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  • 1.
    Andersson-Wenckert, Ingrid
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Pedodonti.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Kieri, C
    Durability of extensive Class II open-sandwich restorations with a resin-modified glass ionomer cement after 6 years.2004Inngår i: American Journal of Dentistry, ISSN 0894-8275, Vol. 17, nr 1, 43-50 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate the durability of a modified open-sandwich restoration utilizing a resin-modified glass ionomer cement (RMGIC) in large cavities. METHODS: 268, mostly extensive, Class II Vitremer/Z100 restorations were placed in 151 patients. 47% of the restorations were placed in patients considered as caries-risk patients. Six experimental groups, differing from each other in thickness of RMGIC layer and preconditioning, were evaluated at baseline and annually during 6-7 years according to modified USPHS criteria. RESULTS: After 6 years, 220 restorations were evaluated. 42 failures (19%) were observed. The most frequent reasons for failure were material fracture (n = 11), tooth fractures (n = 9) and secondary caries (n = 10). Non-acceptable proximal dissolution of the RMGIC was seen in six restorations. Significantly more failures, but similar dissolution of the RMGIC, were recorded in high caries risk patients. No differences were seen between the experimental groups or between restorations with thick or thin RMGIC layer. 160 restorations were also evaluated at 7 years. Another 13 failures were observed, eight with non-acceptable dissolution, three secondary caries and two fractures. It can be concluded that the modified open sandwich restoration showed an acceptable durability for the extensive restorations evaluated. An accelerating dissolution of the RMGIC was observed at the end of the study.

  • 2. Astvaldsdottir, Alfheidur
    et al.
    Dagerhamn, Jessica
    van Dijken, Jan W. V.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Naimi-Akbar, Aron
    Sandborgh-Englund, Gunilla
    Tranaeus, Sofia
    Nilsson, Mikael
    Longevity of posterior resin composite restorations in adults: A systematic review2015Inngår i: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 43, nr 8, 934-954 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective: To conduct a systematic review of the literature on the longevity of posterior resin composite restorations in adults. Material and methods: A systematic literature search was conducted according to predetermined criteria for inclusion and exclusion. The studies selected were prospective clinical trials with a minimum follow-up time of 4 years, 40 restorations per experimental group and an annual attrition rate of less than 5%. Initially, abstracts and full-text articles were assessed independently and the assessment was subsequently agreed on by five reviewers. The methodological quality of the studies was assessed according to the Swedish Council on Health Technology Assessment (SBU) standard checklist for determining the extent to which studies meet basic quality criteria. Results: In all, the literature search identified 4275 abstracts and 93 articles were read in fulltext. There were eighteen studies which met the criteria for inclusion, eight of which were included in the analysis. There were 80 failures of restorations with a total follow-up time at risk for failure of 62,030 months. The overall incidence rate for all causes of failure was 1.55 lost restorations per 100 restoration years. The most common biological reason for failure (a total of 31 restorations) was secondary caries, with or without fracture of the restoration. The quality of the evidence was low. Conclusions: In an efficacy setting, the overall survival proportion of posterior resin composite restorations is high. The major reasons for failure are secondary caries and restoration fracture which supports the importance of adequate follow-up time. Clinical significance: The overall survival proportion of posterior composite restorations was high, but the results cannot be extrapolated to an effectiveness setting. The importance of adequate follow-up time is supported by the finding that secondary caries often occurred after 3 years or later.

  • 3.
    Berglund, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandteknikerprogrammet.
    Hulterström, Anna Karin
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandteknikerprogrammet.
    Gruffman, Ewa
    Umeå universitet, Medicinsk fakultet, Odontologi, Odontologisk materialvetenskap.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Dimensional change of a calcium aluminate cement for posterior restorations in aqueous and dry media.2006Inngår i: Dental Materials, ISSN 0109-5641, Vol. 22, nr 5, 470-476 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 4. 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, Vol. 63, nr 3, 173-178 s.Artikkel 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.

  • 5. de Gee, Anton J
    et al.
    Kleverlaan, Cees J
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Dentala kompositer: betydelsen av polymerisationskrympning och genererade spänningar2007Inngår i: Tandläkartidningen, ISSN 0039-6982, Vol. 99, nr 3, 40-44 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During the curing shrinkage of adhesively bonded resin composites tensile stresses develop, which are exerted back onto the cavity walls. the extent of the stress determines whether part of the tooth structure will fracture. Unfortunately, shrinkage stress values are not available for the general practitioner. Recommendations are therefore made for the use of low shrinkage and/or low shrinkage stress resin ccomposites for different cavity types. In the current study, thirty resin composites were evaluated for shrinkage and shrinkage stress. The majorityof the composites compplied with the hypothesis that a low shrinkage is accompanied with a high shrinkage stress and visa-versa. Some composite materials showed both a low shrinkage and a low shrinkage stress and are thus proposed to give the least problems with respect to marginal seal and enamel fracture.

  • 6.
    Dijken, Jan W. V. van
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    A two-year clinical evaluation of a new calcium aluminate cement in Class II cavities2003Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 61, nr 4, 235-40 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 7.
    Hansson, Patrik
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Bergdahl, Jan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Bergdahl, Maud
    Nyberg, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Fysiologi. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Nilsson, Lars-Göran
    Relationship between natural teeth and memory in a healthy elderly population2013Inngår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 121, nr 4, 333-340 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The relationship between mastication and cognitive function remains unclear, but both animal and experimental human studies suggest a possible causal relationship. In the present study it was hypothesized that natural teeth are of importance for hippocampus-based cognitive processes, such as episodic long-term memory. A population-based sample of 273 participants (55-80yr of age; 145 women) was investigated in a cross-sectional study. The participants underwent health assessment, completed a battery of cognitive tests, and took part in an extensive clinical oral examination. The number of natural teeth contributed uniquely and significantly to explaining variance (3-4%) in performance on measures of episodic memory and semantic memory over and above individual differences in age, years of education, gender, occupation, living conditions, and medical history. The number of natural teeth did not have an influence on the performance of measures of working memory, visuospatial ability, or processing speed. Within the limitations of the current study, a small, but significant, relationship between episodic memory and number of natural teeth is evident.

  • 8. Hultin, Margareta
    et al.
    Davidson, Thomas
    Gynther, Goran
    Helgesson, Gert
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Nordenram, Gunilla
    Norlund, Anders
    Rohlin, Madeleine
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Tranaeus, Sofia
    Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL2012Inngår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, 543-552 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health-related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.

  • 9.
    Johansson, Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Anderson-Weckert, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Hagenbjörk-Gustavsson, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    van Dijken, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Ozone air levels adjacent to a dental ozone gas delivery system2007Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 65, nr 6, 324-330 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 10.
    Johansson, Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Claesson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    van Dijken, J W V
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Antibacterial effect of ozone on cariogenic bacterial species.2009Inngår i: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 37, nr 6, 449-453 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim was to evaluate the antibacterial effect of ozone on cariogenic bacterial species with and without the presence of saliva and a possible effect on the salivary proteins.

    Methods: Suspensions of Actinomyces naeslundii (ACTCC 12104T), Lactobacilli casei (N CTC 151) and Streptococcus mutans (NCTC 10449), in salt buffer or in saliva, were exposed to ozone gas delivered by the ozone generator Healozone™ 2130C. Aliquots of the suspensions were taken after 10, 30 and 60s ozone exposures and cultivated on agar plates. Initial number of bacteria per ml was 8.0×107 (SD 2.2×107) (A. naeslundii), 1.0×108 (SD 3.1×106) (L. casei) and 1.0×108 (SD 7.0×105) (S. mutans), respectively. The proteins were separated by SDS electrophoresis and visualized by silver staining.

    Results: In salt buffer 92%, 73% and 64% of the initial numbers of A. naeslundiiS. mutans and L. casei, respectively, were killed already after 10s ozone exposure, while approximately 99.9% of the bacteria were dead after a 60s exposure. After 10 and 30s, but not after 60s exposure to ozone, S. mutans and L. casei were less efficiently killed in saliva compared to the salt buffer. Various saliva proteins were degraded by ozone after a 60s exposure.

    Conclusions:The cariogenic species S. mutansL. casei and A. naeslundii were almost eliminated following 60s of ozone treatment. This killing was reduced in the presence of saliva although increasing the ozone application time to 60s overcame these reductants in saliva. Detection of altered salivary proteins indicates that saliva components constitute additional targets for ozone.

  • 11.
    Johansson, Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    van Dijken, Jan W V
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Karlsson, Lena
    Division of Cariology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Andersson-Wenckert, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Treatment effect of ozone and fluoride varnish application on occlusal caries in primary molars: a 12-month study2014Inngår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 18, nr 7, 1835-1843 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The aim of this study is to evaluate the effect of ozone and fluoride varnish on occlusal caries in primary molars in a split-mouth study.

    MATERIALS AND METHODS: Caries risk was estimated by treating Public Dental Health Service dentists. Children with occlusal caries with Ekstrand index scores ≤3 (VI ≤3) were included. Selection of caries lesions was discontinued for ethical reasons due to non-acceptable clinical results during the follow-up. In the continued evaluation pairs of teeth with non-cavitated caries lesions, Ekstrand score ≤2a (VI ≤2) were selected. Fifty pairs of carious primary molars were included, 18 boys and 15 girls (mean 4.7 years, range 3-8). At baseline, the lesions were assessed by visual inspection (VI) and laser-induced fluorescence (LF), in each pair to treatment with 40 s ozone (HealOzone(TM), 2,100 ppm) or fluoride varnish Duraphat®. The treatments and evaluations were repeated at 3, 6 9 months and evaluations only at 12 months.

    RESULTS: Medium-high caries risk was observed in VI ≤3 children and low-medium risk in VI ≤2a children. In the 15 pairs VI ≤3 lesions, 8 treated with ozone and 9 with fluoride progressed to failure. In the 35 pairs VI ≤2a lesions, one lesion failed. Median baseline LF values in the VI ≤3 group were 76 and 69, for ozone and fluoride lesions, respectively, and 21 and 19 in the VI ≤2a group. At 12 months, LF values in the VI ≤2a group were 15 and 18. No improvement or difference in LF values was found over time between the caries lesions treated with ozone or fluoride.

    CONCLUSIONS: Neither ozone nor fluoride varnish treatments stopped the progression of caries in cavitated lesions. In low and medium caries risk children, non-cavitated lesions following both treatments showed slight or no progression. The use of ozone or fluoride varnish treatments in this regime as caries preventive method, added to the daily use of fluoridated toothpaste, to arrest caries progression in primary molars must therefore be questioned.

  • 12.
    Konradsson, Katarina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Claesson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    van Dijken, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Dental biofilm, gingivitis and interleukin-1 adjacent to approximal sites of a bonded ceramic.2007Inngår i: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 34, nr 12, 1062-1067 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to investigate in vivo the influence of aged, resin-bonded, ceramic restorations on approximal dental biofilm formation and gingival inflammatory response, associated with and without customary oral hygiene. Material and Methods: In a cross-sectional and in a 10-day experimental gingivitis study, Quigley-Hein plaque index, gingival index (GI), crevicular fluid and its levels of interleukin (IL)-1alpha, -1beta and receptor antagonist were measured at appoximal surfaces of leucite-reinforced bonded ceramic coverages, resin composite restorations and enamel and compared intra-individually in 17 participants. Results: No differences were found between the ceramic, composite and enamel regarding plaque index, GI, levels of IL-1alpha, -1beta and the receptor antagonist. Throughout, higher crevicular fluid amounts were observed at ceramic sites compared with the enamel (p<0.05). In the experimental gingivitis, plaque index, GI, crevicular fluid and its IL-1alpha levels increased significantly. Conclusion: The need for optimal oral hygiene and professional preventive oral health care does not seem to be reduced with regard to approximal surfaces of aged, resin-bonded, leucite-reinforced ceramic restorations in comparison with those of a hybrid, resin composite and enamel.

  • 13.
    Konradsson, Katarina
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Claesson, Rolf
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral mikrobiologi.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Mutans streptococci and lactobacilli in plaque on a leucite-reinforced dental ceramic and on a calcium aluminate cement.2006Inngår i: Clinical Oral Investigations, ISSN 1432-6981, Vol. 10, nr 3, 175-180 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this in vivo study, the proportions of mutans streptococci and lactobacilli in plaque were examined (1) on proximal surfaces of bonded, leucite-reinforced ceramic crowns and (2) on class V restorations of calcium aluminate cement (CAC). The examined proportions were intraindividually compared with those of resin composite and enamel. Mutans streptococci and lactobacilli in samples from plaque that was accumulated for 10 days on the following surfaces were determined by cultivation on blood agar plates and species-selective plates: (1) proximal leucite-reinforced ceramic crown, class II composite and enamel (n=11); and (2) class V restoration of CAC and composite, and enamel (n=17). Mutans streptococci and lactobacilli in the samples were distributed in three groups: 0, >0-1, and >1% of total bacteria. The surfaces with detected mutans streptococci were similarly distributed between the materials and enamel. The highest proportion of mutans streptococci and lactobacilli were observed on ceramic followed by composite and enamel. A higher proportion of lactobacilli, but not of mutans streptococci, was detected on enamel compared to CAC and composite. However, no significant differences were found between the surfaces. Conclusively, the materials investigated did not show different relative proportions of mutans streptococci and lactobacilli in plaque, compared to enamel.

  • 14.
    Konradsson, Katarina
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Effect of a novel ceramic filling material on plaque formation and marginal gingiva.2002Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 60, nr 6, 370-374 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 15.
    Lampa, Ewa
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Brechter, Anna
    Umeå universitet, Medicinsk fakultet, Odontologi.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Effect of a Nonrinse Conditioner on the Durability of a Polyacid-modified Resin Composite Fissure Sealant2004Inngår i: Journal of Dentistry for Children, ISSN 0022-0353, Vol. 71, nr 2, 152-157 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to evaluate the effect of the simplified conditioning on durability of polyacid-modified resin composite (PMRC; Dyract Seal) fissure sealants. The effectiveness of a nonrinsing conditioner (NRC) on retention of PMRC sealants (92) was studied in a split-mouth design.

    Methods: The enamel of 1 molar was pretreated with NRC and coated with Prime & Bond NT (Dentsply DeTrey, Konstanz, Germany)/PMRC. The contralateral molar was conditioned with 36% phosphoric acid and sealed with Delton. The sealant retention was evaluated during 2 years. In addition 49 pairs were sealed with Prime & BondNT/PMRC after conditioning with 36% phosphoric acid and evaluated after 1 year.

    Results: Significantly higher loss rates at 1 and 2 years were observed for the NRC/Prime &

    Bond NT/PMRC sealants. At 2 years, partial and total loss rates for Delton were 23% and 11%, and for NRC/Prime & Bond NT/PRMC sealants were 44% and 40%, respectively. At

    1 year, phosphoric acid-conditioned Prime & Bond NT/PMRC sealants showed significantly better retention than the NRC-conditioned PMRC sealants and the phosphoric acid- conditioned Delton sealants.

    Conclusions: Conditioning with NRC prior to sealant application cannot be recommended.

  • 16.
    Lindberg, A
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Peutzfeldt, A
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Curing depths of a universal hybrid and a flowable resin composite cured with quartz tungsten halogen and light-emitting diode units.2004Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 62, nr 2, 97-101 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 17.
    Lindberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Resin composites: Sandwich restorations and curing techniques2005Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Since the mid-1990s resin composite has been used for Class II restorations in stress-bearing areas as an alternative to amalgam. Reasons for this were the patients’ fear of mercury in dental amalgam and a growing demand for aesthetic restorations. During the last decades, the use of new resin composites with more optimized filler loading have resulted in reduced clinical wear. Improved and simplified amphiphilic bonding systems have been introduced. However, one of the main problems with resin composites, its polymerization shrinkage, has not been solved yet. During the polymerization of the resin composites, they shrink as a result of the conversion of the monomers into rigid polymers by a radical addition reaction. The resulting shrinkage stresses in the bonded resin composite restorations may cause adhesive failures at the resin composite/tooth structure interface and/or cohesive failures within the tooth or the resin composite. The interfacial failures may result in post-operative sensitivity, recurrent caries or pulpal injury. This thesis evaluates different restorative and light-curing techniques that are proposed to reduce the polymerization shrinkage and also the effect of new lightcuring units, light-emitting diodes (LED) and high-power quartz tungsten halogen (QTH) light on curing depth and degree of conversion of resin composites. Two restorative techniques using a polyacid-modified resin composite or a flowable resin composite in combination with conventional resin composite in sandwich restorations were evaluated in an intraindividual comparison with a conventional resin composite restoration. The durability of the polyacid-modified resin composite sandwich technique was investigated in a three year clinical follow-up study. A scanning electron microscope replica method was used for evaluation of the interfacial adaptation in vivo of both sandwich combinations. The depth of cure of the flowable resin composite was evaluated with the use of Wallace hardness testing. Degree of conversion for resin composite cured with the new LED units was evaluated with Fourier Transform Raman spectroscopy.

    Major results and conclusions from the studies are:

    • Neither the sandwich restoration with polyacid-modified resin composite nor the flowable resin composite improved the interfacial adaptation of the restorations.

    • No difference in durability was found between the sandwich restorations with polyacidmodified resin composite or the resin composite restorations. A low failure rate was observed for both types of restorations after a clinical observation time of three years.

    • The depth of cure of the flowable resin composite was higher than the depth of cure of the resin composite. It was found that the curing time of the resin composite studied could be reduced or the increment layer thickness increased compared to earlier recommendations.

    • LED curing units of the latest generation were able to cure resin composites to a higher degree of conversion than the control QTH unit

    • The use of soft-start curing did not improve the interfacial adaptation of neither of resin composite restorations tested.

  • 18.
    Lindberg, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Emami, N
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    A Fourier transform Raman spectroscopy analysis of the degree of conversion of a universal hybrid resin composite cured with light-emitting diode curing units.2005Inngår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, nr 3, 105-112 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The degree of conversion (DC), of a universal hybrid resin composite cured with LED curing units with low and high power densities and a 510 mW/cm2 quartz tungsten halogen unit, was investigated with Fourier Transform Raman spectroscopy. Three curing depths (0, 2, 4mm) and 0 and 7 mm light guide tip - resin composite (LT - RC) distances were tested. The DC of the LED units varied between 52.3% - 59.8% at the top surface and 46.4% - 57.0% at 4 mm depth. The DC of specimen cured with a 0 mm LT- RC distance at 4 mm depth varied between 50.8% - 57.0% and with 7 mm distance between 46.4% - 55.4%. The low power density LED unit showed a significantly lower DC for both distances at all depth levels compared to the other curing units (p < 0.05). Significant differences between the other curing units were only found at the 4 mm depth level cured from 7 mm distance (p < 0.05). The reduction in DC by increasing LT- RC distance was less than 10% for all curing units. It can be concluded that the improved LED curing units could cure the studied resin composite to the same DC as the control unit.

  • 19.
    Lindberg, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Hörstedt, Per
    Umeå universitet, Medicinsk fakultet, Medicinsk biovetenskap, Patologi.
    In vivo interfacial adaptation of class II resin composite restorations with and without a flowable resin composite liner.2005Inngår i: Clinical Oral Investigations, ISSN 1432-6981, Vol. 9, nr 2, 77-83 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate in vivo the interfacial adaptation of class II resin composite restorations with and without a flowable liner. In 24 premolars scheduled to be extracted after 1 month, 48 box-shaped, enamel-bordered class II cavities were prepared and restored with a flowable liner (FRC, Tetric Flow/Tetric Ceram/Syntac Single-Component) or without (TRC), cured with three different curing modes: soft start and 500- or 700-mW/cm2 continuous irradiation. Interfacial adaptation was evaluated by quantitative scanning electron microscopic analysis using replica method. Gap-free adaptation in the cervical enamel (CE) was observed for FRC and TRC in 96.2 and 90.2%, for the dentin (D) in 63.6 and 64.9%, and for occlusal enamel (OE) in 99.7 and 99.5%, respectively. The difference between the two restorations was not statistically significant (ns). Significant better adaptation was observed for OE than CE and D (p<0.01), and for CE than D (p<0.01). Gap-free adaptation with the soft-start and 500- and 700-mW/cm2 continuous-curing modes was observed for CE: 88.7%, 92.7%, 97.9% (ns); OE: 99.8%, 98.7%, 100% (ns); and D: 64.0%, 63.9%, and 64.6% (ns), respectively. It can be concluded that neither the use of flowable resin composite liner nor the curing mode used influenced the interfacial adaptation.

  • 20.
    Lindberg, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lindberg, M
    3-year evaluation of a new open sandwich technique in Class II cavities.2003Inngår i: American Journal of Dentistry, ISSN 0894-8275, Vol. 16, nr 1, 33-36 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate the durability of a new open sandwich restoration with, as shown in a previous scanning electron microscope study, improved interfacial adaptation. A polyacid-modified resin-based composite (PMRC; compomer) was placed as an intermediate layer and covered with resin composite (RC). A direct RC restoration was used as control. MATERIALS AND METHODS: Of 57 patients, each received at least one pair of Class II restorations, one PMRC/RC open sandwich and one RC control. In total, 75 pairs of Class II restorations, 68 premolars and 82 molars, all in occlusion, were placed by two dentists. Most of the cavities were surrounded by enamel. The restorations were evaluated at baseline, 6, 12, 24 and 36 months by a slightly modified USPHS criteria. RESULTS: Five of 148 restorations evaluated during 3 years were rated as unacceptable. Two, one in each group, because of endodontic treatment and one RC restoration was replaced because of tooth fracture. Secondary caries was observed contiguous to one restoration in each group at the 36-month recall. Except for the two patients with pulpitis, none of the others reported postoperative sensitivity. No significant differences were seen between the restoration techniques. For marginal adaptation a significant change occurred between baseline and 6 months in both groups. For marginal discoloration, a significant change was observed at 6 months in the sandwich group and at 36 months in the RC group. Color match of the resin composite material changed significantly in both groups at 36 months. It was concluded that both techniques showed good durability during the 3-year follow up.

  • 21.
    Lindberg, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lindberg, Marianne
    Nine-year evaluation of a polyacid-modified resin composite/resin composite open sandwich technique in Class II cavities2007Inngår i: Journal of Dentistry, ISSN 0300-5712, Vol. 35, nr 2, 124-129 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of this study was to evaluate in an intraindividual comparison the durability of a polyacid-modified resin composite/resin composite open sandwich restoration in a 9 years follow-up. A polyacid-modified resin composite (PMRC; compomer, Dyract) was placed as an intermediate layer and covered with resin composite (RC, Prisma TPH). A direct RC restoration was used as control. METHODS: Each of 57 patients, received at least one pair of Class II restorations, one open sandwich and one resin composite control. In total 75 pairs of Class II restorations, 68 premolars and 82 molars, all in occlusion, were placed by two dentists. Most of the cavities were surrounded by enamel. The restorations were evaluated at baseline, 6, 12, 24, 36 months and 9 years by slightly modified USPHS criteria. Survival of restorations grouped on the two different techniques was determined using Kaplan-Meier survival curves. RESULTS: After 9 years, 14 of 135 evaluated restorations were estimated as unacceptable, 6 in the sandwich group and 8 in the control group. Over all annual failure rate during the 9-year period was 1.1%. The survival rate was not significant different between the two techniques (p=0.604). Reasons of failure were: secondary caries (8), fracture of tooth (1), fracture of restoration (2), endodontic treatment (3). CONCLUSIONS: Both restorative techniques showed good durability during the 9-year period. No clinical advantage was observed for the sandwich technique.

  • 22. Loguercio, Alessandro Dourado
    et al.
    Reis, Alessandra
    Bortoli, G
    Patzlaft, R
    Kenshima, Silvia
    Rodrigues Filho, Leonardo Eloy
    Accorinte Mde, L
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Influence of adhesive systems on interfacial dentin gap formation in vitro.2006Inngår i: Operative dentistry, ISSN 0361-7734, Vol. 31, nr 4, 431-441 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: This study measured: 1) the interfacial dentin gap formation (IGW) of 2 etch & rinse and 3 self-etch systems with different degrees of acidity and determined the correlation between the smear layer thickness and interfacial gap formation after 1 day and 6 months water storage; 2) the hybrid layer thickness (HLT) produced by the adhesives applied under different smear layer thicknesses. METHODS AND MATERIALS: Three self-etch adhesives, a mild (Clearfil SE Bond; SE), a moderate (Optibond Solo Plus Self-Etch Primer; SO) and a strong (Tyrian Self Priming Etchant + One Step Plus; TY), and 2 etch & rinse systems (Single Bond; SB and Scotchbond Multi-Purpose Plus; SBMP) were studied. After flat grinding of the occlusal surfaces, 30 molars were sectioned longitudinally in 2 halves. Dentin surfaces with thick and thin smear layers were obtained for each tooth after polishing different sections on 60- and 600-grit SiC paper, respectively. A resin composite (Z250) build-up was made on each tooth section after randomized application of the adhesives. After 24-hour storage in water, resin-dentin bonded sticks (0.8 mm2) were prepared and divided for 1-day and 6-month measurements. The IGW was measured in a stereomicroscope under 400x. SEM micrographs were also made in order to measure the HLT provided by each adhesive. RESULTS: The thickness of the smear layer did not influence the mean gap width (p>0.05). The etch & rinse systems showed the lowest mean IGW in the 1-day group. Their IGW remained unchanged after 6 months. The self-etch systems showed wider initial IGW, which diminished after 6 months water storage, to sizes similar to the etch & rinse systems. The hybrid layer was thicker when bonded to #60 SiC-treated dentin; however, this difference was only statistically different for the 3-step etch & rinse system (p=0.001). The thickest hybrid layers were observed for the 2 etch & rinse adhesive systems and the thinnest for the mild self-etch. A negative and strong correlation between IGW and HLT was observed for the self-etching adhesive systems tested (r=80.2, p=0.01).

  • 23. Nordenram, Gunilla
    et al.
    Davidson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Norlund, Anders
    Rohlin, Madeleine
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Tranæus, Sofia
    Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis2013Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 71, nr 3-4, 937-951 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.

  • 24. Pallesen, Ulla
    et al.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Restoration of traumatized teeth with resin composites2007Inngår i: Textbook and color atlas of traumatic injuries to the teeth, Blackwell munkgaard , 2007, 716-728 s.Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    The primary choice for initial restoratioon of a crown-fractured front tooth has for long time been resin composite material. The restoration can in most cases be performed immediately after injury if there is no sign of periodontal injury and the tooth responds to a sensibility test. The method´s adhesive charater is conservative to toothstructure and with minimal risk of pulpal complication. In addition it offers an esthetic solution to the patient immediately after an injury, which may bring a little joy in a sad situation. The resin composite build-up is often changed or repaired couple of times, before the tooth is resored with a porcelain or porcelain fused to metal crown, at a time when the pulp is out of danger for more invasive preparation. In some cases an endodontictretment is still necessary. After crown therapy a gingival inflammation may occer due to the usual sub-gingival preparations. Afer some years in situ, the crowns may present an esthetic problem due to exposure of un-esthetic crown-margins. The invasive permanent crown restorations are thefore often not sucessful on a longterm scale. On other hand a conservativedirect restoration of an extensively fractured incisor crown with composite may be an exceedingly demanding procedure, involing esthetic acceptability, function and biological aspects and require significant skills, which may influence durability. When are we ready to consider the non-invasive resin composite crown build-up as a permanent restoration? Has its durability improved? Do today´s materials and techniques result in a better prognosis? Where are the problems? In this chapter these matters will be discussed with focus on factors in clinical procedures, which can influence the longevity of the restoration.

  • 25. Pallesen, Ulla
    et al.
    van Dijken, Jan W. V.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Halken, Jette
    Hallonsten, Anna-Lena
    Hoigaard, Ruth
    Longevity of posterior composite restorations in permanent teeth in Public Dental Health Service: A prospective 8 years follow up (vol 41, pg 297, 2013)2013Inngår i: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 41, nr 11, 1132-1133 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 26.
    Persson, Anitha
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Claesson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    van Dijken, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Levels of mutans streptococci and lactobacilli in plaque on aged restorations of an ion-releasing and a universal hybrid composite resin2005Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 63, nr 1, 21-25 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this in vivo study was to evaluate the cariogenic microflora of plaque on aged restorations of a hydroxyl, fluoride, and calcium ion-releasing composite resin (IRCR) (Ariston pHc), and to compare it intra-individually with a universal hybrid composite resin and enamel. Each of 19 subjects received one proximal restoration of the IRCR, one proximal universal hybrid composite resin restoration (CR) and each subject had one non-filled proximal enamel control surface to make intra-individual comparisons possible. To avoid peak ion releases from the materials, aged restorations were studied. Plaque was collected from 57 surfaces using sterile applicator tips. Samples were cultured to determine the numbers of mutans streptococci, lactobacilli, and total microorganisms. The relative numbers for mutans streptococci (% of total bacteria) were: IRCR 0.59%, CR 0.40%, enamel 0.22%. Two outliers were found in the IRCR group. Excluding these outliers resulted in a relative number of 0.33%. Lactobacilli were detected in the plaque from only 9 surfaces and at very low relative proportions for all three surfaces: 0.01%. The enamel surfaces showed the lowest relative numbers of mutans streptococci and lactobacilli, but the differences were not significant. It can be concluded that the ion release of the IRCR did not influence the growth of cariogenic microorganisms in dental plaque.

  • 27.
    Persson, Anitha
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lingström, P
    Bäcklund, T
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Evaluation of a skin reference electrode used for intraoral pH measurements in combination with a microtouch electrode2004Inngår i: Clinical Oral Investigations, ISSN 1432-6981, Vol. 8, nr 3, 172-175 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this in vivo study was to evaluate a skin reference electrode used with the microtouch method for measurements of intraoral pH. Registrations of plaque pH were made in ten healthy subjects before and up to 30 min after a mouth rinse with 10% sucrose. A microtouch electrode (Beetrode) was used in combination with two different half-cell reference electrodes: a skin silver-silver chloride plate or a glass capillary reference electrode. The skin electrode was placed on the subject's forearm in combination with a conductive gel. The glass capillary electrode, together with one of the test subject's fingers, was placed in a beaker with a 3 M KCl solution. High agreement between the two reference systems resulted in almost identical plaque-pH curves (r=0.97). The mean differences between the two systems at the different time points varied between -0.15 and +0.01 pH units, with an overall mean pH difference of 0.03 pH units. It can be concluded that the use of the skin reference electrode may very well replace the traditional reference electrode used in combination with a microtouch electrode for intraoral use.

  • 28.
    Persson, Anitha
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lingström, P
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Effect of a hydroxyl ion-releasing composite resin on plaque acidogenicity2005Inngår i: Caries Research, ISSN 0008-6568, Vol. 39, nr 3, 201-206 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this in vivo study was to evaluate the neutralizing capacity, registered as change of plaque acidogenicity, on aged proximal restorations of an ion-releasing composite resin (IRCR), which releases hydroxyl, calcium, and fluoride ions at low pH. Twenty patients, with a mean age of 63 years (range 43-85), participated. All had one aged proximal IRCR restoration (mean age 15 months) and one nonrestored enamel surface to make an intraindividual comparison possible. The neutralizing effect of the IRCR was evaluated by measuring plaque pH, using the microtouch method, after a mouthrinse with 10% sucrose. The plaque pH measurements were repeated 1.5 years later on the IRCR (mean age 34 months), the enamel surfaces and a universal hybrid composite resin (CR). At both 15 and 34 months, the plaque on the IRCR surfaces showed the least acidogenic potential for the whole 60-min time interval. The largest differences between the IRCR, CR and enamel were found during the first 15 min. At 15 months, the total areas under the plaque pH curve (AUC(5.7) and AUC(6.2)) differed significantly between the IRCR and enamel surfaces for the time periods 0-5 min and 5-15 min. At 34 months, significant differences were found between IRCR and CR at the 0- to 5-min time period. It can be concluded that IRCR restorations countered the plaque pH fall and maintained it at levels where less enamel and dentin demineralization can occur. Copyright (c) 2005 S. Karger AG, Basel.

  • 29.
    Persson, Anitha
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lingström, Peter
    Bergdahl, Maud
    Claesson, Rolf
    Umeå universitet, Medicinsk fakultet, Odontologi.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly2007Inngår i: Gerodontology, ISSN 0734-0664, Vol. 24, nr 2, 98-104 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The effect of multiple daily applications of a prophylactic gel, with buffering substances, on plaque acidogenicity in elderly institutionalised individuals was evaluated. Background: Many elderly suffer from reduced salivary flow, poor oral hygiene and increased levels of cariogenic bacteria and are considered to be at an increased risk for coronal and root caries. Reinforcing the buffering capacity of dental plaque by the addition of substances such as bicarbonate and phosphates may decrease their caries activity. Materials and methods: Fourteen elderly, with subjective dry mouth, were treated for 16-day-periods at random with: (i) Profylin fluoride gel with buffering components; (ii) Profylin fluoride gel without buffering components and (iii) rinsing with water. Applications were made four times a day and each period was followed by a 2-week wash-out period. The plaque pH was registered after a carbohydrate challenge and the following were recorded before and after each test period: stimulated salivary secretion rate, buffer capacity, number Colony Farming Units (CFU) mutans streptococci, lactobacilli and a sample of Candida albicans on oral mucosa. Results: Eleven participants (mean age 76.6 years) fulfilled the study. Changes in plaque pH measurements, when calculated as area under the curve (AUC(6.2) and AUC(5.7)) values (pH x min), before and after each of the three treatments, showed no significant differences. A tendency to a higher plaque acidogenicity and amount of cariogenic microorganisms was found after the gel treatments. C. albicans was found in low levels. Conclusion: Frequent applications of the gel did not result in an improved neutralising effect in the elderly. This may be caused by a combination of several factors, such as the level of oral dryness of the individuals and low solubility, release and retention of the gel substances in plaque. Instead, an increased plaque acidogenicity was noted.

  • 30.
    Persson, Anitha
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Lingström, Peter
    Bergdahl, Maud
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Buffering effect of a prophylactic gel on dental plaque.2006Inngår i: Clinical Oral Investigations, ISSN 1432-6981, Vol. 10, nr 4, 289-295 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate the effect of a new prophylactic gel on plaque pH and plaque fluoride concentration. Twelve participants with normal (n=6, >/=0.7 ml/min) and low (n=6, <0.7 ml/min) stimulated whole salivary secretion rate were included. After 3 days of plaque accumulation, at random the participants were (1) treated with Profylin fluoride gel with buffering components (active gel), (2) treated with Profylin fluoride gel without buffering components (placebo gel), (3) asked to rinse with water, and (4) given no treatment. All test series were followed by rinsing with a nutrition solution; after which registration of plaque pH was performed during 60 min. There were two drop outs with low salivary secretion rate in the water session. The overall least pronounced pH fall was found after the use of the prophylactic gel. Significant differences between the prophylactic gel and the placebo gel were found for the participants with normal secretion rate. Fluoride plaque concentrations evaluated in 12 individuals after (1) application of the active gel, (2) rinsing with 0.2% NaF, and (3) rinsing with water showed significantly higher values after rinsing with the NaF solution. It can be concluded that application of the active gel, particularly in subjects with normal salivary secretion rate, in general, buffered plaque pH to higher levels. Factors like concentration of buffering agent and solubility of the gel need to be further evaluated to improve the effect.

  • 31. Rohlin, Madeleine
    et al.
    Nilner, Krister
    Davidson, Thomas
    Gynther, Goran
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nordenram, Gunilla
    Norlund, Anders
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Tranaeus, Sofia
    Treatment of adult patients with edentulous arches: a systematic review2012Inngår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, 553-567 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. Materials and Methods: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). Results: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. Conclusions: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism.

  • 32.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet.
    Calcium aluminate cement as dental restorative: Mechanical properties and clinical durability2004Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    In 1995, the Swedish government recommended the discontinuation of amalgam as restorative in paediatric dentistry. Because the mercury content in amalgam constitutes an environmental hazard, its use has declined. The use of resin composites is increasing, but the polymerisation shrinkage of the material is still undesirably high, and the handling of uncured resin can cause contact dermatitis. A new restorative material has recently been developed in Sweden as an alternative to amalgam and resin composite: a calcium aluminate cement (CAC). CAC has been marketed as a ceramic direct restorative for posterior restorations (class I, II) and for class V restorations. This thesis evaluates mechanical properties and clinical durability of the calcium aluminate cement when used for class II restorations. Hardness, in vitro wear, flexural strength, flexural modulus, and surface roughness were evaluated. A scanning electron replica method was used for evaluation of the interfacial adaptation to tooth structures in vivo. The durability was studied in a 2-year intra-individually clinical follow-up of class II restorations.

    Major results and conclusions from the studies are as follows:

    • The CAC was a relatively hard material, harder than resin-modified glass ionomer cement but within the range of resin composites. The CAC wore less than resin-modified glass ionomer cement but more than resin composite.

    • Flexural strength of CAC was in the same range as that of zinc phosphate cement and far below that of both resin composite and resin-modified glass ionomer cement. Flexural modulus of CAC was higher than both resin composite and resin-modified glass ionomer cement. The low flexural strength of CAC precludes its use in stress-bearing areas.

    • Surface roughness of CAC could be decreased by several polishing techniques.

    • For CAC restorations, interfacial adaptation was higher to dentin but lower to enamel compared with resin composite restorations. Fractures were found perpendicular to the boarders of all CAC restorations and may indicate expansion of the material.

    • After 2 years of clinical service, the class II CAC restorations showed an unacceptably high failure rate. Material fractures and tooth fractures were the main reasons for failure.

  • 33.
    Sunnegårdh-Grönberg, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Davidson, Thomas
    Gynther, Goran
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Nordenram, Gunilla
    Norlund, Anders
    Rohlin, Madeleine
    Tranaeus, Sofia
    Hultin, Margareta
    Treatment of adult patients with partial edentulism: a systematic review2012Inngår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, 568-581 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this systematic review was to identify and critically appraise published studies of treatment methods used in general practice to rehabilitate adult patients with single tooth loss or partial edentulism, with special emphasis on outcomes reported after at least 5 years of follow-up. Materials and Methods: Three databases were searched using specified indexing terms. Publications were included if the study design, research questions, and sample size satisfied pre-established criteria. Reference lists of relevant publications and systematic reviews were also searched. The quality of evidence was classified according to the GRADE system as high, moderate, low, or very low. Results: The search yielded 7,675 titles, of which 1,130 were read in full text. A final total of 15 publications were deemed eligible for inclusion: 5 of moderate quality and 10 of low quality. The five studies of moderate quality were all related to implant-based treatment. The 5-year survival rates for implant-supported single crowns and prostheses were 91% and 94.7%, respectively (implant survival rates: 98.5% and 94.9%, respectively). The underlying scientific evidence was low in quality. No relevant publications were identified regarding the economic aspects of treatment. Conclusion: Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss or partial edentulism.

  • 34.
    Sunnegårdh-Grönberg, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Dijken, Jan W. V. van
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lindberg, A
    Hörstedt, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Interfacial adaptation of a calcium aluminate cement used in class II cavities, in vivo2004Inngår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 8, nr 2, 75-80 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this in vivo study was to evaluate the interfacial marginal adaptation of a calcium aluminate cement, Doxadent (DD), and to compare it intra-individually with a resin composite, Tetric Ceram/Syntac Single-Component (TC/SS), in Class II cavities. Sixteen Class II box-shaped, enamel-bordered cavities were prepared in eight premolars scheduled to be extracted after 1 month's service for orthodontic reasons. The interfacial marginal adaptation (internal surfaces) of the restorations was evaluated by a quantitative scanning electron microscope analysis using a replica method. DD showed a statistically significant, lower degree of gap-free adaptation to enamel compared with TC/SS: 84% vs. 93%. To dentin, DD showed a significantly better adaptation than TC/SS: 72% vs. 49%. A high frequency of enamel fractures perpendicular to the margins was observed for the DD restorations, which may be explained by an expansion of the calcium-aluminate cement. It can be concluded that DD showed a better adaptation to dentin while TC/SS showed a better adaptation to enamel. The dimensional changes of DD have to be investigated before clinical use can be recommended.

  • 35.
    Sunnegårdh-Grönberg, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistprogrammet. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Peutzfeldt, Anne
    Department of Dental Materials, School of Dentistry, University of Copenhagen, Denmark.
    Dijken, Jan W. V. van
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Flexural strength and modulus of a novel ceramic restorative cement intended for posterior restorations as determined by a three-point bending test2003Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 61, nr 2, 87-92 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to compare a new restorative cement intended for posterior restorations, Doxadent, with other types of tooth-colored materials as regards flexural strength and flexural modulus. The new restorative material consists mainly of calcium aluminate. Four hybrid resin composites, one polyacid-modified resin composite, one resin-modified glass ionomer cement, one conventional glass ionomer cement, one zinc phosphate cement, and an experimental version as well as the marketed version of Doxadent were investigated. Flexural strength and flexural modulus were tested according to ISO standard 4049 and determined after 1 d, 1 week, and 2 weeks. Together with the zinc phosphate cement, Doxadent had the lowest flexural strengths (13-22 MPa). The strongest materials were the resin composites and the polyacid-modified resin composite (83-136 MPa). The highest flexural modulus was found for Doxadent (17-19 GPa). The flexural strength of Doxadent decreased significantly from 1 week to 2 weeks, while flexural modulus remained unchanged. The other materials reacted in different ways to prolonged water storage. It can be concluded that the restorative cement Doxadent had significantly lower flexural strength and significantly higher flexural modulus than today's materials used for direct posterior restorations.

  • 36.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    A 6-year clinical evaluation of Class I poly-acid modified resin composite/resin composite laminate restorations cured with a two-step curing technique.2003Inngår i: Dental Materials, ISSN 0109-5641, Vol. 19, nr 5, 423-428 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Polymerization shrinkage is still one of the main disadvantages of resin composite restorations (RC). Especially in cavities with a high C-factor, debonding can occur. A laminate restoration including a base with a more elastic behavior might result in a better adaptation. The purpose of this study was to evaluate the durability of a combination of two techniques suggested to counter the stress formation in direct RC restorations in cavities with the highest C-factor. METHODS: Each of the 29 patients received one or two pair(s) of Class I restorations. The first restoration was a poly-acid modified resin composite/resin composite (PMRC/RC) sandwich restoration and the second a direct RC restoration. Both restorations, except for the PMRC layer, were placed with oblique layering and two-step curing technique. Ninety restorations, 23 premolar and 67 molars, were evaluated annually with slightly modified USPHS criteria during 6 years. RESULTS: At 6 years, 41 pairs were evaluated. A cumulative failure rate of 2.4% was observed for both the RC and the laminate restorations. One laminate restoration showed non-acceptable color match, but was not replaced and one RC restoration showed non-acceptable marginal adaptation. Two cases of slight postoperative sensitivity were observed in one patient. Three restorations were partially replaced due to primary proximal caries. SIGNIFICANCE: A high durability for and no differences, were observed between both restorative techniques in Class I cavities.

  • 37.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Durability of three simplified adhesive systems in Class V non-carious cervical dentin lesions.2004Inngår i: American Journal of Dentistry, ISSN 0894-8275, Vol. 17, nr 1, 27-82 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To investigate the durability of three simplified systems in Class V non-carious abrasion/erosion lesions. METHODS: 144 non-carious cervical dentin lesions were restored either with Clearfil Liner Bond 2, a 2-step self-etching primer (n = 46), One Coat Bond, a one bottle total-etch system applied with one coat (n = 46), or Prompt-L-Pop, a 1-step self-etching primer ("all-in-one") (n = 52), in 90 individuals. Ninety-eight of the lesions showed sclerotic dentin and 46 were non-sclerotic. Sixty-one were slightly roughened with a diamond bur before conditioning. The restorations were evaluated every 6 months during a 2-year period with slightly modified USPHS criteria. RESULTS: All except three restorations were evaluated over 2 years. The cumulative loss rates for Clearfil Liner Bond 2, One Coat Bond and Prompt-L-Pop were at 6 months: 4.3, 2.2 and 3.9%, at 18 months: 4.3, 10.9 and 15.4% and at 24 months: 8.7, 13.0 and 21.2%, respectively. The cumulative loss rates of the materials in sclerotic lesions (15.7%) versus non-sclerotic lesions (14.0%) were not significanty different. Restorations placed with a diamond bur-roughened lesions showed a loss rate of 14.5%, while for the non-roughened lesions the frequency was 14.8%.

  • 38.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Resin-modified glass ionomer cement and self-cured resin composite luted ceramic inlays. A 5-year clinical evaluation.2003Inngår i: Dental Materials, ISSN 0109-5641, Vol. 19, nr 7, 670-674 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study evaluated IPS Empress ceramic inlays luted with two chemical-cured luting agents, a resin-modified glass ionomer cement (Fuji Plus (F)) and a resin composite (RC) (Panavia 21 (P)). METHODS: Seventy-nine ceramic inlays were placed in Class II cavities in 29 patients. At least two inlays were placed in each patient to compare the luting techniques intra-individually. In each patient half of the inlays were luted with F and the other half with P. The inlays were evaluated clinically, according to modified USPHS criteria (van Dijken, 1986), at baseline, after 6 months, and yearly during 5 years. RESULTS: At 5 years, 71 inlays were evaluated. Two small partial fractures were observed at 3 years (1P, 1F). One inlay showed recurrent root caries at 4 years (P). Four inlays, two in each group showed non-acceptable color match (2P, 2F). Small defects were observed in 4 inlays (2P, 2F). A slight ditching of the cement margins was observed in both luting groups but did not seem to increase during the second half of the evaluation. No significant difference in durability was observed between the two luting agents. SIGNIFICANCE: IPS Empress inlays luted with the chemical-cured RC and the resin-modified glass ionomer cement functioned satisfactory during the 5 years follow-up.

  • 39.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Retention of a resin-modified glass ionomer adhesive in non-carious cervical lesions. A 6-year follow-up.2005Inngår i: Journal of Dentistry, ISSN 0300-5712, Vol. 33, nr 7, 541-547 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to evaluate the clinical retention of a new resin-modified glass ionomer cement based adhesive combined with a hybrid resin composite or a poly-acid modified resin composite in non-carious cervical lesions during a 6-year period. METHODS: The resin-modified glass ionomer adhesive (Fuji Bond LC), was placed in 73 cervical lesions, 36 with a universal hybrid resin composite (Tetric Ceram) and 37 with a poly-acid modified resin composite (Hytac). Fifty-one in lesions with sclerotic dentin and 22 in non-sclerotic ones. Of the sclerotic lesions 38 were slightly roughened with a diamond bur before conditioning. The restorations were evaluated with slightly modified USPHS criteria every six months during a 6-year period. RESULTS: All except six restorations were evaluated during the 6 years. Twelve (17.9%) were lost, four Tetric Ceram (11.8%) and eight Hytac (24.2%) (p<0.05). Four were found in non-sclerotic lesions (20.0%) and eight in sclerotic lesions (17.0%). The differences between the sclerotic and non-sclerotic and the roughened and non-roughened lesions were not significant. CONCLUSIONS: The resin-modified glass adhesive showed a superior clinical retention combined with the resin composite material, with an annual failure rate of 2%.

  • 40.
    van Dijken, Jan
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    A four-year clinical evaluation of a highly filled hybrid resin composite in posterior cavities.2005Inngår i: The Journal of Adhesive Dentistry, ISSN 1461-5185, Vol. 7, nr 4, 343-349 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate the four-year performance of a highly filled resin composite in Class II and Class I cavities. MATERIALS AND METHODS: Each of 63 participants received at least one pair of restorations of the same size: one resin composite (Tetric Ceram) and one calcium aluminate cement. Seventy-one pairs were placed. The restorations were evaluated clinically according to slightly modified USPHS criteria at baseline, after 6 months, 1, 2, 3, and 4 years. At 3 years, the calcium aluminate cement material showed an inacceptable clinical cumulative failure frequency of 57% and its evaluation was discontinued. RESULTS: Postoperative sensitivity was reported for 5 restorations (2 resin composite, 3 calcium aluminate cement). At 4 years, a cumulative failure frequency of 7.5% was observed for the resin composite material. Reasons for failure were partial material fracture (2), cusp fracture (2) and endodontic treatment (1). CONCLUSION: An annual failure rate of 1.9% for the resin composite material provided a good clinical performance during the 4-year period, which fulfills the ADA criteria for posterior resin composite materials.

  • 41.
    van Dijken, Jan
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Fiber-reinforced packable resin composites in Class II cavities2006Inngår i: Journal of Dentistry, ISSN 0300-5712, Vol. 34, nr 10, 763-769 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate the 6-year performance of two glass fiber-reinforced packable resin composites in Class II cavities. METHODS: Sixty-three participants received 87 medium to large, cervically dentin bordered, Class II restorations of two fiber-reinforced resin composites, 42 Nulite F (N) and 45 Alert (A). The restorations were evaluated clinically, according to slightly modified USPHS criteria at baseline, after 6 months, and yearly during 6 years. RESULTS: At 2 years the cumulative failure frequencies for N and A were 4.8% and 2.2%, respectively, which increased at 6 years to 25.0% and 12.8%. Reasons for failure were secondary caries, material and cusp fracture. The majority of the failures occurred after 3 years. Secondary caries occurred between 4 and 6 years. The incorporation of fibers resulted in very rough surface characteristics. CONCLUSIONS: A rather high failure rate was observed for one of the fiber-reinforced resin composites, while the other fulfilled the ADA criteria. The occurrence of most failures after 3 years indicated the necessity of long-term evaluations of new materials.

  • 42.
    van Dijken, Jan
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Sörensson, Ebba
    Umeå universitet, Medicinsk fakultet, Odontologi.
    Clinical Bonding of a Single-step Self-etching Adhesive in Noncarious Cervical Lesions2007Inngår i: The journal of adhesive dentistry, ISSN 1461-5185, Vol. 9, nr 2, 241-243 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to evaluate the clinical retention to dentin of a single-step self-etching adhesive system.

    Materials and Methods: A total of 133 Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a polyacid-modified resin composite (Dyract AP) in noncarious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and then every 6 months during a 2- year follow-up. Dentin bonding efficacy was determined by the percentage of lost restorations.

    Results: During the 2 years, 130 restorations could be evaluated. The cumulative loss rate at 2 years was 7.7%, with no significant differences between the two restorative materials. The self-etching adhesive fulfilled the 18-month full acceptance ADA criteria.

    Conclusion: The single-step self-etching adhesive showed acceptable clinical retention rates to dentin surfaces during the evaluation period independent of restorative material used.

  • 43.
    van Dijken, Jan
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Sunnegårdh-Grönlund, Karin
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Lindberg, Anders
    Clinical long-term retention of etch-and-rinse and self-etch adhesive systems in non-carious cervical lesions A 13 years evaluation2007Inngår i: Dental Materials, ISSN 0109-5641, Vol. 23, nr 9, 1101-1107 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. METHODS: A total of 337 Class V restorations of three three-step etch-and-rinse, one two-step etch-and-rinse and three self-etch adhesive systems were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and then every 6 months during a 13 years follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. RESULTS: During the 13 years, 275 restorations could be evaluated. The cumulative loss rate at 13 years was 60.3%, with significant different failures rates for the different systems varying between 26.3 and 94.7%. Three materials fulfilled the ADA 18 months full acceptance criteria. Three systems showed already at 18 months or earlier catastrophical debonding rates. The annual failure rates for the three-step etch-and-rinse systems were: Allbond 2 4.1%, Clearfil LB 2.0% and Denthesive 7.3%. For the two-step etch-and-rinse Gluma 2000 6.5%, and for the self-etch systems ART 3.2%, Denthesive 2 5.7% and PUB 3 4.5% CONCLUSION: A continuous degradation of the resin-dentin bond was observed for all bonding systems during the follow-up expressed by the increasing loss rates. A wide variation of dentin bonding effectiveness was seen between the systems independent to adhesion strategy.

  • 44.
    van Dijken, Jan W. V.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    A 6-year prospective evaluation of a one-step HEMA-free self-etching adhesive in Class II restorations2013Inngår i: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 29, nr 11, 1116-1122 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The aim of this study was to evaluate the clinical effectiveness of a one-step HEMA-free self-etching adhesive (SEA) placed with a micro-fine hybrid resin composite in Class II restorations. The restorations were compared intraindividually with 2-step HEMA containing SEA-giomer restorations. Material and methods. Fifty-four patients with at least one pair of two similar Class II cavities participated (30 men, 24 women; mean age 57.1 yrs). A total of 115 Class II composite restorations were placed with (1) a one step HEMA-free adhesive and a micro-fine hybrid resin composite (Gbond/Gradia Direct: 60; GG) and (2) a 2-step HEMA-containing SEA and a giomer (FL Bond/Beautifil: SS; FB). Each participant received in a randomized way at least one restoration with each of the experimental materials. The restorations were evaluated at baseline and yearly during a 6 year followup using modified USPHS criteria. Results. During the 6 years, 111 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Fourteen failed restorations (12.6%) were observed during the follow up, 5 GG (8.5%; 4 premolar and 1 molar teeth) and 9 FB (17.7%; 1 premolar and 8 molar teeth) (p <0.05). Annual failure rate at 6 years were 1.4% for GB and 3.0% for FB. Main reasons of failure were bulk fracture of resin composite for FB and tooth fracture for GB. Signcance. The HEMA-free SEA-hybrid RC restorations showed good clinical durability in Class II cavities after 6 years. The HEMA-containing SEA-giomer restorations showed a rather high failure frequency. (C) 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  • 45.
    van Dijken, Jan W. V.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Pallesen, Ulla
    A Randomized 10-year Prospective Follow-up of Class II Nanohybrid and Conventional Hybrid Resin Composite Restorations2014Inngår i: Journal of Adhesive Dentistry, ISSN 1461-5185, Vol. 16, nr 6, 585-592 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To evaluate the 10-year durability of a nanohybrid resin composite in Class II restorations in a randomized controlled intraindividual comparison with its conventional hybrid resin composite predecessor. Materials and Methods: Each of 52 participants received at least two Class II restorations that were as similar as possible. The cavities were chosen at random to be restored with a nanohybrid resin composite (Excite/Tetric EvoCeram (TEC); n = 61) and a conventional hybrid (Excite/Tetric Ceram (TC); n = 61). The restorations were evaluated with slightly modified USPHS criteria at baseline and then annually for 10 years. The overall performance of the experimental restorations was tested after intra-individual comparison and their ranking was tested using Friedman's two-way ANOVA. The level of significance was set at 5%. Results: Four patient drop-outs with 8 restorations (4TEC, 4TC) were registered during the follow-up. A prediction of the caries risk showed that 16 of the evaluated 52 patients were considered as high risk patients. In total, 22 restorations, 11 TEC (3 premolars, 8 molars) and 11 TC (3 premolars, 8 molars) restorations failed during the 10 years. The main reason for failure was secondary caries (50%). 63% of the recurrent caries lesions were found in high caries risk participants. The overall success rate at 10 years was 80.7%, with an annual failure rate of 1.9%. No statistically significant difference was found in the overall survival rate between the two investigated resin composites. Conclusion: The nanohybrid and the conventional hybrid resin composite showed good clinical effectiveness in extensive Class II restorations during the 10-year study.

  • 46.
    van Dijken, Jan W. V.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Pallesen, Ulla
    Univ Copenhagen, Fac Hlth Sci, Inst Odontol, DK-1168 Copenhagen, Denmark.
    A randomized controlled three year evaluation of "bulk-filled" posterior resin restorations based onstress decreasing resin technology2014Inngår i: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 30, nr 9, E245-E251 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The objective of this randomized controlled prospective clinical trial was to evaluate the efficacy of a flowable resin composite (SDR) bulk fill technique in posterior restorations and to compare it intraindividually with a conventional 2 mm resin composite curing technique in a 3-year follow up. Materials and methods. Thirty-eight pairs Class II and 15 pairs Class I restorations were placed in 38 patients with a mean age of 55.3 years (range 32-87). Each patient received at random at least two, as similar as possible, Class II or Class I restorations of two restorative techniques. In all cavities a single step self-etch adhesive (Xeno V) was applied. In one of the cavities of each pair, a flowable resin composite (SDR) was placed, in bulk increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with a nano-hybrid resin composite (Ceram X mono) layer. In the second cavity, the hybrid resin composite was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 3 years. Caries risk and parafunctional habits of the participants were estimated. Results. After three years, 76 Class II and 28 Class I restorations could be observed. One molar resin composite-only tooth showed post-operative sensitivity during 3 weeks for temperature changes and occlusal forces. Two failed Class II molar restorations in the resin composite-only group were observed during the first year, one cusp fracture and one resin composite fracture. An annual failure rate of 1.3% was found for the resin composite only restorations and of 0% in the bulk-filled restorations (n.s.). Ten participants were estimated as having high caries risk and eleven showed active bruxing habits. Significance. The 4 mm bulk-fill technique with the flowable resin composite SDR showed highly clinical effectiveness, which was comparable during the 3-year follow-up with the 2 mm resin composite layering technique. 

  • 47.
    van Dijken, Jan W. V.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Pallesen, Ulla
    Randomized 3-year Clinical Evaluation of Class I and II Posterior Resin Restorations Placed with a Bulk-fill Resin Composite and a One-step Self-etching Adhesive2015Inngår i: The Journal of Adhesive Dentistry, ISSN 1461-5185, Vol. 17, nr 1, 81-88 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations. Materials and Methods: Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients (mean age 52.4 years). Each patient received at least two extended Class I or Class II restorations that were as similar as possible. In all cavities, a one-step self-etching adhesive (XenoV+) was applied. One of the cavities of each pair was randomly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with an ormocer-based nanohybrid resin composite (Ceram X mono+). In the other cavity, only the resin composite CeramX mono+ was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years. Caries risk and bruxing habits of the participants were estimated.

    Results: No post-operative sensitivity was reported. At the 3-year follow-up, 196 restorations - 74 Class I and 122 Class II - were evaluated. Seven restorations failed (3.6%), 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations, all of which were Class II. The main reason for failure was tooth fracture, followed by resin composite fracture. The annual failure rate (AFR) for all restorations (Class I and II) was 1.2% for the bulk filled restorations and 1.0% for the resin composite-only restorations (p > 0.05). For the Class II restorations, the AFR was 2.2% and 1.6%, respectively. Conclusion: The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up.

  • 48. van Dijken, Jan Wv
    et al.
    Sunnegårdh-Grönberg, Karin
    Umeå universitet, Medicinsk fakultet, Odontologi. Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistutbildning.
    A calcium aluminate cement as restorative material in Class V cavities.2004Inngår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 28, nr 3, 111-8 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Recently a calcium aluminate cement (Doxa Certex, Uppsala, Sweden) has been developed intended to be used as direct restorative filling material.The aim of this study was to evaluate intra-individually the experimental calcium aluminate cement (CAC) and a resin composite (RC;Tetric Ceram) in Class V restorations. Each of 46 participants received at least one pair of restorations of the same size, one CAC and one RC.The 119 restorations were evaluated clinically, according to slightly modified USPHS criteria, at baseline, after 6 mths, 1, 2 and 3 yrs. None of the patients reported post-operative sensitivity. At 3 yrs, 111 restorations were evaluated. Significantly better clinical durability was shown for RC.Two non-acceptable CAC restorations were observed at 6 months, 3 CAC and 1 RC at 12 months, 5 CAC and 2 RC at 24 months, and 8 CAC at 36 months.This resulted in a cumulative failure frequency of 32% for the CAC material and 5% for the RC material. Main reason for failure for the CAC was total or partial lost restorations, and for the RC lost restorations. It can be concluded that the CAC showed a non-acceptable clinical failure rate for Class V restorations.

  • 49.
    Wikén Albertsson, Katarina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Persson, Anitha
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    van Dijken, Jan WV
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandhygienistutbildning.
    Effect of essential oils containing and alcohol-free chlorhexidine mouthrinses on cariogenic micro-organisms in human saliva2013Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, nr 3-4, 883-891 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The aim of this study was to evaluate the effect on mutans streptococci and lactobacilli in saliva of mouthrinsing with essential oils and an alcohol-free chlorhexidine. Materials and method. Twenty healthy volunteers (mean age 59 years) participated in the double-blind randomized cross-over study. Three mouthrinses were used in 16 days rinsing periods in addition to their regular mechanical oral hygiene: a solution with essential oils (EO; Listerine), a solution with alcohol-free chlorhexidine (CHX; Paroex) and water (negative control). The mouthrinse periods were separated by 3-month washout periods. At days 0 (baseline) and 17 (end) of each mouthrinse period, paraffin stimulated whole saliva was collected in order to analyse CFU/ml saliva of mutans streptococci and lactobacilli. Results. Only the CHX rinse showed a significant difference for CFU mutans streptococci between baseline and end (p = 0.004). The CFU mutans streptococci at the end of the rinse periods showed statistically significant differences between CHX vs EO (p = 0.039) and CHX vs water (p = 0.022). The difference in CFU lactobacilli between baseline and end was significant for CHX (p = 0.031), but not for the other rinses. No statistically significant differences for lactobacilli were found at the end of the rinse periods between the mouthrinses. Conclusion. A significant reduction in amount of cariogenic bacteria in saliva was observed after 16 days of alcohol-free chlorhexidine mouthrinse but not after the essential oils rinse. The high number of participant's not changing to a bacterial class with a reduced number of micro-organisms showed that both rinses had little clinical significance as a caries preventing treatment method, which can decrease the number of CFU cariogenic micro-organisms.

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