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  • 201.
    Carlsson, Jonas
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Rönnberger, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Rhythmical Jaw Opening – Closing Patterns in Subjects with TMD Pain An analysis of jaw motor behavior during a 5 minute observation period2015Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    A deeper understanding of jaw motor control is critical for clinical diagnosis and rehabilitation. Decreased jaw opening-closing amplitude and irregular frequency may be related to pain or dysfunction in the jaw system. This study observed how these parameters changed over a five minute rhythmical jaw opening-closing session among subjects with arthralgia and/or myalgia. Pre- and post-trial the subjects rated intensity of pain and sense of tiredness of the jaw on a numerical rating scale (NRS-11).

     

    In this pilot study, seven female patients with arthralgia/myalgia were instructed to perform a rhythmical jaw opening-closing task during five minutes. The movement was recorded with a 3D optoelectronic recording system. The variables were i) mean jaw opening amplitudes (mm), ii) mean jaw opening-closing cycle times (s) and iii) self-reported intensity of pain and sense of tiredness pre- and post-task. The data was analyzed using Wilcoxon signed rank test for two related samples.  P < 0.05 was considered statistically significant.

     

    The results showed a significant decrease in amplitude and cycle time between the first and the second minute, during the remaining four minutes the parameters kept steady. The self-rated intensity of pain and sense of tiredness were significantly higher after the test than prior to it. There was no difference in standard deviation for amplitude or cycle time between the recordings.

     

    It’s possible that the results are outcomes of the reported intensity of pain and sense of tiredness; additional research on the subject is needed to interpret the results to a bigger context.

  • 202.
    Carlsson, Sarah
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lundgren, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Evaluation of a Postgraduate Course in Intraoral Imaging Technique2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 203.
    Cederbring, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Norberg, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Size and Position of the Active Area in Intraoral Radiographic Sensors2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 204. Cederholm, Tommy
    et al.
    Marcus, Claude
    Rössner, Stephan
    Hellénius, Mai-Lis
    Björck, Inger
    Bosaeus, Ingvar
    Forsum, Elisabet
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Hernell, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Hulthén, Lena
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Larsson, Jörgen
    Lissner, Lauren
    Nilsson, Ake
    Nyman, Margareta
    Palmblad, Jan
    Sandberg, Ann-Sofie
    Aman, Per
    Replik till Lars-Erik Holm: Forskaren, samhället och jäv [The researcher, the society and partiality]2008Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, nr 16, s. 1206-1207Artikkel i tidsskrift (Fagfellevurdert)
  • 205.
    Cederlind, Erik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Peltonen, Sandra
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Caries prevalence among three sub populations of 12-year old children in Addis Ababa, Ethiopia - an observation study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 206. Chajes, Veronique
    et al.
    Biessy, Carine
    Ferrari, Pietro
    Romieu, Isabelle
    Freisling, Heinz
    Huybrechts, Inge
    Scalbert, Augustin
    de Mesquita, Bas Bueno
    Romaguera, Dora
    Gunter, Marc J.
    Vineis, Paolo
    Hansen, Camilla Plambeck
    Jakobsen, Marianne Uhre
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Katzke, Verana
    Neamat-Allah, Jasmine
    Boeing, Heiner
    Bachlechner, Ursula
    Trichopoulou, Antonia
    Naska, Androniki
    Orfanos, Philippos
    Pala, Valeria
    Masala, Giovanna
    Mattiello, Amalia
    Skeie, Guri
    Weiderpass, Elisabete
    Agudo, Antonio
    Maria Huerta, Jose
    Ardanaz, Eva
    Jose Sanchez, Maria
    Dorronsoro, Miren
    Ramon Quiros, Jose
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Winkvist, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Sonested, Emily
    Key, Tim
    Khaw, Kay-Tee
    Wareham, Nicolas J.
    Peeters, Petra H. M.
    Slimani, Nadia
    Plasma Elaidic Acid Level as Biomarker of Industrial Trans Fatty Acids and Risk of Weight Change: Report from the EPIC Study2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 2, artikkel-id e0118206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition ( EPIC) cohort. Methods Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow- up, age, energy, alcohol, smoking status, physical activity, and region. Results In women, doubling elaidic acid was associated with a decreased risk of weight loss ( odds ratio ( OR) = 0.69, 95% confidence interval ( CI) = 0.55- 0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5- year follow- up ( OR = 1.23, 95% CI = 0.97- 1.56, p = 0.082) ( p- trend<. 0001). In men, a trend was observed for doubling elaidic acid level and risk of weight loss ( OR = 0.82, 95% CI = 0.66- 1.01, p = 0.062) while no significant association was found with risk of weight gain during the 5- year follow- up ( OR = 1.08, 95% CI = 0.88- 1.33, p = 0.454). No association was found for saturated and cismonounsaturated fatty acids. Conclusions These data suggest that a high intake of industrial trans fatty acids may decrease the risk of weight loss, particularly in women. Prevention of obesity should consider limiting the consumption of highly processed foods, the main source of industrially- produced trans fatty acids.

  • 207.
    Chen, Peter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nasir, Ahmad
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Fluoride concentration in saliva after toothbrushing2012Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 208.
    Chiappe Olsson, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lindholm, Emelie
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Prevalence of Aggregatibacter actinomycetemcomitans in Saliva from Children aged 7-9: - and evaluation of two different DNA extraction methods2017Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    Periodontitis is an inflammatory disease caused by bacterial infection that can lead to loss of supporting tissues around the teeth. Studies show that different ethnic populations demonstrate major differences in prevalence of the disease and in which form the disease occur. The presence of the bacteria Aggregatibacter actinomycetemcomitans (A.a) is associated with the aggressive form of the disease, diagnosed primarily in young people. 

    The present study aims to describe the prevalence of A.a in children aged 7-9 years living in Sweden with different ethnic backgrounds and to evaluate two different ways of extracting bacterial DNA. The hypothesis was that prevalence of A.a would correlate with the origin of the subjects, thus anticipating a higher prevalence in subjects of African origin than those of other ethnicity. 

    Stimulated saliva samples from 85 children were studied. Two methods were used to extract DNA, manually and automatically. qPCR was used to investigate if the samples contained A.a. 

    The essential results showed that the highest prevalence of A.a was found in samples belonging to children with African origin. The manual method extracted DNA in a higher amount and from more samples compared to the automatic method. Sweden is nowadays multicultural and the clinical issues change with the population. Other clinical questions needs to be answered and previous truths need to be reassessed, for example periodontal problems in younger individuals. In this study, the manual method of extracting DNA proved to be more sensitive than the automatic, though more studies need to be conducted to draw any conclusions.

  • 209. Chuang, Shu-Chun
    et al.
    Norat, Teresa
    Murphy, Neil
    Olsen, Anja
    Tjonneland, Anne
    Overvad, Kim
    Boutron-Ruault, Marie Christine
    Perquier, Florence
    Dartois, Laureen
    Kaaks, Rudolf
    Teucher, Birgit
    Bergmann, Manuela M.
    Boeing, Heiner
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Grioni, Sara
    Sacerdote, Carlotta
    Panico, Salvatore
    Palli, Domenico
    Tumino, Rosario
    Peeters, Petra H. M.
    Bueno-de-Mesquita, Bas
    Ros, Martine M.
    Brustad, Magritt
    Asli, Lene Angell
    Skeie, Guri
    Quiros, J. Ramon
    Gonzalez, Carlos A.
    Sanchez, Maria-Jose
    Navarro, Carmen
    Aicua, Eva Ardanaz
    Dorronsoro, Miren
    Drake, Isabel
    Sonestedt, Emily
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Key, Timothy
    Crowe, Francesca
    Khaw, Kay-Tee
    Wareham, Nicholas
    Ferrari, Pietro
    Slimani, Nadia
    Romieu, Isabelle
    Gallo, Valentina
    Riboli, Elio
    Vineis, Paolo
    Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort2012Inngår i: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, nr 1, s. 164-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Previous studies have shown that high fiber intake is associated with lower mortality. However, little is known about the association of dietary fiber with specific causes of death other than cardiovascular disease (CVD). Objective: The aim of this study was to assess the relation between fiber intake, mortality, and cause-specific mortality in a large European prospective study of 452,7 I 7 men and women. Design: HRs and 95% CIs were estimated by using Cox proportional hazards models, stratified by age, sex, and center and adjusted for education, smoking, alcohol consumption, BMI, physical activity, total energy intake, and, in women, ever use of menopausal hormone therapy. Results: During a mean follow-up of 12.7 y, a total of 23,582 deaths were recorded. Fiber intake was inversely associated with total mortality (HRper (10-g/d) (increase): 0.90; 95% Cl: 0.88, 0.92); with mortality from circulatory (HRper (10-g/d increase): 0.90 and 0.88 for men and women, respectively), digestive (HR: 0.61 and 0.64), respiratory (HR: 0.77 and 0.62), and non-CVD noncancer inflammatory (HR: 0.85 and 0.80) diseases; and with smoking-related cancers (HR: 0.86 and 0.89) but not with non-smoking-related cancers (HR: 1.05 and 0.97). The associations were more evident for fiber from cereals and vegetables than from fruit. The associations were similar across BMI and physical activity categories but were stronger in smokers and participants who consumed >18 g alcohol/d. Conclusions: Higher fiber intake is associated with lower mortality, particularly from circulatory, digestive, and non-CVD noncancer inflammatory diseases. Our results support current recommendations of high dietary fiber intake for health maintenance. Am J Clin Nutr 2012;96:164-74.

  • 210.
    Cistulli, Peter
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi.
    Gotsopoulos, Helen
    Marklund, Marie
    Umeå universitet, Medicinsk fakultet, Odontologi, Ortodonti.
    Lowe, Alan
    Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances2004Inngår i: Sleep Medicine Reviews, Vol. 8, s. 443-457Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Snoring and obstructive sleep apnea form part of a spectrum of sleep disordered breathing affecting a significant proportion of the general population and particularly the middle aged. The consequences can be severe and even life threatening for both the individual directly affected and those more remotely involved. Adverse sequelae can manifest themselves acutely or in the longer term as a result of obstructive breathing induced hypersomnolence, neurocognitive deficits and cardiovascular abnormilities. The combination of anatomical and neuromuscular risk factors in the pathogenesis of OSA has resulted in a varied appoach to its management. One such treatment option is mandibular repositioning appliances (MRA), which mechanically stabilize the airway. Whilst the efficacy of this simple intervention has been rigorously proven quite recently in a significant proportion of patients with varying disease severity, individual patient selection in its application remains uncertain. Short-term side-effects are common but usually transient, whilst in the long-term minor permanent adverse developments on the dentition and occlusion have been reported. Considering both the medicolegal implications of snoring and OSA and the increasing popularity of MRA, it is recommended that skilled multidisciplinary respiratory and dental personnel form the primary care team.

  • 211.
    Claesson, Rolf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Gudmundson, Jan
    Östersund, Sweden.
    Höglund-Åberg, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Haubek, Dorte
    Aarhus, Denmark.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Detection of a 640-bp deletion in the Aggregatibacter actinomycetemcomitans leukotoxin promoter region in isolates from an adolescent of Ethiopian origin2015Inngår i: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 7, artikkel-id 26974Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The expression of the leukotoxin of Aggregatibacter actinomycetemcomitans is regulated by the leukotoxin promoter. A 530-bp deletion or an 886-bp insertion sequence (IS) element in this region has earlier been described in highly leukotoxic isolates. Here, we report on highly leukotoxic isolate with a 640-bp deletion, which was detected in an adolescent of Ethiopian origin.

  • 212.
    Claesson, Rolf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Höglund-Åberg, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Haubek, Dorte
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Age-related prevalence and characteristics of Aggregatibacter actinomycetemcomitans in periodontitis patients living in Sweden2017Inngår i: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 9, artikkel-id 1334504Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The presence of Aggregatibacter actinomycetemcomitans in patients with periodontitis has been extensively studied for decades. Objective: To study the prevalence of A. actinomycetemcomitans in younger and older periodontitis patients and to genetically characterize isolates of this bacterium. Design: Data from microbiological analyses of 3459 subgingival plaque samples collected from 1445 patients, 337 'younger' patients (<= 35 yrs) and 1108 'older' patients (>35 yrs) during 15 years (2000-2014), has been summerized. Isolates of A. actinomycetemcomitans were serotyped, leukotoxin promoter typed (JP2 and non JP2) and arbitrarily primed PCR (APPCR) genotyped. The origin of the JP2 genotype detected in the study population was determined. Results: The prevalence of A. actinomycetemcomitans was higher among younger than older patients and samples from the younger patients contained higher proportions of the bacterium. Serotype b was more prevalent among younger patients and the majorty of these isolates was from the same AP-PCR genotype. The JP2 genotype was detected in 1.2% of the patients, and the majority of these carriers were of non-African origin. Conslusions: For presence and charcteristics of A. actinomycetemcomitans in clinical samples the age of the carriers were a discriminating factor. Additional, apparently non- African carriers of the JP2 genotype of A. actinomycetemcomitans were identified.

  • 213.
    Claesson, Rolf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Kanasi, Eleni
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Anders, Johansson
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Sotirios, Kalfas
    School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
    A new cleavage site for elastase within the complement component 32010Inngår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 118, nr 10, s. 765-768Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The lysosomal enzyme elastase was earlier shown to cleave the complement molecule C3. During somepreliminary experiments on the interactions of certain pathogenic bacteria with the innate defencemechanisms, we observed C3 cleavage, in the presence of elastase, to fragments not previouslydescribed. To elucidate this proteolytic reaction, the present study was conducted. Degradation of C3in mixtures with elastase or cathepsin G was detected by an immunoblot procedure using anti-C3c andanti-C3d antibodies after separating the proteins by SDS-PAGE. Certain C3 fragments were analysedfor amino acid sequence. The results revealed the existence of a cleavage site for elastase at the positionalanine1350 ⁄ lysine1351 of the C3 molecule, which has not been previously described. The fragmentresulted from this cleavage has a size of about 39 kDa and it contains a part or the whole of C3d. Thiscleavage was distinct from the one previously described at position 987 ⁄ 988, which gives a 34 kDaC3d-containing fragment.

  • 214.
    Claesson, Rolf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lagervall, Maria
    Department of Periodontology at Skanstull, Stockholm County Council, Stockholm, Sweden.
    Höglund-Åberg, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Haubek, Dorte
    Department of Pediatric Dentistry, School of Dentistry, Aarhus, Denmark.
    Detection of the highly leucotoxic JP2 clone of Aggregatibacter actinomycetemcomitans in members of a Caucasian family living in Sweden2011Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, nr 2, s. 115-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Carriers of the JP2 clone of Aggregatibacter actinomycetemcomitans exhibit an enhanced risk for developing aggressive periodontitis compared with individuals carrying non-JP2 clones. While the JP2 clone is almost exclusively detected among adolescents of African descent, reports on Caucasians colonized with the JP2 clone are remarkably few.

    Objective: The aim of this paper is to report on the history of periodontal disease and microbiological findings in a Caucasian family.

    Material and Methods: A. actinomycetemcomitans and other periodontitis-associated bacterial species in subgingival plaque samples were quantified by conventional culture technique. Leucotoxin promoter typing, serotyping and further characterizations of A. actinomycetemcomitans isolates were performed by PCR. DNA sequencing of the pseudogene, hbpA was performed to determine the origin of the detected JP2 clones. Further, genetically ancestry testing of family members was carried out.

    Results: The JP2 clone was detected in samples from two of the family members, a 33-year-old daughter and her 62-year-old mother. Relationship of their JP2 clones with JP2 clone strains from the Mediterranean area of Africa was indicated. Genotyping confirmed the Caucasian origin of all family members.

    Conclusions: Caucasian JP2 carriers exist and older subjects can carry the JP2 clone of A. actinomycetemcomitans.

  • 215.
    Claesson, Rolf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Sjögren, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Esberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Brundin, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Granlund, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Actinomyces radicidentis and Actinomyces haliotis, coccoid Actinomyces species isolated from the human oral cavity2017Inngår i: Anaerobe, ISSN 1075-9964, E-ISSN 1095-8274, Vol. 48, s. 19-26Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There are few reports on the bacterial species Actinomyces radicidentis in the literature. In this study, putative A. radicidentis isolates were collected from 16 root canal samples from 601 examined patients. The isolates were examined by biochemical tests, 16S rRNA gene sequencing, Arbitrarily-primed (AP-) PCR, antibiotic susceptibility testing, and MALDI-TOF analyses. In parallel, two A. radicidentis reference strains and two putative A. radicidentis isolates from United Kingdom were tested. Sixteen of the 18 isolates were confirmed as A. radicidentis. The remaining two isolates, both of which were isolated from root canals (one from Sweden and the other from the UK), but were identified as Actinomyces haliotis by sequencing ∼ 1300 base pairs of the 16S rRNA-gene. This isolates had a divergent, but between them similar, AP-PCR pattern, and a common distribution of sequence signatures in the 16S rRNA gene, but were not identified by MALDI-TOF. A. haliotis is a close relative to A. radicidentis, hitherto only been described from a sea-snail. The identity of A. haliotis was confirmed by a phylogenetic tree based on 16S rRNA gene sequences with species specific sequences included, and by additional biochemical tests. The examined bacteria exhibited similar antibiotic susceptibility patterns when tested for 10 separate antibiotic classes with E-tests (bioMérieux). The MIC90 for β-lactams (benzylpenicillin and cefuroxime) and vancomycin was 0.5 mg/L, for colistin and ciprofloxacin 8 mg/mL and for the other antibiotic classes ≤ 25 mg/mL The isolation of A. haliotis from infected dental root canals cast doubt on the accepted opinion that all Actinomyces infections have an endogenous source.

  • 216. Clavero, J
    et al.
    Lundgren, Stefan
    Umeå universitet, Medicinsk fakultet, Odontologi, Käkkirurgi.
    Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications.2003Inngår i: Clinical Implant Dentistry and Related Research, Vol. 5, nr 3, s. 154-60Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The placement of endosseous implants in edentulous areas is frequently limited by inadequate bone volume of the residual ridge. Local bone grafts from the mandible are a convenient source of autogenous bone for alveolar reconstruction prior to implant placement. PURPOSE: The aim of the present study was to document and compare the morbidity and the frequency of complications occurring at two intraoral donor sites: the mandibular symphysis and the mandibular ramus. MATERIAL AND METHODS: This study reviewed 53 consecutively treated patients: 29 with autogenous bone grafts from the mandibular symphysis and 24 with mandibular ramus bone grafts. Each patient received a questionnaire 18 months after surgery regarding problems that may have occurred during the postoperative period. RESULTS: In the patients in whom bone was harvested from the mandibular ramus, there were fewer postoperative symptoms immediately after the operation than with mandibular symphysis harvesting. Twenty-two of the 29 patients with symphysis grafts experienced decreased sensitivity in the skin innervated by the mental nerve 1 month after the operation. Five of the 24 patients with ramus grafts experienced decreased sensitivity in the vestibular mucosa corresponding to the innervation of the buccal nerve. Eighteen months after the surgery, 15 of the 29 patients in the symphysis group still had some decreased sensitivity and presented with permanent altered sensation. Only one of the patients grafted from the mandibular ramus presented with permanent altered sensation in the posterior vestibular area. No major complication occurred in the donor sites in any of the 53 patients. CONCLUSION: The results of this study favored the use of the ascending mandibular ramus as an intraoral donor site for bone grafting.

  • 217. Conaway, H. Herschel
    et al.
    Henning, Petra
    Lerner, Ulf H.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Vitamin A metabolism, action, and role in skeletal homeostasis2013Inngår i: Endocrine reviews, ISSN 0163-769X, E-ISSN 1945-7189, Vol. 34, nr 6, s. 766-797Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Vitamin A (retinol) is ingested as either retinyl esters or carotenoids and metabolized to active compounds, such as 11-cis-retinal, which is important for vision, and all-trans-retinoic acid (ATRA), which is the primary mediator of biological actions of vitamin A. ATRA binds to retinoic acid receptors (RARs), which heterodimerize with retinoid X receptors (RXRs). RAR-RXR heterodimers function as transcription factors, binding RAR responsive elements in promoters of different genes. Numerous cellular functions, including bone cell functions, are mediated by vitamin A; however, it has long been recognized that increased levels of vitamin A can have deleterious effects on bone resulting in increased skeletal fragility. Bone mass is dependent on the balance between bone resorption and bone formation. A decrease in bone mass may be caused by either an excess of resorption or decreased bone formation. Early studies indicated that the primary skeletal effect of vitamin A was to increase bone resorption, but later studies have shown that vitamin A can not only stimulate the formation of bone resorbing osteoclasts, but inhibit their formation as well. Effects of vitamin A on bone formation have not been studied in as great a detail and are not as well characterized as effects on bone resorption. Several epidemiological studies have shown an association between vitamin A, decreased bone mass, and osteoporotic fractures, but the data are not conclusive, for other studies have found no associations, and some studies have suggested that vitamin A primarily promotes skeletal health. In this presentation, we have summarized how vitamin A is absorbed, metabolized, and functions intracellularly. Vitamin A deficiency and excess are introduced, and detailed descriptions of clinical and pre-clinical studies of the effects of vitamin A on the skeleton are presented.

  • 218. Conaway, H. Herschel
    et al.
    Henning, Petra
    Lie, Anita
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Tuckermann, Jan
    Lerner, Ulf H.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Centre for Bone and Arthritis Research at Department of Internal Medicine and Clinical Nutrition, Institute for Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Activation of dimeric glucocorticoid receptors in osteoclast progenitors potentiates RANKL induced mature osteoclast bone resorbing activity2016Inngår i: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 93, s. 43-54Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Glucocorticoid (GC) therapy is the greatest risk factor for secondary osteoporosis. Pathogenic mechanisms involve an initial increase in bone resorption followed by decreased bone formation. To gain a better understanding of the resorptive activity of GCs, we have used mouse bone marrow macrophages (BMM) to determine if GCs can directly modulate RANKL stimulated osteoclast formation and/or activity. In agreement with previous studies, experiments performed in plastic wells showed that GCs (dexamethasone, hydrocortisone, and prednisolone) inhibited osteoclast number and size during the initial phases of RANKL stimulated osteoclastogenesis; however, in prolonged cultures, decreased apoptosis was observed and escape from GC induced inhibition occurred with an enhanced number of osteoclasts formed, many with an increased area. When BMM cells were seeded on bone slices, GCs robustly enhanced RANKL stimulated formation of resorption pits and release of CTX without affecting the number or size of osteoclasts formed and with no effect on apoptosis. Stimulation of pit formation was not associated with increased life span of osteoclasts or an effect on mRNA expression of several osteoclastic or osteoclastogenic genes. The potentiation of RANKL induced CTX release by dexamethasone was significantly less in BMM cells from mice with conditional knockout of the osteoclastic glucocorticoid receptor and completely absent in cells from Gem mice, which carry a point mutation in one dimerizing interface of the GC receptor. These data suggest that: 1. Plastic is a poor medium to use for studying direct effects of GCs on osteoclasts 2. GCs can enhance bone resorption without decreasing apoptosis, and 3. A direct enhancement of RANKL mediated resorption is stimulated by the dimeric GC -receptor.

  • 219.
    Conaway, H Herschel
    et al.
    University of Arkansas for Medical Sciences.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Molekylär paradontologi.
    Retinoids and bone2011Inngår i: Contemporary aspects of endocrinology / [ed] Evanthia Diamanti-Kandarakis, InTech, 2011, s. 443-454Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 220. Conaway, H Herschel
    et al.
    Persson, Emma
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Halén, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Granholm, Susanne
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Svensson, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Pettersson, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk farmakologi.
    Lie, Anita
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Retinoids inhibit differentiation of hematopoietic osteoclast progenitors2009Inngår i: The FASEB Journal, ISSN 0892-6638, E-ISSN 1530-6860, Vol. 23, nr 10, s. 3526-3538Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Whether vitamin A promotes skeletal fragility, has no effect on fracture rate, or protects against bone loss is unclear. In the present study, effects of retinoids on osteoclast differentiation in cultured mouse bone marrow cells (BMCs), bone marrow macrophages (BMMs), spleen cells, and RAW264.7 cells were evaluated by analyzing osteoclast formation and expression of genes important in signal transduction and osteoclast function. All-trans-retinoic acid (ATRA) did not stimulate osteoclastogenesis in BMCs, but inhibited hormone and RANKL-induced gene expression and formation of osteoclasts. In BMMs, spleen cells, and RAW264.7 cells, osteoclast differentiation and formation stimulated by M-CSF/RANKL were inhibited (IC(50) = 0.3 nM) by ATRA. The effect was exerted at an early step of RANKL-induced differentiation. ATRA also abolished increases of the transcription factors c-Fos and NFAT2 stimulated by RANKL and suppressed down-regulation of the antiosteoclastogenic transcription factor MafB. By comparing effects of several compounds structurally related to ATRA, as well as by using receptor antagonists, evaluation pointed to inhibition being mediated by RARalpha, with no involvement of PPARbeta/delta. The results suggest that activation of RARalpha by retinoids in myeloid hematopoietic precursor cells decreases osteoclast formation by altering expression of the transcription factors c-Fos, NFAT2, and MafB.

  • 221.
    Conaway, H. Herschel
    et al.
    Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
    Pirhayati, Amir
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Molekylär paradontologi.
    Persson, Emma
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Molekylär paradontologi.
    Pettersson, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk farmakologi.
    Svensson, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Lindholm, Catharina
    Center for Bone and Arthritis Research at the Institute for Medicine, Sahlgrenska Academy at the University of Gothenburg.
    Henning, Petra
    Center for Bone and Arthritis Research at the Institute for Medicine, Sahlgrenska Academy at the University of Gothenburg.
    Tuckermann, Jan
    Tissue-specific Hormone Action, Leibniz Institute for Age Research, Fritz Lipmann Institute, D-07745 Jena, Germany.
    Lerner, Ulf H.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Molekylär paradontologi.
    Retinoids Stimulate Periosteal Bone Resorption by Enhancing the Protein RANKL: a Response Inhibited by Monomeric Glucocorticoid Receptor2011Inngår i: Journal of Biological Chemistry, ISSN 0021-9258, E-ISSN 1083-351X, Vol. 286, s. 31425-31436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Increased vitamin A (retinol) intake has been suggested to increase bone fragility. In the present study, we investigated effects of retinoids on bone resorption in cultured neonatal mouse calvarial bones and their interaction with glucocorticoids (GC). All-trans-retinoic acid (ATRA), retinol, retinalaldehyde, and 9-cis-retinoic acid stimulated release of (45)Ca from calvarial bones. The resorptive effect of ATRA was characterized by mRNA expression of genes associated with osteoclast differentiation, enhanced osteoclast number, and bone matrix degradation. In addition, the RANKL/OPG ratio was increased by ATRA, release of (45)Ca stimulated by ATRA was blocked by exogenous OPG, and mRNA expression of genes associated with bone formation was decreased by ATRA. All retinoid acid receptors (RAR alpha/beta/gamma) were expressed in calvarial bones. Agonists with affinity to all receptor subtypes or specifically to RAR alpha enhanced the release of (45)Ca and mRNA expression of Rankl, whereas agonists with affinity to RAR beta/gamma or RAR gamma had no effects. Stimulation of Rankl mRNA by ATRA was competitively inhibited by the RAR alpha antagonist GR110. Exposure of calvarial bones to GC inhibited the stimulatory effects of ATRA on 45Ca release and Rankl mRNA and protein expression. This inhibitory effect was reversed by the glucocorticoid receptor (GR) antagonist RU 486. Increased Rankl mRNA stimulated by ATRA was also blocked by GC in calvarial bones from mice with a GR mutation that blocks dimerization (GR(dim) mice). The data suggest that ATRA enhances periosteal bone resorption by increasing the RANKL/OPG ratio via RAR alpha receptors, a response that can be inhibited by monomeric GR.

  • 222. Cornelis, M C
    et al.
    Byrne, E M
    Esko, T
    Nalls, M A
    Ganna, A
    Paynter, N
    Monda, K L
    Amin, N
    Fischer, K
    Renstrom, F
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Ngwa, J S
    Huikari, V
    Cavadino, A
    Nolte, I M
    Teumer, A
    Yu, K
    Marques-Vidal, P
    Rawal, R
    Manichaikul, A
    Wojczynski, M K
    Vink, J M
    Zhao, J H
    Burlutsky, G
    Lahti, J
    Mikkilä, V
    Lemaitre, R N
    Eriksson, J
    Musani, S K
    Tanaka, T
    Geller, F
    Luan, J
    Hui, J
    Mägi, R
    Dimitriou, M
    Garcia, M E
    Ho, W-K
    Wright, M J
    Rose, L M
    Magnusson, P K E
    Pedersen, N L
    Couper, D
    Oostra, B A
    Hofman, A
    Ikram, M A
    Tiemeier, H W
    Uitterlinden, A G
    van Rooij, F J A
    Barroso, I
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Xue, L
    Kaakinen, M
    Milani, L
    Power, C
    Snieder, H
    Stolk, R P
    Baumeister, S E
    Biffar, R
    Gu, F
    Bastardot, F
    Kutalik, Z
    Jacobs, D R
    Forouhi, N G
    Mihailov, E
    Lind, L
    Lindgren, C
    Michaëlsson, K
    Morris, A
    Jensen, M
    Khaw, K-T
    Luben, R N
    Wang, J J
    Männistö, S
    Perälä, M-M
    Kähönen, M
    Lehtimäki, T
    Viikari, J
    Mozaffarian, D
    Mukamal, K
    Psaty, B M
    Döring, A
    Heath, A C
    Montgomery, G W
    Dahmen, N
    Carithers, T
    Tucker, K L
    Ferrucci, L
    Boyd, H A
    Melbye, M
    Treur, J L
    Mellström, D
    Hottenga, J J
    Prokopenko, I
    Tönjes, A
    Deloukas, P
    Kanoni, S
    Lorentzon, M
    Houston, D K
    Liu, Y
    Danesh, J
    Rasheed, A
    Mason, M A
    Zonderman, A B
    Franke, L
    Kristal, B S
    Karjalainen, J
    Reed, D R
    Westra, H-J
    Evans, M K
    Saleheen, D
    Harris, T B
    Dedoussis, G
    Curhan, G
    Stumvoll, M
    Beilby, J
    Pasquale, L R
    Feenstra, B
    Bandinelli, S
    Ordovas, J M
    Chan, A T
    Peters, U
    Ohlsson, C
    Gieger, C
    Martin, N G
    Waldenberger, M
    Siscovick, D S
    Raitakari, O
    Eriksson, J G
    Mitchell, P
    Hunter, D J
    Kraft, P
    Rimm, E B
    Boomsma, D I
    Borecki, I B
    Loos, R J F
    Wareham, N J
    Vollenweider, P
    Caporaso, N
    Grabe, H J
    Neuhouser, M L
    Wolffenbuttel, B H R
    Hu, F B
    Hyppönen, E
    Järvelin, M-R
    Cupples, L A
    Franks, Paul W
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA; Lund Univ, Dept Clin Sci, Malmo, Sweden.
    Ridker, P M
    van Duijn, C M
    Heiss, G
    Metspalu, A
    North, K E
    Ingelsson, E
    Nettleton, J A
    van Dam, R M
    Chasman, D I
    Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption2015Inngår i: Molecular Psychiatry, ISSN 1359-4184, E-ISSN 1476-5578, Vol. 20, nr 5, s. 647-656Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Coffee, a major dietary source of caffeine, is among the most widely consumed beverages in the world and has received considerable attention regarding health risks and benefits. We conducted a genome-wide (GW) meta-analysis of predominately regular-type coffee consumption (cups per day) among up to 91 462 coffee consumers of European ancestry with top single-nucleotide polymorphisms (SNPs) followed-up in ~30 062 and 7964 coffee consumers of European and African-American ancestry, respectively. Studies from both stages were combined in a trans-ethnic meta-analysis. Confirmed loci were examined for putative functional and biological relevance. Eight loci, including six novel loci, met GW significance (log10Bayes factor (BF)>5.64) with per-allele effect sizes of 0.03-0.14 cups per day. Six are located in or near genes potentially involved in pharmacokinetics (ABCG2, AHR, POR and CYP1A2) and pharmacodynamics (BDNF and SLC6A4) of caffeine. Two map to GCKR and MLXIPL genes related to metabolic traits but lacking known roles in coffee consumption. Enhancer and promoter histone marks populate the regions of many confirmed loci and several potential regulatory SNPs are highly correlated with the lead SNP of each. SNP alleles near GCKR, MLXIPL, BDNF and CYP1A2 that were associated with higher coffee consumption have previously been associated with smoking initiation, higher adiposity and fasting insulin and glucose but lower blood pressure and favorable lipid, inflammatory and liver enzyme profiles (P<5 × 10(-8)).Our genetic findings among European and African-American adults reinforce the role of caffeine in mediating habitual coffee consumption and may point to molecular mechanisms underlying inter-individual variability in pharmacological and health effects of coffee.

  • 223. Couto, E
    et al.
    Boffetta, P
    Lagiou, P
    Ferrari, P
    Buckland, G
    Overvad, K
    Dahm, C C
    Tjønneland, A
    Olsen, A
    Clavel-Chapelon, F
    Boutron-Ruault, M-C
    Cottet, V
    Trichopoulos, D
    Naska, A
    Benetou, V
    Kaaks, R
    Rohrmann, S
    Boeing, H
    von Ruesten, A
    Panico, S
    Pala, V
    Vineis, P
    Palli, D
    Tumino, R
    May, A
    Peeters, P H
    Bueno-de-Mesquita, H B
    Büchner, F L
    Lund, E
    Skeie, G
    Engeset, D
    Gonzalez, C A
    Navarro, C
    Rodríguez, L
    Sánchez, M-J
    Amiano, P
    Barricarte, A
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Manjer, J
    Wirfärt, E
    Allen, N E
    Crowe, F
    Khaw, K-T
    Wareham, N
    Moskal, A
    Slimani, N
    Jenab, M
    Romaguera, D
    Mouw, T
    Norat, T
    Riboli, E
    Trichopoulou, A
    Mediterranean dietary pattern and cancer risk in the EPIC cohort.2011Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 104, nr 9, s. 1493-1499Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Although several studies have investigated the association of the Mediterranean diet with overall mortality or risk of specific cancers, data on overall cancer risk are sparse.

    METHODS: We examined the association between adherence to Mediterranean dietary pattern and overall cancer risk using data from the European Prospective Investigation Into Cancer and nutrition, a multi-centre prospective cohort study including 142,605 men and 335,873. Adherence to Mediterranean diet was examined using a score (range: 0-9) considering the combined intake of fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. Association with cancer incidence was assessed through Cox regression modelling, controlling for potential confounders.

    RESULTS: In all, 9669 incident cancers in men and 21,062 in women were identified. A lower overall cancer risk was found among individuals with greater adherence to Mediterranean diet (hazard ratio=0.96, 95% CI 0.95-0.98) for a two-point increment of the Mediterranean diet score. The apparent inverse association was stronger for smoking-related cancers than for cancers not known to be related to tobacco (P (heterogeneity)=0.008). In all, 4.7% of cancers among men and 2.4% in women would be avoided in this population if study subjects had a greater adherence to Mediterranean dietary pattern.

    CONCLUSION: Greater adherence to a Mediterranean dietary pattern could reduce overall cancer risk.

  • 224.
    Cricchio, Giovanni
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    On guided bone reformation in the maxillary sinus to enable placement and integration of endosseous implants. Clinical and experimental studies.2011Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Dental caries and periodontal disease are the major causes for tooth loss. While dental caries commonly involve the posterior teeth in both jaws, the teeth most commonly lost due to periodontal problems are the first and second molars in the maxilla. As a consequence, the upper posterior jaw is frequently edentulous. Implant therapy today is a predictable treatment modality for prosthetic reconstruction of edentulous patient. Insufficient amounts of bone, due to atrophy following loss of teeth or due to the presence of the maxillary sinus, can make it impossible to insert implants in the posterior maxilla. During the 1970s and 1980s, Tatum, Boyne and James and Wood and Moore first described maxillary sinus floor augmentation whereby, after the creation of a lateral access point, autologous bone grafts are inserted to increase crestal bone height and to create the necessary conditions for the insertion of implants. This surgical procedure requires a two-stage approach and a double surgical site: first, bone is harvested from a donor site and transplanted to the recipient site; then, after a proper healing period of between 4 to 6 months, the implants are inserted. This kind of bone reconstruction, even if well documented, has its limitations, not least in the creation of two different surgical sites and the consequent increased risk of morbidity. In 2004, Lundgren et al. described a new, simplified technique for the elevation of the sinus floor. The authors showed that by lifting the sinus membrane an empty space was created in which blood clot formations resulted in the establishment of new bone. The implants were placed simultaneously to function as “tent poles”, thus maintaining the sinus membrane in a raised position during the subsequent healing period. An essential prerequisite of this technique is to obtain optimal primary implant stability from the residual bone in the sinus floor. An extremely resorbed maxillary sinus floor, with, for example, less than 2-3 mm of poor quality residual bone, could impair implant insertion.

    The aims of the present research project were (i) to evaluate the donor site morbidity and the acceptance level of patients when a bone graft is harvested from the anterior iliac crest, (ii) to evaluate implant stability, new bone formation inside the maxillary sinus and marginal bone resorption around the implants in long term follow up when maxillary sinus floor augmentation is performed through sinus membrane elevation and without the addition of any grafting material, (iii) to investigate new bone formation inside the maxillary sinus, in experimental design, using a resorbable space-maker device in order to maintain elevation of the sinus membrane where there is too little bone to insert implants with good primary stability.

    In Paper I, 70 consecutively treated patients were retrospectively evaluated in terms of postoperative donor site morbidity and donor site complications. With regard to donor site morbidity, 74% of patients were free of pain within 3 weeks, whereas 26% had a prolonged period of pain lasting from a few weeks to several months. For 11% of patients there was still some pain or discomfort 2 years after the grafting surgery. Nevertheless, patients acceptance was high and treatment significantly improved oral function, facial appearance, and recreation/social activities and resulted in an overall improvement in the quality of life of formerly edentulous patients.

    In Paper I and III, some differently shaped space-making devices were tested on primates (tufted capuchin - Cebus apella) in two experimental models aimed at evaluating whether a two-stage procedure for sinus floor augmentation could benefit from the use of a space-making device to increase the bone volume and enable later implant installation with good primary stability, without the use of any grafting material. An histological examination of the specimens showed that it is possible to obtain bone formation in contact with both the Schneiderian membrane and the device. In most cases the device was displaced. The process of bone formation indicated that this technique is potentially useful for two-stage sinus floor augmentation. The lack of device stability within the sinus requires further improvement in space-makers if predictable bone augmentation is to be achieved.

    In Paper IV, a total of 84 patients were subjected to 96 membrane elevation procedures and the simultaneous placement of 239 implants. Changes of intra-sinus and marginal bone height in relation to the implants were measured in intraoral radiographs carried out during insertion after 6 months of healing, after 6 months of loading and then annually. Computerised tomography was performed pre-surgically and 6 months post-surgically. Resonance frequency analysis measurements were performed at the time of implant placement, at abutment connection and after 6 months of loading. The implant follow-up period ranged from a minimum of one to a maximum of 6 years after implant loading. All implants were stable after 6 months of healing. A total of three implants were lost during the follow-up period giving a survival rate of 98.7%. Radiography demonstrated an average of 5.3 ± 2.1 mm of intra-sinus new bone formation after 6 months of healing. RFA measurements showed adequate primary stability (implant stability quotient 67.4 ± 6.1) and small changes over time.

    In conclusion, harvesting bone from the iliac crest could result in temporary donor site morbidity, but in 11% of patients pain or discomfort was still present up to 2 years after surgery. However, patient satisfaction was good despite this slow or incomplete recovery, as showed by the quality of life questionnaire. Maxillary sinus membrane elevation without the use of bone grafts or bone substitutes results in predictable bone formation both in animal design, where the sinus membrane is supported by a resorbable device, and in clinical conditions, where the membrane is kept in the upper position by dental implants. This new bone formation is accompanied by a high implant survival rate of 98.7% over a follow-up period of up to 6 years. Intra-sinus bone formation remained stable in the long-term follow-up. It is suggested that the secluded compartment allowed bone formation in accordance with the principle of guided tissue regeneration. This technique reduces the risks of morbidity related to bone graft harvesting and eliminates the costs of grafting materials.

  • 225.
    Cricchio, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Imburgia, Mario
    Sennerby, Lars
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Immediate Loading of Implants Placed Simultaneously with Sinus Membrane Elevation in the Posterior Atrophic Maxilla: a Two-Year Follow-Up Study on 10 Patients2014Inngår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 16, nr 4, s. 609-617Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Clinical studies on immediate loading of implants in the posterior atrophic maxilla are rare.

    PURPOSE: The study aims to evaluate immediate loading of implants placed with sinus membrane elevation without additional grafting material for bone augmentation of the maxillary sinus floor.

    MATERIALS AND METHODS: The study group comprised of 10 patients in whom a total of 10 maxillary sinus floor augmentations were performed. A total of 21 dental implants (1 to 4) were inserted through the residual bone to protrude into the maxillary sinus under the elevated sinus membrane. The implant site was underprepared to improve primary stability. All the implants were inserted with a torque insertion no less than 20 Ncm. Implants were loaded immediately after surgery with a screw-retained temporary acrylic restoration. Intraoral X-rays were taken at implant insertion, after 6 months loading, and after 1st and 2nd year of loading. Resonance frequency analysis (RFA) was performed at the time of initial placement and after 6 months of functional loading. RESULTS: RFA after implant insertion gave an implant stability quotient (ISQ) level with a range from 62 to 72. All implants remained clinically stable during the follow-up period of 2 years. Radiography demonstrated on average 5.7 ± 3.4 mm of intrasinus new bone formation after 6 months of implant loading. RFA measurements showed ISQ mean values of 67 (range: 62-72) and 68 (range: 62-71) at placement and after 6 months of loading, respectively.

    CONCLUSION: Within the limits of this case series report, it is concluded that maxillary sinus membrane elevation with simultaneous placement and immediate loading of implants without the use of any additional grafting material shows predictable results after 2 years of functional loading. Moreover, evidence of intrasinus bone formation around the implants was found in all patients. Further studies are needed to study the influence of immediate loading on the mineralization of bone forming at dental implant sites.

  • 226.
    Cricchio, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Donor site morbidity in two different approaches to anterior iliac crest bone harvesting2003Inngår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 5, nr 3, s. 161-169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Bone grafting is a surgical technique for the reconstruction of the atrophic edentulous maxilla prior to treatment with endosseous implants. The anterior iliac crest is a commonly used donor site.

    PURPOSE: The aim of this study was to evaluate the donor site morbidity and complications when harvesting corticocancellous bone from the medial table of the anterior iliac crest and compare this with results when bone was harvested from the lateral and superior table of the anterior iliac crest. In addition, the outcome of the oral rehabilitation was evaluated by means of a quality-of-life questionnaire.

    MATERIAL AND METHODS: The study was composed of 70 consecutively treated patients with a mean age of 56 years. The patients were retrospectively evaluated with regard to postoperative donor site morbidity and complications at the donor site.

    RESULTS: For the donor site morbidity, 74% of the patients were free of pain within 3 weeks, whereas 26% of the patients had a prolonged period of pain lasting from a few weeks to several months. For 11% of the patients, there was still some pain or discomfort 2 years after the grafting surgery. For gait disturbance the figures were similar: 79% had no problems after 3 weeks. For the eight patients who still had some pain after 2 years, which was considered permanent, three also had gait disturbance. There was a total of three major complications (4%), one iliac wing fracture and two neurologic injuries.

    CONCLUSION: When harvesting a large amount of unicortical corticocancellous bone blocks from the the superolateral site of the iliac crest with a "peel off" technique, morbidity and complication rates do not differ significantly compared with those of the traditional anterior medial approach. Oral rehabilitation with maxillary reconstruction with bone grafts from the iliac crest and endosseous implants significantly improved oral function, facial appearance, and recreation/social activities and resulted in an overall improvement in quality of life in formerly edentulous patients.

  • 227.
    Cricchio, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Palma, Vinicious Canavarros
    Faria, Paolo E P
    de Olivera, José Americo
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sennerby, Lars
    Salata, Luiz A
    Histological outcomes on the development of new space-making devices for maxillary sinus floor augmentation2011Inngår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 13, nr 3, s. 224-230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Previous studies have pointed out that the mere elevation of the maxillary sinus membrane promotes bone formation without the use of augmentation materials.

    Purpose: This experimental study aimed at evaluating if the two-stage procedure for sinus floor augmentation could benefit from the use of a space-making device in order to increase the bone volume to enable later implant installation with good primary stability.

    Materials and Methods: Six male tufted capuchin primates (Cebus apella) were subjected to extraction of the three premolars and the first molar on both sides of the maxilla to create an edentulous area. The sinuses were opened using the lateral bone-wall window technique, and the membrane was elevated. One resorbable space-making device was inserted in each maxillary sinus, and the bone window was returned in place. The animals were euthanatized after 6 months, and biopsy blocks containing the whole maxillary sinus and surrounding soft tissues were prepared for ground sections.

    Results: The histological examination of the specimens showed bone formation in contact with both the schneiderian membrane and the device in most cases even when the device was displaced. The process of bone formation indicates that this technique is potentially useful for two-stage sinus floor augmentation. The lack of stabilization of the device within the sinus demands further improvement of space-makers for predictable bone augmentation.

    Conclusions: It is concluded that (1) the device used in this study did not trigger any important inflammatory reaction; (2) when the sinus membrane was elevated, bone formation was a constant finding; and (3) an ideal space-making device should be stable and elevate the membrane to ensure a maintained connection between the membrane and the secluded space.

  • 228.
    Cricchio, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Palma, Vinícius Canavarros
    Faria, Paulo E P
    de Oliveira, José Américo
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sennerby, Lars
    Salata, Luiz A
    Histological findings following the use of a space-making device for bone reformation and implant integration in the maxillary sinus of primates2009Inngår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 11, nr suppl 1, s. e14-e22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Previous studies have shown that membrane elevation results in predictable bone formation in the maxillary sinus provided that implants can be placed as tent poles. In situations with an extremely thin residual crest which impairs implant placement, it is possible that a space-making device can be used under the sinus membrane to promote bone formation prior to placement of implants.

    PURPOSE: The present study was conducted to test the hypothesis that the use of a space-making device for elevation of the sinus membrane will result in predictable bone formation at the maxillary sinus floor to allow placement of dental implants.

    MATERIALS AND METHODS: Eight tufted capuchin primates underwent bilateral sinus membrane elevation surgery, and a bioresorbable space-making device, about 6 mm wide and 6 mm in height, was placed below the elevated membrane on the sinus floor. An oxidized implant (Nobel Biocare AB, Gothenburg, Sweden) was installed in the residual bone protruding into the created space at one side while the other side was left without an implant. Four animals were sacrificed after 6 months of healing. The remaining four animals received a second implant in the side with a space-making device only and followed for another 3 months before sacrifice. Implant stability was assessed through resonance frequency analysis (RFA) using the Osstell (Osstell AB, Gothenburg, Sweden) at installation, 6 months and 9 months after the first surgery. The bone-implant contact (BIC) and bone area inside the threads (BA) were histometrically evaluated in ground sections.

    RESULTS: Histologically there were only minor or no signs of bone formation in the sites with a space-making device only. Sites with simultaneous implant placement showed bone formation along the implant surface. Sites with delayed implant placement showed minor or no bone formation and/or formation of a dense fibrous tissue along the apical part of the implant surface. In the latter group the apical part of the implant was not covered with the membrane but protruded into the sinus cavity.

    CONCLUSIONS: The use of a space-making device, with the design used in the present study, does not result in bone formation at the sinus floor. However, membrane elevation and simultaneous placement of the device and an implant does result in bone formation at the implant surface while sites with implants placed 6 months after membrane elevation show only small amounts of bone formation. It is suggested that lack of stabilization of the device and/or a too extensive elevation of the membrane may explain the results.

  • 229.
    Cricchio, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sennerby, Lars
    Department of Biomaterials, Institute for Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sinus bone formation and implant survival after sinus membrane elevation and implant placement: a 1- to 6-year follow-up study2011Inngår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 22, nr 10, s. 1200-1212Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate the long-term clinical and radiographic results of the maxillary sinus membrane elevation technique where implants were inserted in a void space created by the elevation of the sinus membrane without adding any graft material.

    Materials and methods: A total of 84 patients were subjected to 96 membrane elevation procedures and simultaneous placement of 239 implants. Changes of intra-sinus and marginal bone height in relation to the implants were measured in intraoral radiographs taken at insertion, after 6 months of healing, after 6 months of loading and then annually. Computerized tomography was performed pre-surgically and 6 months post-surgically. Resonance Frequency Analyses measurements were performed at the time of implants placement, at abutment connection and after 6 months of loading. The implant follow-up period ranged from a minimum of one to a maximum of 6 years after implants loading.

    Results: All implants were stable after 6 months of healing. A total of three implants were lost during the follow-up period giving a survival rate of 98.7%. Radiography demonstrated on average 5.3±2.1 mm of intra-sinus new bone formation after 6 months of healing. RFA measurements showed adequate primary stability (implant stability quotient 67.4±6.1) and small changes over time.

    Conclusion: Maxillary sinus membrane elevation and simultaneous placement of implants without the use of bone grafts or bone substitutes result in predictable bone formation with a high implant survival rate of 98.7% during a follow-up period of up to 6 years. The intra-sinus bone formation remained stable in the long-term follow-up. It is suggested that the secluded compartment allowed for bone formation according to the principle of guided tissue regeneration. The high implant survival rate of 98.7% indicated that the implants sufficiently supported the fixed bridges throughout the study period. This technique reduces the risks for morbidity related to harvesting of bone grafts and eliminates the costs of grafting materials.

  • 230.
    Crnalic, Sead
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Hörnberg, Emma
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Wikström, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Tieva, Åse
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Svensson, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Widmark, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Bergh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Nuclear androgen receptor staining in bone metastases is related to a poor outcome in prostate cancer patients2010Inngår i: Endocrine-Related Cancer, ISSN 1351-0088, E-ISSN 1479-6821, Vol. 17, nr 4, s. 885-895Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Androgen receptors (ARs) are probably of importance during all phases of prostate cancer (PC) growth, but their role in bone metastases is largely unexplored. Bone metastases were therefore collected from hormone-naive (n=11), short-term castrated (n=7) and castration-resistant PC (CRPC, n=44) patients by biopsy (n=4) or at surgery to alleviate symptoms from metastases complications (metastasis surgery, n=58), and immunostained for nuclear ARs, Ki67, active caspase-3, prostate-specific antigen (PSA) and chromogranin A, and results were related to serum PSA, treatments and outcome. Nuclear AR immunostaining was decreased and apoptosis was increased, but cell proliferation remained largely unaffected in metastases within a few days after surgical castration. In CRPC patients, nuclear AR staining of metastases was increased when compared to short-term castrated patients. The nuclear AR staining score was related to tumour cell proliferation, but it was not associated with other downstream effects of AR activation such as apoptosis and PSA staining, and it was only marginally related to the presence of neuroendocrine tumour cells. Serum PSA at metastasis surgery, although related to outcome, was not associated with AR staining, markers of metastasis growth or PSA staining in metastases. High nuclear AR immunostaining was associated with a particularly poor prognosis after metastasis surgery in CRPC patients, suggesting that such men may benefit from the potent AR blockers now tested in clinical trials.

  • 231.
    Crossner, Claes-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    Försök till tidig diagnos av kariessjukdomen1980Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The aim of the present thesis was to find a test for prediction of caries activity which would be useful in routine clinical work.Correlations between oral health, general health, food habits and socioeconomic conditions were investigated in 4- and 8-year-old children. It was found that the salivary secretion rate and the prevalence of oral lactobacilli were factors which might be useful in caries prediction.In 5- and 8-year-old children negative correlations between caries frequency and secretion rate, pH and buffer effect of saliva were demonstrated. However, these parameters showed a wide range of variation.A dip-slide test (Dentocult®), for determination of the number of lactobacilli in saliva, were investigated. The test proved to be reliable for determining of the number of lactobacilli in saliva.The clinical use of information on salivary secretion rate and number of lactobacilli in saliva in prediction of caries activity was examined in 115 14-year-old children over a period of 64 weeks. The number of lactobacilli in saliva, but not the salivary secretion rate, was correlated to caries activity. The number of lactobacilli in saliva seems to reflect the frequency of ingested fermentable carbohydrates and indirectly the risk for initiation of carious lesions. However, when the lactobacillus test is used it is important that there are no such areas of microbial retention on the teeth, as open cavities, poorly executed conservations, dentures or orthodontic bands. The lactobacillus test would make it possible to individualize prophylactic caries treatment.

  • 232.
    Dahlberg, Jesper
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Use of Herbal Medicinal Products in a Swedish Public Dental Service Population2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 233.
    Dahlin, Anna M
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Van Guelpen, Bethany
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Hultdin, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Palmqvist, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Plasma vitamin B12 concentrations and the risk of colorectal cancer: a nested case-referent study2008Inngår i: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 32, nr 2, s. 304-314Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this nested case-referent study, we related plasma concentrations of vitamin B12 to the risk of colorectal cancer, taking into consideration prediagnostic plasma folate and total homocysteine concentrations. Subjects were 226 cases and double matched referents from the population-based Northern Sweden Health and Disease Study. Follow-up times from recruitment to diagnosis ranged from 0.1 to 12.7 years, with a median of 4.2 years. Plasma vitamin B12 concentrations were inversely associated with the risk of rectal cancer: univariate odds ratio for the highest versus lowest quintile 0.34 (95% confidence interval (95% CI) 0.13-0.83), p(trend) = 0.004. Risk estimates were attenuated slightly but remained statistically significant after adjustment for body mass index, current smoking, recreational and occupational physical activity, alcohol intake and prediagnostic plasma folate and total homocysteine concentrations: OR 0.30 (95% CI 0.08-0.99), p(trend) = 0.025. The corresponding univariate and fully adjusted odds ratios for colon cancer were 1.25 (CI 0.66-2.36), p(trend) = 0.185 and 1.42 (CI 0.67-3.05), p(trend) = 0.113, respectively. The observed over-risk was attributable to left-sided colon cancer. Interaction analyses including vitamin B12, folate and homocysteine were in line with the results for vitamin B12 alone. In conclusion, these results suggest that increasing levels of plasma vitamin B12, alone or together with other factors involved in one-carbon metabolism, may reduce the risk of rectal cancer, whereas for colon cancer, the association appears to be less clear.

  • 234.
    Dahlqvist, Johanna
    et al.
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Öron- näs- och halssjukdomar.
    Dahlqvist, Åke
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Öron- näs- och halssjukdomar.
    Marklund, Marie
    Umeå universitet, Medicinsk fakultet, Odontologi, Ortodonti.
    Berggren, Diana
    Umeå universitet, Medicinsk fakultet, Klinisk vetenskap, Öron- näs- och halssjukdomar.
    Stenlund, Hans
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Franklin, Karl
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Lungmedicin.
    Physical findings in the upper airways related to obstructive sleep apnea in men and women2007Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 127, nr 6, s. 623-630Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    CONCLUSIONS:There are gender differences when it comes to the risk factors for sleep apnea. Large tonsils, a high tongue and a wide uvula are risk factors for sleep apnea in men, while large tonsils and a retrognathic mandible are risk factors in women. Upper airway abnormalities including mandibular retrognathia are, however, unable to predict sleep apnea among snorers being investigated for suspected sleep apnea.

    OBJECTIVES: To identify gender-specific risk factors for obstructive sleep apnea and the diagnostic performance from physical upper airway examinations among snoring men and women investigated because of suspected sleep apnea.

    PATIENTS AND METHODS: The dimensions of the uvula, tonsils, velopharynx and tongue, and nasal septal deviation, mandibular position, neck circumference, weight, and height were systematically scored in 801 consecutive snoring patients (596 men and 205 women), who had been referred for a primary sleep apnea recording.

    RESULTS: In men, large tonsils, a high tongue, and a wide uvula were independent factors associated with an apnea-hyopnea index of > 15. In women, large tonsils and mandibular retrognathia were independent factors associated with an apnea-hypopnea index of > 15. The positive predictive values for upper airway abnormalities ranged between 0.20 and 0.25 in men and between 0.09 and 0.15 in women.

  • 235.
    Dahlstrand Rudin, Arvid
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Burstedt, John
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    The importance of OuterMembrane Protein A in SerumResistance in Aggregatibacteractinomycetemcomitans serotype astrain D7SS2017Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    The Gram-negative bacterium Aggregatibacter actinomycetemcomitans is primarily associatedwith aggressive forms of periodontal disease. Additionally, it has occasionally been found to causemetastatic infections in non-oral sites. This requires the ability to evade the bactericidal activity ofthe complement system of the humoral immune system. Outer membrane proteins, namely,Omp100 and OmpA have been connected to normal human serum resistance for several bacteriaspecies. The objective of this study was to investigate if serum-resistant ompA mutants can beobtained, and to detect changes in OMP expression. We used A. actinomycetemcomitansserotype a strain D7SS and D7SS ompA knockouts. The strains were incubated in 50 % NHS.This resulted in a substantial decrease of survival among D7SS ompA knockouts. D7SS ompAknockouts were exposed to 50 % NHS once more to confirm stable serum resistance. 13 out of14 tested clones showed growth, indicating that serum resistant ompA mutants could begenerated. SDS-PAGE gel of extracted outer membrane vesicles revealed an additional proteinband of approximately 34 kDa in at least 4 of 5 tested serum resistant ompA mutants. This proteinband has been analyzed in the laboratory, and according to LC-MS/MS it contains an OmpAhomologue, which has been named OmpA2. We conclude that OmpA2 expression might be amajor mechanism for serum survival in A. actinomycetemcomitans serotype a strain D7SS ompAknockouts.

  • 236.
    Dahlén, Gunnar
    et al.
    Göteborgs Universitet.
    Claesson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Höglund Åberg, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Haubek, Dorte
    Aarhus University Denmark.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Kwamin, Francis
    Ghana University, Ghana.
    Subgingival bacteria in Ghanaian adolescents with or without progression of attachment loss2014Inngår i: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 6, artikkel-id 23977Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study describes subgingival bacterial profiles associated with clinical periodontal status in Ghanaian adolescents with or without progression of attachment loss.

    MATERIALS AND METHODS: Among 500 adolescents included in a cohort study, 397 returned 2 years later for a periodontal re-examination, including full-mouth CAL measurements. At follow-up, a subgroup of 98 adolescents was also subjected to bacterial sampling with paper points at four periodontal sites (mesial aspect of 11, 26, 31, and 46) and analyzed with the checkerboard DNA-DNA hybridization technique against DNA-probes from nine periodontitis-associated bacterial species.

    RESULTS: The 98 Ghanaian adolescents examined in the present study were similar to the entire group examined at the 2-year follow-up with respect to age, gender, and CAL ≥3 mm. A high detection frequency of Fusobacterium nucleatum and Prevotella intermedia (>99%) using checkerboard analysis was found, while for Aggregatibacter actinomycetemcomitans the detection frequency was <50%. A strong correlation was found at the individual level between the presence of P. intermedia and the total CAL change, and P. intermedia and Porphyromonas gingivalis were strongly correlated with a change in CAL and probing pocket depth (PPD) at the sampled sites. In a linear regression model, a significant discriminating factor for the total CAL change in the dentition during the 2-year follow-up period was obtained for P. intermedia and public school.

    CONCLUSION: This study indicates that subgingival bacterial species other than A. actinomycetemcomitans, for example, P. intermedia, have a significant association with periodontal breakdown (change in CAL) in Ghanaian adolescents with progression of periodontal attachment loss.

  • 237. Dalton Bittencourt, DD
    et al.
    Ezecelevski, IG
    Reis, A
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Loguercio, AD
    An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions.2005Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, nr 3, s. 173-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 238.
    Danielsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Oral lichen planus: studies of factors involved in differentiation, epithelial mesenchymal transition and inflammation2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: Lichen planus is a chronic inflammation of skin and mucosa with unknown cause. Oral Lichen Planus, OLP, affects around 2% of the population. Autoimmunity has been suggested as a possible cause as the disease has autoimmune features such as female predominance, cyclic nature and cytotoxic T-cell infiltrate. It has been suggested that the intense inflammatory response seen in OLP is caused by factors on the keratinocyte surface triggering the immune system. Chronic inflammation is one of the hallmarks of oral lichen planus and chronic inflammation is connected to increased risk of tumor development. WHO classifies OLP as a potentially malignant condition with increased risk of developing Squamous cell carcinoma of head and neck, SCCHN, but malignant transformation of OLP is a matter of controversy. The aim of these studies was to further elucidate the autoimmune and premalignant character of OLP. Factors involved in malignant transformation, autoimmunity and inflammation were analyzed in normal oral mucosa, OLP and SCCHN. Factors studied were the signal transducers of Transforming growth factor-β the Smad proteins, microRNAs, COX-2, the receptor CXCR-3 and its ligands CXCL-10 and -11 and ELF-3.

    Material and methods: In the study on Smad protein expression formalin fixed and paraffin embedded biopsies from normal oral mucosa, OLP and SCCHN was used. For the remaining studies fresh frozen biopsies from OLP and normal controls was used. All of the fresh frozen OLP samples and their controls were micro dissected to be able to analyze the epithelial part only as well as sections of the whole biopsy. Methods used are immunohistochemistry, qRT-PCR and Western blot.

    Results: Analyses of smad proteins expression showed a clear increase of smad3 and smad7 in OLP compared to normal oral mucosa. The expressions of smad proteins in the tumors were more heterogeneous. Some of the SCCHN samples showed a similar expression as OLP while others did not. Micro RNA analyzes showed that miR-21 and miR-203 was significantly increased in OLP epithelium compared to normal oral epithelium while the expression of miR-125b and their potential targets p53 and p63 was decreased in OLP. The presence of COX-2 was significantly higher in OLP than normal controls. At the same time the expression of miR-26b, a suggested repressor of COX-2 was decreased in OLP compared to normal mucosa. The receptor CXCR-3 and its ligands CXCL-10 and -11 were increased in OLP. Expressions of the differentiation involved factor ELF-3 mRNA as well as protein were decreased in OLP.

    Conclusion: The factors studied are involved in differentiation, malignant transformation and inflammation. Some of the results in these studies indicate a similar expression pattern for OLP and SCCHN. Several of the factors studied are involved in differentiation and their deregulation suggests a disturbed differentiation pattern and this could indicate a premalignant character of OLP but malignant transformation of OLP lesions are relative rare. A lot of these factors are also involved in inflammatory processes and connected to autoimmune diseases and their deregulation in OLP could also support an autoimmune cause of the disease. Based on our studies a suggestion is that the disturbed differentiation pattern triggers the intense immune response directed against the epithelial cells seen in OLP.

  • 239.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Rentoft, Matilda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Coates, Philip
    Tayside Tissue Bank/Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Elisabet
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Autoantibodies and decreased expression of the transcription factor ELF-3 together with increased chemokine pathways support an autoimmune phenotype and altered differentiation in lichen planus located in oral mucosa2013Inngår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 27, nr 11, s. 1410-1416Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background  The pathogenesis of oral lichen planus (OLP), a chronic inflammatory disease, is not fully understood. It is known that OLP has autoimmune features, and it is suggested to be an autoimmune disease. ELF-3 is involved in differentiation of keratinocytes and deregulated in different tumours and inflammatory diseases. CXCR-3 and its ligands CXCL-10 and CXCL-11 are increased in autoimmune diseases and linked to Th-1 immune response. Objectives  To analyse and compare expression of ELF-3, CXCR-3, CXCL-10 and CXCL-11 in OLP lesions and controls in whole and microdissected epithelium. Methods  Tissue biopsies from 20 patients clinically and histologically diagnosed with OLP and 20 healthy controls were studied using whole tissues or microdissected epithelium. By the use of qRT-PCR, mRNA levels of ELF-3, CXCR-3, CXCL-10 and CXCL-11 were studied. Western blot was used for analysis of ELF-3 protein expression. Sera from 19 OLP patients and 20 controls were analysed with ELISA in search for autoantibodies. Results  The upregulation of CXCR-3, CXCL-10 and CXCL-11 found in OLP is similar to previous findings showing an autoimmune phenotype in lichen planus (LP) and lichen sclerosus. Decreased expression of the differentiation-related transcription factor ELF-3 was also seen in OLP lesions, and we further demonstrate presence of circulating autoantibodies against the ELF-3 protein in sera from 3 of 19 (16%) LP patients tested. Conclusions  On the basis of these findings, we confirm that OLP shows features of an autoimmune disease and suggest deregulated differentiation of keratinocytes to be one of the causes of the disease phenotype.

  • 240.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Coates, Philip J
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Nylander, Elisabet
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Genes Involved in Epithelial Differentiation and Development are Differentially Expressed in Oral and Genital Lichen Planus Epithelium Compared to Normal Epithelium2014Inngår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 94, nr 5, s. 526-530Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Lichen planus (LP) is a chronic mucocutaneous disease with unknown cause. Patients with LP often have both oral and genital lesions, but these conditions are often considered as separate diseases and treated accordingly. To find out which genes are differently expressed in mucosal LP compared to normal mucosa and establish whether oral and genital LP are in fact the same disease, whole genome expression analysis was performed on epithelium from 13 patients diagnosed with oral and/or genital LP and normal controls. For confirmation of keratin 4 and corneodesmosin expression, quantitative reverse-transcription PCR and immunohistochemistry were used. Many genes involved in epithelial development and differentiation are differently expressed in epithelium from LP compared to normal epithelium. Several of the differentially expressed genes are common for oral and genital LP and the same biological processes are altered which supports the fact that oral and genital LP are manifestations of the same disease. The change in gene expression indicates that differentiation is altered leading to changes in the epithelial barrier.

  • 241.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ebrahimi, Maijd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Increased levels of COX-2 in oral lichen planus supports an autoimmune cause of the disease2012Inngår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 26, nr 11, s. 1415-1419Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is not fully understood. OLP has autoimmune features and auto immunity has been suggested as a potential cause, whereas WHO has classified OLP as a premalignant condition. Association between chronic inflammation and cancer is known and chronic inflammation is one of the characteristics of OLP. A protein connected to inflammation and suggested to be involved in cancer development is cyclooxygenase-2 (COX-2) which can be inhibited by microRNA-26b (miR-26b).

    Objective: The aim was to map levels of COX-2 and miR-26b in OLP lesions to see if there was any correlation between expression of COX-2 and its regulator miR-26b in OLP.

    Methods: In biopsies from 20 OLP patients and 20 age and gender-matched controls laser- micro dissection of epithelium was performed. Quantitative RT-PCR, immunohistochemistry and Western blot were used in the analysis.

    Results: Levels of COX-2 mRNA were significantly higher while levels of miR-26b were significantly lower in OLP lesions compared to controls. Using immunohistochemistry normal oral mucosa samples did not show any expression of COX-2 while OLP samples expressed the protein. No COX-2 protein was detectable with Western blot.

    Conclusion: Increased expression of COX-2 and decreased expression of miR-26b in OLP suggests both to play a role in OLP. COX-2 has been connected to both malignant development and autoimmunity but as malignant development of OLP is quite rare we suggest that the increased levels of COX-2 seen here support an autoimmune cause of the disease.

  • 242.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Elisabet
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Alterations in factors involved in differentiation and barrier function in the epithelium in oral and genital lichen planus2017Inngår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 97, nr 2, s. 214-218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Lichen planus is a chronic recurrent inflammatory disease affecting both skin and mucosa, mainly in oral and/or genital regions. Keratinocytes go through a well-regulated process of proliferation and differentiation, alterations in which may result in defects in the protective epithelial barrier. Long-term barrier impairment might lead to chronic inflammation. In order to broaden our understanding of the differentiation process in mucosal lichen planus, we mapped the expression of 4 factors known to be involved in differentiation. Biopsies were collected from oral and genital lichen planus lesions and normal controls. Altered expression of all 4 factors in epithelium from lichen planus lesions was found, clearly indicating disturbed epithelial differentiation in lichen planus lesions.

  • 243.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Endodonti.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Protetik.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Reply to increased levels of COX-2 and oral lichen planus by P.D. Pigatto, F. Spaderi, G.P. Bombeccari, G. Guzzi by Danielsson et al2013Inngår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 27, nr 3, s. 395-396Artikkel i tidsskrift (Fagfellevurdert)
  • 244.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wahlin, Ylva Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Coates, PJ
    Division of Medical Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Increased expression of Smad proteins, and in particular Smad3, in oral lichen planus compared to normal oral mucosa2010Inngår i: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 39, nr 9, s. 639-644Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Backgound: Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa which the World Health Organisation (WHO) considers a premalignant condition. One step in malignant development is so called epithelial mesenchymal transition (EMT), a process whereby epithelial cells acquire mesenchymal characteristics. EMT occurs during embryogenesis and wound healing but also in some human diseases such as cancer and fibrosis. A factor known to induce EMT is transforming growth factor-beta (TGF-beta), which uses the Smad proteins as mediators for its signalling. TGF-beta is also often over-expressed in squamous cell carcinoma of the head and neck (SCCHN).

    Methods: In the present study we mapped expression of Smad proteins in OLP lesions by immunohistochemistry, and compared to expression in normal and sensitive oral mucosa. The latter group of patients had developed SCCHN after shorter or longer periods of diffuse oral symptoms. The aim was to see if there were any signs of EMT related changes in the OLP lesions, as judged by changes in the TGF-beta pathway.

    Conclusion: Changes in the TGF-beta pathway related to EMT are seen in the very earliest stages of oral malignancy and become more severe as lesions progress.

  • 245.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Protetik.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Decreased expression of ELF-3 indicating disturbed differentiation in oral lichen planus2012Inngår i: Oral Diseases, ISSN 1354-523X, E-ISSN 1601-0825, Vol. 18, nr Special Issue, Suppl. 1, s. 20-20Artikkel i tidsskrift (Annet vitenskapelig)
  • 246.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Gu, Xiaolian
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Altered expression of miR-21, miR-125b, and miR-203 indicates a role for these microRNAs in oral lichen planus2012Inngår i: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 41, nr 1, s. 90-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Oral lichen planus (OLP), which is a chronic inflammatory disease of the oral mucosa with unknown etiology, affects about 2% of the population. MicroRNAs are small non-coding RNAs involved in normal processes such as development and differentiation as well as progression of human diseases. The aim of this study was to investigate the expression of miR-21, miR-125b, and miR-203 and to compare RNA levels of their potential targets, the tumor suppressor p53 and its relative p63, both known to be deregulated in OLP.

    Methods: In biopsies from 20 patients with OLP and 20 age- and sex-matched healthy controls, epithelium was laser dissected and analyzed for the expression of miR-21, miR-125b, miR-203, p53, and p63 using qRT/PCR.

    Results: Increased expression of miR-21 and miR-203, decreased expression of miR-125, and down-regulation of p53 and ΔNp63 RNA were seen in OLP compared to normal oral mucosa. When comparing microRNA expression to levels of p53 and p63 RNA, a significant negative correlation was seen between ΔNp63 and miR-203 and between miR-21 and p53, respectively.

    Conclusion: Results indicate a role for the studied microRNAs in changes seen in OLP.

  • 247.
    Danielsson Niemi, Liza
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Host ligands and oral bacterial adhesion: studies on phosphorylated polypeptides and gp-340 in saliva and milk2010Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Infectious diseases e.g. gastric ulcer, caries and perodontitis, are caused by bacteria in a biofilm. Adhesion of bacteria to host ligands e.g. proteins, polypeptides and glycoproteins, is a key event in biofilm formation and colonization of surfaces such as mucosa and tooth tissues. Thus, host ligands could contribute to the susceptibility to infectious diseases. The general aim of this doctoral thesis was to study the effect of phosphorylated polypeptides and gp-340 in saliva and milk on oral bacterial adhesion and aggregation.

    Statherin is a non-glycosylated, phosphorylated polypeptide in saliva. The polypeptide inhibits precipitation and crystal growth of calcium phosphate and mediates adhesion of microorganisms. By using a hybrid peptide construct, the domain for adhesion of Actinomyces isolated from human infections and from rodents was found to reside in the C-terminal end, and the adhesion was inhibitable. With alanine substitution the peptide recognition epitope in the C-terminal end was delineated to Q and TF, where QAATF was an optimal inhibitory peptide. In contrast, human commensal Actinomyces bound to the middle region in a non-inhibitable fashion. Gp-340 is another protein in saliva, and it is a large, multifunctional glycoprotein. Four novel size variants (I-IV) of salivary gp-340 were distinguished within individuals, and their glycoforms were characterized. All four size variants were identical in the N-terminal amino acid sequence and shared core carbohydrates. Low-glyco lung gp-340, high-glyco saliva gp-340, and size variants I-III aggregated bacteria differently. Human milk, which shares many traits with saliva, could inhibit adhesion of Streptococcus mutans to saliva-coated hydroxyapatite (s-HA), a model for teeth, in an individually varying fashion. Human milk caseins, lactoferrin, secretory IgA, and IgG inhibited the binding avidly. By using synthetic peptides the inhibitory epitope in b-casein was mapped to a C-terminal stretch of 30 amino acids. Inhibition by human milk, secretory IgA and the b-casein-derived inhibitory peptide was universal among a panel of mutans streptococci.

    The main conclusions are: (i) statherin mediates differential binding of commensal versus infectious Actinomyces strains with small conformation-dependent binding epitopes, (ii) salivary gp-340 has individual polymorphisms that at least affect binding of bacteria, (iii) human milk inhibits S. mutans adhesion to s-HA in an individually varying fashion, and the C-terminal end of human milk β-casein is one inhibitory component. Together these results suggest that the studied host ligands can influence the composition of the oral biofilm. Statherin may protect the host from colonization of bacteria associated with infections. Gp-340 size variants may affect functions related to host innate immune defences such as interactions with a wide array of bacteria, and human milk may have a protective effect in infants from colonization of mutans streptococci.

  • 248.
    Danielsson Niemi, Liza
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Hernell, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Human milk compounds inhibiting adhesion of mutans streptococci to host ligand-coated hydroxyapatite in vitro2009Inngår i: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 43, nr 3, s. 171-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Acquisition of mutans streptococci at an early age is a risk factor for later caries development. Following our recent finding that human milk may inhibit adhesion of Streptococcus mutans the aim of the present study was to identify compounds in human milk preventing adhesion of mutans streptococci to saliva- or gp340-coated hydroxyapatite (s-HA and gp340-HA) using an in vitro model system. Superdex 200 fractions of human milk and purified proteins were screened for binding inhibition of the S. mutans strain Ingbritt. Avid inhibition was seen to both s-HA and gp340-HA for caseins, lactoferrin, IgA and IgG, and moderate inhibition for alpha-lactalbumin and bile salt-stimulated lipase, whereas albumin and lysozyme had no effect. The inhibitory epitope in beta-casein was delineated to its C-terminal LLNQELLNPTHQIYPVTQPLAPVHNPISV stretch by use of synthetic peptides. Similarly, a peptide (SCKFDEYFSQSCA) corresponding to the human lactoferrin stretch that is highly homologous to the previously shown inhibitory stretch of bovine lactoferrin was found to inhibit S. mutans Ingbritt binding. Inhibition by human milk, IgA, and the inhibitory beta-casein peptide was universal among 4 strains of S. mutans (Ingbritt, NG8, LT11, JBP) and 2 strains of S. sobrinus (6715 and OMZ176). IgG inhibited 4, alpha-lactalbumin 3 and lactoferrin 2 of these 6 strains. It was also confirmed that none of the milk components coated on HA mediated S. mutans Ingbritt adhesion, which was consistent with the finding that no milk protein was recognized on Western blots by gp340/DMBT1 monoclonal antibodies.

  • 249.
    Danielsson Niemi, Liza
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Salivary statherin peptide-binding epitopes of commensal and potentially infectious Actinomyces spp. delineated by a hybrid peptide construct2004Inngår i: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 72, nr 2, s. 782-787Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Adhesion of microorganisms to host receptor molecules such as salivary statherin molecules is a common event in oral microbial colonization. Here we used a hybrid peptide construct (with both a hydroxyapatite-binding portion and a test peptide portion) to map the interaction of Actinomyces species (and Candida albicans) with statherin. Adhesion to hybrid peptides and truncated statherin variants revealed three binding types, types I to III. (i) Type I strains of rat, hamster, and human infection origins bound C-terminal-derived QQYTF and PYQPQY peptides. The QQYTF peptide inhibited statherin binding for some strains but not for others. (ii) Type II strains of human and monkey tooth origins bound middle-region-derived YQPVPE and QPLYPQ peptides. Neither strain was inhibited by soluble peptides. (iii) Type III strains of human infection origins (and C. albicans) did not bind to either statherin-derived peptides or truncated statherin. Moreover, the type I strains inhibited by QQYTF were also inhibited by TF and QAATF peptides and were detached from statherin by the same peptides. In conclusion, it is suggested that commensal and potentially infectious microorganisms bind middle or C-terminal statherin differently and that other microbes might require discontinuous epitopes.

  • 250. Davidson, Thomas
    et al.
    Rohlin, Madeleine
    Hultin, Margareta
    Jemt, Torsten
    Nilner, Krister
    Sunnegårdh Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Tranaeus, Sofia
    Nilsson, Mats
    Reimbursement systems influence prosthodontic treatment of adult patients2015Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, nr 6, s. 414-420Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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