J.
    Rinaldi, Sabina
    Romieu, Isabelle
    Gallo, Valentina
    Riboli, Elio
    van Gils, Carla H.
    Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study2015In: Breast Cancer Research, ISSN 1465-5411, E-ISSN 1465-542X, Vol. 17, article id 15Article in journal (Refereed)
    Abstract [en]

    Introduction: Specific coffee subtypes and tea may impact risk of pre- and post-menopausal breast cancer differently. We investigated the association between coffee (total, caffeinated, decaffeinated) and tea intake and risk of breast cancer. Methods: A total of 335,060 women participating in the European Prospective Investigation into Nutrition and Cancer (EPIC) Study, completed a dietary questionnaire from 1992 to 2000, and were followed-up until 2010 for incidence of breast cancer. Hazard ratios (HR) of breast cancer by country-specific, as well as cohort-wide categories of beverage intake were estimated. Results: During an average follow-up of 11 years, 1064 premenopausal, and 9134 postmenopausal breast cancers were diagnosed. Caffeinated coffee intake was associated with lower risk of postmenopausal breast cancer: adjusted HR = 0.90, 95% confidence interval (CI): 0.82 to 0.98, for high versus low consumption; P-trend = 0.029. While there was no significant effect modification by hormone receptor status (P = 0.711), linear trend for lower risk of breast cancer with increasing caffeinated coffee intake was clearest for estrogen and progesterone receptor negative (ER-PR-), postmenopausal breast cancer (P = 0.008). For every 100 ml increase in caffeinated coffee intake, the risk of ER-PR- breast cancer was lower by 4% (adjusted HR: 0.96, 95% CI: 0.93 to 1.00). Non-consumers of decaffeinated coffee had lower risk of postmenopausal breast cancer (adjusted HR = 0.89; 95% CI: 0.80 to 0.99) compared to low consumers, without evidence of dose-response relationship (P-trend = 0.128). Exclusive decaffeinated coffee consumption was not related to postmenopausal breast cancer risk, compared to any decaffeinated-low caffeinated intake (adjusted HR = 0.97; 95% CI: 0.82 to 1.14), or to no intake of any coffee (HR: 0.96; 95%: 0.82 to 1.14). Caffeinated and decaffeinated coffee were not associated with premenopausal breast cancer. Tea intake was neither associated with pre- nor post-menopausal breast cancer. Conclusions: Higher caffeinated coffee intake may be associated with lower risk of postmenopausal breast cancer. Decaffeinated coffee intake does not seem to be associated with breast cancer.

  • 138. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjonneland, Anne
    Overvad, Kim
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Landberg, Rikard
    Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and risk of type 2 diabetes in Scandinavian men and women2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 1, p. 88-96Article in journal (Refereed)
    Abstract [en]

    Background: Studies that use dietary biomarkers to investigate the association between whole-grain intake and the risk of developing type 2 diabetes (T2D) are lacking. Objective: We examined the association between plasma total alkylresorcinols and the alkylresorcinol C17:0-to-C21:0 ratio, biomarkers of whole-grain wheat and rye intake and relative whole grain rye over whole-grain wheat intake, respectively, and the risk of T2D among Scandinavian men and women. Design: A nested case-control study was established within the Northern Sweden Health and Disease Study and the Danish Diet, Cancer and Health cohort. Alkylresorcinol concentrations and the ratios of C17:0 to C21:0 were determined in plasma samples from 931 case-control pairs. ORs for T2D were calculated for plasma total alkylresorcinol concentration or C17:0-to-C21:0 ratio in quartiles with the use of conditional logistic regression that was adjusted for potential confounders. Additional analyses with whole-grain wheat and rye intake estimated from food-frequency questionnaires (FFQs) as exposures were also performed. Results: The plasma total alkylresorcinol concentration was not associated with T2D risk (OR: 1.34; 95% CI: 0.95, 1.88) for the highest compared with the lowest quartiles in multivariable adjusted models. However, the C17:0-to-C21:0 ratio was associated with a lower diabetes risk (OR: 0.54; 95% CI: 0.37, 0.78). Analyses with whole-grain intake estimated from FFQs yielded similar results. Conclusions: Total whole-grain wheat and rye intake, reflected by alkylresorcinols in plasma, was not associated with a lower risk of T2D in a population with high whole-grain intake. In contrast, the proportion of whole-grain rye to whole-grain wheat intake, indicated by the plasma C17:0-to-C21:0 ratio, was inversely associated with T2D. This suggests that whole-grain intake dominated by rye may be favorable for T2D prevention.

  • 139. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjønneland, Anne
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Landberg, Rikard
    Reply to A Abbasi2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1725-1726Article in journal (Refereed)
  • 140. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjønneland, Anne
    Overvad, Kim
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Landberg, Rikard
    Reply to J-B Qin et al2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1723-1724Article in journal (Refereed)
  • 141. Bjorck, Lena
    et al.
    Rosengren, Annika
    Winkvist, Anna
    Capewell, Simon
    Adiels, Martin
    Bandosz, Piotr
    Critchley, Julia
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Guzman-Castillo, Maria
    O'Flaherty, Martin
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 8, article id e0160474Article in journal (Refereed)
    Abstract [en]

    Objective In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025. Methods We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E %. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends. Results In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur. Conclusion CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity.

  • 142.
    Björk, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Brynolfsson, Linda
    Umeå University, Faculty of Medicine, Department of Odontology.
    Clinical Experimental study of Dental Mineralization in Sweden vs. Vietnam2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 143.
    Björk, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wu, Jenny
    Umeå University, Faculty of Medicine, Department of Odontology.
    PCR Analysis as a Method of Microbiological Control in Endodontic Treatment Is there a Correlation to Healing? A pilot study2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: It is scientifically established that absence of viable bacteria in the root canal prior to root filling is an important factor for a successful outcome of endodontic treatment. Culturing technique is often used to confirm a root canal free from bacteria before obturation. This technique has some unfavorable limitations. Polymerase chain reaction (PCR) is a molecular technique which can be used to analyze the endodontic microflora and enable faster analytical progress. It is however uncertain if PCR can be used to predict treatment outcome in endodontic treatment. The aim of this study is to investigate whether PCR as a method could be used to predict treatment outcome by bacterial sampling prior to root filling.

     

    Methods: During strict aseptic conditions, bacterial samples were taken in 24 single-rooted teeth on two occasions. The first samples were taken directly after access cavity was made, and the second samples were taken after the canals were treated and cleaned with antimicrobial substances, using sterile saline and paper points. The samples were transferred to fluid thioglycolate medium. Analyzes of all the samples were made with PCR-method and culturing technique. These results were correlated to healing seen in x-rays for each tooth.

     

    Results: No correlation between healing and bacterial DNA numbers prior to root filling analysis was found. Neither was a correlation found between the bacterial DNA numbers prior to treatment and bacterial numbers before root filling.

     

    Conclusions: The results indicate that PCR, as a method, cannot be used to predict the outcome of endodontic treatment.

  • 144. Björnström, H
    et al.
    Naji, S
    Simic, D
    Sjöström, Inger
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Twetman, Svante
    Umeå University, Faculty of Medicine, Odontology, Pediatric Dentistry.
    Fluoride levels in saliva and dental plaque after consumption of snacks prepared with fluoridated salt.2004In: European journal of paediatric dentistry, Vol. 5, no 1, p. 41-5Article in journal (Refereed)
    Abstract [sv]

    AIM: To determine the concentration of fluoride in saliva and supragingival dental plaque at designated time intervals after consumption of snacks prepared with a standardised amount of fluoridated salt. STUDY DESIGN: The investigation had a single blind prospective crossover design. METHODS: A group of 11 healthy young adults volunteered to participate after verbal and written information and consent. After a 1-week fluoride depletion period, the subjects consumed popcorn prepared with either fluoridated (250 mg/kg) or non-fluoridated salt during 30 minutes. Unstimulated whole saliva and samples of supragingival plaque were collected before consumption (baseline) and at 30, 60 and 120 minutes after the intake. Fluoride concentration was determined with a fluoride-specific electrode and the post-ingestion levels were compared with baseline by ANOVA. RESULTS: In saliva, the mean fluoride concentrations at baseline ranged from 0.021 to 0.027 mg/L and after the 30 minutes consumption of fluoride prepared snacks a 15-fold increase (p<0.001) was found. The same pattern was disclosed in the plaque samples. In both saliva and plaque, the fluoride levels remained significantly elevated after 2 hours (p<0.001 and p<0.05, respectively). CONCLUSION: Consumption of snacks prepared with fluoridated table salt resulted in significantly increased fluoride levels in saliva and supragingival plaque for a period of at least two hours.

  • 145.
    Bladh, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Johansson, Johan
    Umeå University, Faculty of Medicine, Department of Odontology.
    The Use of Intraoral Radiographs for Identification of Edentulous Patients Rehabilitated with Implants2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aims of this study were; i) to determine the accuracy by which two intraoral radiographic examinations performed on patients with edentulous mandibles treated with dental implants can be matched. ii) To determine if prosthodontic supra-construction is important for matching. iii) Investigate if there is a difference between oral and maxillofacial radiologists (OMR) and dental practitioners, not specialized in oral and maxillofacial radiology (NOMR), regarding their ability to match. What features of the radiographs the operators used to acquire a match was also investigated.

    Intraoral radiographic examinations from 59 patients were used. Examinations from 47 patients performed at installation of the supra-structure and at follow-up examinations were used as “ante-mortem” and “post-mortem” records respectively. Examinations from 12 patients were added to the “post-mortem” records without match. The study was divided into two parts. In part one all ante- and ”post-mortem” records had the supra-structure masked and in part two it was visible. Seven dentists (4 OMR, 3 NOMR) were instructed to specify on what basis each matching was made and grade the confidence on a three-graded scale.

    OMR had 93 % and 98 % accuracy in part one and two respectively. NOMR had 64 % and 88 %. Bone anatomy was the most commonly used feature by OMR to obtain a match. For NOMR it was the appearance of the fixtures. OMR reported higher confidence in their ability to match the examinations. This study indicates that OMR can be a valuable resource in identification missions where remnants of implant treated people can be expected.

  • 146.
    Blind, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Hulterström, Antti
    Umeå University, Faculty of Medicine, Department of Odontology.
    Berggren, Diana
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Treatment of nasal septal perforations with a custom-made prosthesis2009In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 266, no 1, p. 65-69Article in journal (Refereed)
    Abstract [en]

    We present the fabrication and clinical use of a custom-made nasal septal silicone button that can be inserted transnasally into a perforation of the nasal septum by the physician as an office procedure, or by the patients themselves in their home. Questionnaire and retrospective chart review were used to evaluate the efficacy of this prosthesis as treatment of disturbing symptoms from nasal septal perforation. The study included 41 patients (27 women) with a nasal septal perforation. The follow-up time ranged from 1 to 9 years. Symptoms investigated were nasal obstruction, crusting, feeling of dryness, pain, epistaxis, and whistling from the nose. The degree of experienced symptoms was estimated on a VAS-scale. The questionnaire was answered by 37 of the 41 patients. Fourteen patients were still using their button at the follow-up. Treatment with the prosthesis greatly diminished all the investigated symptoms. Also, use of the silicone button resulted in an improved quality of life. No case of infection was noted in connection with use of the silicone prosthesis.

  • 147. Blomgren, Johan
    et al.
    Dahlén, Gunnar
    Dohnhammar, Ulrica
    Heimdahl, Anders
    Struwe, Johan
    Wahlin, Ylva Britt
    Umeå University, Faculty of Medicine, Department of Odontology, Oral Diagnostics.
    Zimmerman, Mikael
    Få indikationer för antibiotikaprofylax2009In: Tandläkartidningen, ISSN 0039-6982, Vol. 101, no 14, p. 50-54Article in journal (Refereed)
    Abstract [sv]

    Tandläkarnas förskrivning av antibiotika har ökat under senare år. Strama (Samverkan mot antibiotikaresistens) redovisar situationer där antibiotikaprofylax kan göra nytta och tillfällen då det inte har någon bevisad effekt.

  • 148.
    Bodin, Ingrid
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Radiology.
    Impairment of intra-oral sensation, discrimination ability, and swallowing function following radiotherapy and surgery for oral and pharyngeal cancer2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Oral and pharyngeal cancer is commonly treated with a combination of radiotherapy and surgery. It is a clinical knowledge that patients often experience severe swallowing disorders following treatment. Since surgical sequelae are instantaneous and obvious, little attention has been paid to other concurrent effects of the treatment. To shed light on this subject, the aim of this thesis was twofold (i) to make a retrospective inventory of the sequelae following treatment and (ii) to perform a prospective, inceptive examination at diagnosis, and to follow-up after radiotherapy, six months and 12 months after surgery.

    The files of ninety-nine patients revealed that following treatment one-third had to use gastric fistulas and more than nine of ten patients had restricted swallowing capacity. Every second patient could only swallow puréed or liquid food.

    Adequate intra-oral sensation and discrimination ability is essential for bolus preparation and bolus control, for appropriate elicitation of the swallowing reflex and, hence, for the oral phase of swallowing. At the inceptive examination, the prospective part of the study demonstrated intra-oral discrimination ability in patients was equal to that in healthy controls but was impaired six months after treatment and there was no significant improvement after 12 months. It had been expected that the patient’s healthy, non-tumor side would compensate but it did not. An explanation was found when it was revealed that radiotherapy induced a delayed decline in intra-oral sensation. Sensory decline was not demonstrated within a month after radiotherapy but was manifest six months later. Since the radiotherapy field includes the neck, because of the risk for metastasis, it is highly plausible that pharyngeal sensation declines in a manner corresponding to that found intra-orally when the healthy side is irradiated. In accord with this presumption, pharyngeal swallowing function deteriorated in patents with oral tumors. Cineradiographic evaluation of oral and pharyngeal swallowing function disclosed a significant association between the degree of swallowing dysfunction and the degree of sensory decline and with the degree of impairment of shape recognition.

    Conclusions: Delayed intra-oral sensory decline, found to be induced by radiotherapy, can be expected to appear in the entire radiation field, including the oral cavity and the pharynx, with adverse effect on swallowing. Testing intra-oral sensation close to the last radiotherapy session is not advisable, because sensory decline does not develop immediately after radiotherapy but manifests after six months. Spontaneous sensory rehabilitation cannot be expected after six months. The significant association between degree of swallowing dysfunction and degree of intra-oral sensory decline and impaired discrimination ability must be considered in the quest for functional rehabilitation of patients treated for oral or pharyngeal cancer.

  • 149.
    Bodin, Ingrid
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Isberg, Annika
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
    Intraoral sensation before and after radiotherapy and surgery for oral and pharyngeal cancer.2004In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 26, no 11, p. 923-929Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with unilateral oral or pharyngeal cancer often receive bilateral radiotherapy because of the potential for metastases. Because postoperative sequelae are evident on the tumor side, to date little attention has been paid to sensory alterations after radiotherapy on the healthy, nontumor side. The objective of this study was to investigate possible sensory alterations. METHODS: Intraoral sensation was tested bilaterally at standardized sites in 27 patients and 20 controls. Preoperative radiotherapy was bilateral in 19 patients and unilateral in eight patients. Patients were tested before treatment, after radiotherapy, and after surgery at 6 months and 1 year. Comparisons were performed interindividually and intraindividually and between groups. RESULTS: A delayed deterioration of sensation was revealed on the nontumor side 6 months after radiotherapy. There was no recovery 1 year after treatment. CONCLUSIONS: Intraoral sensation cannot be evaluated directly after radiotherapy. It is plausible that sensory deterioration after radiotherapy has an impact on functional rehabilitation after tumor treatment.

  • 150.
    Bodin, Ingrid
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Radiology.
    Lind, Magnus
    Arnander, Claes
    Free radial forearm flap reconstruction in surgery of the oral cavity and pharynx: surgical complications, impairment of speech and swallowing.1994In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 19, no 1, p. 28-34Article in journal (Refereed)
    Abstract [en]

    The first 100 consecutive free radial forearm flaps used in reconstruction for oral and pharyngeal cancer were investigated. Seven re-operations took place due to circulatory impairment of the flap. Two flaps underwent partial, and four total necrosis, one of those patients died of massive haemorrhage. Post-operative infection was significantly correlated to increased time between the last radiotherapy session and surgery. All but eight patients had post-operative impairment of swallowing and all but five patients had impairment of speech articulation or hypernasality. Post-operative time spent in hospital was a range of 12-122 days (mean 37 days). The 2-year survival rate was 70% and the 5-year survival rate was 45%.

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