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  • 1.
    Adern, Bengt
    et al.
    Mälar Hosp, Dept Stomatognath Physiol, Dent Care Ctr, Eskilstuna, Sweden.
    Minston, Ava
    Inst Odontol, Dept Stomatognath Physiol, Jönköping, Sweden;Postgrad Dent Educ Ctr, Orofacial Pain & Jaw Funct, Klostergatan 26,Box 1126, S-70111 Örebro, Sweden.
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Postgrad Dent Educ Ctr, Orofacial Pain & Jaw Funct, Klostergatan 26,Box 1126, S-70111 Örebro, Sweden; Malmö Univ, Fac Odontol, Malmö, Sweden.
    Self-reportance of temporomandibular disorders in adult patients attending general dental practice in Sweden from 2011 to 20132018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 7, p. 530-534Article in journal (Refereed)
    Abstract [en]

    Objectives: The study aim was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) and acceptance or nonacceptance of such disorders in adult patients attending all public dental health services in the County of Sormland, Sweden, during a 3-year period, 2011-2013.

    Methods: Two questions were asked about TMD and the voluntary mouth-opening capacity was measured. The results were registered in a score 0-3. The registration was completed with a question about each patient's acceptance or nonacceptance of their condition.

    Results: More than 73,000 registrations of the TMD condition were performed in general dental clinics from 2011 to 2013. The mean prevalence of a TMD score of 1-3 was 5% and was consistent over these years. Seventy percent of these patients were women. The peak prevalence of TMD was registered in patients aged 30-45years (38%), and the frequency declined in older age groups. Reduced voluntary mouth-opening capacity (<= 35 mm) was found in less than 2% of the participants. About one-fifth of the patients with a TMD-score of 1-3 did not accept their condition and wanted professional care. The frequency of nonacceptance of the condition increased with the severity of symptom score: 15%, 27%, and 49% for scores 1, 2, and 3, respectively.

    Conclusions: This study shows that the prevalence of self-reported TMD in adult patients was consistent from 2011 to 2013 and should be considered as a public health issue in Sweden. Patients with more severe TMD pain symptoms wanted care more frequent. The annual clinical calibrations should be continued to achieve an acceptable level of registration.

  • 2. Adern, Bengt
    et al.
    Stenvinkel, Christer
    Sahlqvist, Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Tegelberg, Ake
    Prevalence of temporomandibular dysfunction and pain in adult general practice patients2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 585-590Article in journal (Refereed)
    Abstract [en]

    Objective. To analyse the prevalence of temporomandibular disorders and related pain (TMD-pain) among adult recall patients in general dental practice. Materials and methods. From November 2006 to September 2008, all adults attending a Swedish Public Dental Service (PDS) clinic for recall examination were asked two standardized questions about temporomandibular pain and dysfunction. Mouth-opening capacity was measured. The responses to the questions and mouth-opening capacity were combined to give a TMD-pain score, on a scale of 0-3. The patients' acceptance of their TMD condition was also noted. Results. The subjects comprised 2837 adults (53% females, 47% men). Of the total sample, 4.9% reported a TMD-pain score of 1-3. The gender difference was significant: women predominated (p < 0.003). Forty-three per cent of those with TMD-pain scores of 1-3 (36% men, 47% women) considered that the condition warranted treatment, especially those registering a pain score (significant difference between pain and dysfunction groups, p < 0.000). Conclusions. The TMD-pain score shows promise as a useful instrument for detecting and recording TMD-pain. The prevalence of TMD disclosed in the study is high enough to be considered a public health concern. Most of the subjects with lower scores on the TMD-pain scale accepted their condition as not severe enough to require treatment.

  • 3.
    Ballo, Ahmed
    et al.
    Gothenburg University.
    Omar, Omar
    Gothenburg Univerity.
    Xia, Wei
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Palmquist, Anders
    Gothenburg University.
    Dental Implant Surfaces Implant Dentistry - A Rapidly Evolving Practic: Physicochemical Properties, Biological Performance, and Trends2011In: Implant Dentistry: A Rapidly Evolving Practice / [ed] Ilser Turkyilmaz, INTECH , 2011Chapter in book (Refereed)
  • 4.
    Bayat, Jari Taghavi
    et al.
    Karolinska Inst, Dept Dent Med, Div Orthodont, SE-14104 Huddinge, Sweden.
    Huggare, Jan
    Karolinska Inst, Dept Dent Med, Div Orthodont, SE-14104 Huddinge, Sweden.
    Mohlin, Bengt
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Orthodont, Gothenburg, Sweden.
    Akrami, Nazar
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Determinants of orthodontic treatment need and demand: a cross-sectional path model study2017In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 39, no 1, p. 85-91Article in journal (Refereed)
    Abstract [en]

    Objectives: To put forward a model predicting orthodontic treatment need and demand. Furthermore, to explore how much of the variance in treatment demand could be explained by a set of self-assessed measures, and how these measures relate to professionally assessed treatment need. Subjects and methods: One hundred and fifty adolescents, aged 13 years, completed a questionnaire which included a set of self-assessed measures dealing with self-esteem, such as dental and global self-esteem, various aspects of malocclusion, such as perceived malocclusion and perceived functional limitation, and treatment demand. Treatment need was assessed by Dental Health Component of the Index of Orthodontic Treatment Need grading. Path analysis was used to examine the relations between the measures and if they could predict treatment need and demand. Results: The measures proved to be reliable and inter-correlated. Path analysis revealed that the proposed model had good fit to the data, providing a test of the unique effect of all included measures on treatment need and demand. The model explained 33% of the variance in treatment demand and 22% of the variance in treatment need. Limitations: The specific age group could affect the generalizability of the findings. Moreover, although showing good fit to data, the final model is based on a combination of theoretical reasoning and semi-explorative approach. Conclusions: The proposed model displays the unique effect of each included measure on treatment need and demand, explaining a large proportion of the variance in perceived treatment demand and professionally assessed treatment need. The model would hopefully lead to improved and more cost-efficient predictions of treatment need and demand.

  • 5. Bazargani, Farhan
    et al.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Bondemark, Lars
    Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: a systematic review2013In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 83, no 6, p. 1074-1082Article, review/survey (Refereed)
    Abstract [en]

    Objective:

    To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging.

    Materials and Methods:

    The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies.

    Results:

    The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive.

    Conclusions:

    CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.

  • 6.
    Bazargani, Farhan
    et al.
    Senior Consultant, Postgraduate Dental Education Center, Department of Orthodontics, Örebro, Sweden.
    Jönson-Ring, Ingrid
    Senior Consultant, Public Dental Service, Uppsala County Council, Department of Orthodontics, Uppsala, Sweden.
    Nevéus, Tryggve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rapid maxillary expansion in therapy-resistant enuretic children: An orthodontic perspective.2016In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 86, no 3, p. 481-486Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:   To evaluate whether rapid maxillary expansion (RME) could reduce the frequency of nocturnal enuresis (NE) in children and whether a placebo effect could be ruled out.

    METHODS:   Thirty-four subjects, 29 boys and five girls with mean age of 10.7 ± 1.8 years suffering from primary NE, were recruited. All subjects were nonresponders to the first-line antienuretic treatment and therefore were classified as "therapy resistant." To rule out a placebo effect of the RME appliance, all children were first treated with a passive appliance for 4 weeks. Rhinomanometry (RM), acoustic rhinometry (AR), polysomnographic registration, and study casts were made at different time points.

    RESULTS:   One child experienced severe discomfort from the RME appliance and immediately withdrew from the study. Following RME, the long-term cure rate after 1 year was 60%. The RM and AR measurements at baseline and directly after RME showed a significant increase in nasal volume and nasal airflow, and there was a statistically significant correlation between reduction in enuresis and increase in nasal volume. Six months postretention, a 100% relapse of the dental overexpansion could be noted.

    CONCLUSIONS:   RME has a curative effect in some children with NE, which could be connected to the positive influence of RME on the sleep architecture. Normal transverse occlusion does not seem to be a contraindication for moderate maxillary expansion in attempts to cure NE in children.

  • 7. Brage, M.
    et al.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Johansson, A.
    Humoral immune response to Aggregatibacter actinomycetemcomitans leukotoxin2011In: Journal of Periodontal Research, ISSN 0022-3484, E-ISSN 1600-0765, Vol. 46, no 2, p. 170-175Article in journal (Refereed)
    Abstract [en]

    Background and Objective: Periodontal disease is an inflammatory condition caused by bacterial infections that result in loss of the tooth supporting tissue. The periodontal pathogens produce virulence factors with capacity to affect the host immune response. Aggregatibacter actinomycetemcomitans is a periodontal pathogen that produces a leukotoxin that specifically affects human leukocytes. The aims of the present study were to examine the presence and function of systemic antibodies to the leukotoxin. Material and Methods: One hundred and ninety-seven middle-aged (57 +/- 5 years) Swedes with well-documented periodontal status and medical factors related to cardiovascular diseases were studied. These data have been published previously. The serum samples were examined for the presence of leukotoxin antibodies by western blot and the capacity to neutralize leukotoxicity in an activity assay with leukotoxin and cultured leukemic cells. Results: The results showed a high prevalence (57%) of antibodies against A. actinomycetemcomitans leukotoxin in the analyzed population. These antibodies were correlated with leukotoxin neutralizing capacity as well as with the ELISA titers of A. actinomycetemcomitans-specific IgA and IgG. In addition, high levels of leukotoxin antibodies were correlated with increasing age, but not with periodontal disease parameters or cardiovascular risk factors. Conclusion: Systemic antibodies against A. actionmycetemcomitans leukotoxin were common in this adult Swedish population. These antibodies might contribute to limit the systemic effects of the infection.

  • 8.
    Brattberg, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Långvarig smärta: epidemiologi, analys och behandling1995In: Tandläkartidningen, ISSN 0039-6982, Vol. 87, no 11-12, p. 727-Article in journal (Refereed)
  • 9. Dasmah, Amir
    et al.
    Rasmusson, Carl
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Rasmusson, Lars
    Simultaneous or Delayed Placement of Surface Modified and Fluoridated Dental Implants into Autogenous Block Bone Grafts: A Histologic and Biomechanical Study in the Rabbit2015In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 17, no 2, p. 395-401Article in journal (Refereed)
    Abstract [en]

    Background: A delayed approach is recommended for reconstruction of the jaws with autogenous bone grafts and dental implants. Experimental studies have shown stronger bone tissue responses to surface modified implants than to nonmodified ones. AimThe aim of the study was to evaluate bone integration and stability of surface modified and fluoridated implants when placed with fresh or healed autogenous bone grafts. Material and Methods: Six rabbits were used in this study. Each right rabbit tibia (control) received an autogenous bone graft, harvested from the calvarium. Eight weeks later, a second graft was harvested from the other side of the calvarium and placed on the left tibia (test) with an implant. Another implant was installed in the healed graft of the right tibia. TiO2-blasted and fluoridated OsseoSpeed(TM) implants (Astra Tech AB, Molndal, Sweden), 3.5mm in diameter and 9mm long, were used. After additional 8 weeks, the rabbits were sacrificed and the implants were removed en bloc for light-microscopic analysis. Bone-to-implant contact (BIC) was registered as well as the amount of bone filling a rectangle indicating a region of interest (ROI). Resonance frequency analysis (RFA) was conducted both at the time of surgery and at the end of the experiment. ResultsThere were no statistically significant differences either in BIC or ROI between the test and control sides. RFA showed higher implant stability for the control side at the time of the surgery, but the difference had leveled out at the time of the sacrifice. Conclusion: The present study showed similar bone tissue responses and stability for surface modified and fluoridated implants after 8 weeks of healing in fresh or healed autogenous bone grafts.

  • 10.
    Edman, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Centrum Oral Rehabilitering, Folktandvården Dalarna.
    Epidemiological studies of Oral Health, development and influencing factors in the county of Dalarna, Sweden 1983–20132016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to describe the development of oral health and possible associations with socioeconomic and socio-behavioural factors, in an adult population over a period of 30 years. A further aim is to describe attitudes to, and demands of dental care, and the impact of oral conditions on quality of life.

    The study sample consisted of 787-1158 individuals, aged between 35-85 years, randomly selected from Dalarna’s population register in 1982, 2002, 2007 and 2012. The studies were carried out in 1983, 2003, 2008 and 2013, and the participants responded to a questionnaire and a clinical examination of oral status.

    There has been a substantial improvement in oral status in regard to the mean number of teeth, intact teeth, and less removable dentures over this period of 30 years. The proportion of individuals with alveolar bone loss decreased significantly between 1983 and 2008, but increased significantly between 2008 and 2013. Smoking was the overall strongest factor associated with alveolar bone loss, after adjustment for socioeconomic and socio-behaviour factors, age and number of teeth. Calculus, visible on radiographs, increased significantly between 2003 and 2013. The proportion of individuals with manifest caries declined significantly between 1983 and 2008, but seems to level out between 2008 and 2013. Socioeconomic and socio-behaviour factors were significantly associated with manifest caries. Preventive treatment, meeting the same caregiver as on previous visits, and information about treatment cost was reported to a significantly lower degree as important in 2013, compared with 2003 and 2008, and booking time for treatment was reported as more difficult in 2013, compared with earlier years. Regular recalls was reported as less important in 2013, compared with 2008. A third of the respondents reported oral impact on daily performance and irregular dental visits, limited economy for dental care, less than 20 remaining teeth, manifest caries and temporomandibular disorder were significantly associated with oral impact on daily performance.

    List of papers
    1. Comparison of oral status in an adult population 35-75 year of age in the county of Dalarna, Sweden in 1983 and 2008
    Open this publication in new window or tab >>Comparison of oral status in an adult population 35-75 year of age in the county of Dalarna, Sweden in 1983 and 2008
    Show others...
    2012 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 36, no 2, p. 61-70Article in journal (Refereed) Published
    Abstract [en]

    The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50,65 and 75 answered a questionnaire and were also clinically and radiographically examined. The number of edentulous individuals decreased from 15% in 1983 to 3 % in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15 % in 1983 to 2 % in 2008. Individuals with moderate periodontitis decreased from 45 % in 1983 to 16 % in 2008. Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated. This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

    Keywords
    Periodontal disease, dental caries, epidemiology, edentulousness, removable dentures
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-213103 (URN)000327048700001 ()22876393 (PubMedID)
    Available from: 2013-12-19 Created: 2013-12-18 Last updated: 2017-12-06Bibliographically approved
    2. Trends over 30years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors: based on epidemiological surveys in Sweden 1983-2013
    Open this publication in new window or tab >>Trends over 30years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors: based on epidemiological surveys in Sweden 1983-2013
    Show others...
    2015 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 4, p. 283-291Article in journal (Refereed) Published
    Abstract [en]

    ObjectiveEpidemiological studies of the prevalence of periodontitis over an extended time using the same methodology to investigate and classify periodontitis are sparse in the literature. Smoking and socio-economic factors have been proven to increase the risk for periodontal disease. The objective of this study was to investigate 30-year time trends, using the same methodology to classify the prevalence and severity in alveolar bone loss (ABL) and to investigate the influence of tobacco and socio-economic factors. MethodsFour cross-sectional epidemiological studies in an adult population were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008 and 2013. Random samples of 787-1133 individuals aged 35-85 who answered a questionnaire about tobacco use and socio-economic factors were radiographically and clinically examined. A number of teeth, ABL and calculus visible on radiographs were registered. The severity of ABL as detected on radiographs was classified into no bone loss, moderate or severe. ResultsThe prevalence of moderate ABL decreased from 45% in 1983 to 16% in 2008, but increased to 33% in 2013 (P<0.05). The prevalence of severe ABL remained the same from 1983 (7%) to 2013 (6%). Calculus visible on radiographs increased from 22% in 2008 to 32% in 2013 (P<0.05). Socio-economic factors had limited impact on the severity of ABL. ConclusionModerate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.

    Keywords
    epidemiology, periodontal disease, smoking
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-265798 (URN)10.1111/idh.12164 (DOI)000362736400009 ()26215672 (PubMedID)
    Available from: 2015-11-03 Created: 2015-11-03 Last updated: 2017-12-01Bibliographically approved
    3. Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population: Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden
    Open this publication in new window or tab >>Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population: Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden
    2016 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 5, p. 385-392Article in journal (Refereed) Published
    Abstract [en]

    Objective. The aim of this study was to investigate the prevalence of dental caries in an adult population using four different cross-sectional studies over a 30-year period and to assess its possible associations with socio-economic and socio-behavioral factors. Materials and methods. Four cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008, and 2013. Random samples of 1012–2243 individuals, aged 20–85 years, who answered a questionnaire about socio-economic and socio-behavioral factors, were radiographically and clinically examined. Results. The proportion of individuals with at least one decayed surface (DS) was 58% in 1983 and significantly lower, 34% in 2008 (p<0.05) and 33% in 2013; the mean number of DS was 2.0 in 1983 and 1.1 in 2013 in the age group 35 to 75 (p < 0.05). In the age group 85, the mean number of DS was 1.2 in 2008 and 2.4 in 2013. Adjusted for age and number of teeth, irregular dental visits, limited financial resources for dental care, smoking, education below university, male gender, daily medication, and single living were positively and statistically associated with manifest caries. Conclusion. The declining trend in the prevalence of manifest caries seems to be broken. In the oldest age group mean number of DS was higher in 2013 compared with 2008, indicating a possible beginning of an increase.  This needs special attention as this group increases in the population, retaining natural teeth high up in age. Manifest caries was found to be associated with socio-economic and socio-behavioral factors.

    Keywords
    Dental caries, epidemiology, socio-behavioral, socio-economic, tobacco
    National Category
    Dentistry
    Research subject
    Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-280078 (URN)10.3109/00016357.2016.1163733 (DOI)000377809300012 ()27215270 (PubMedID)
    Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2017-11-30Bibliographically approved
    4. Attitudes and demands of dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013
    Open this publication in new window or tab >>Attitudes and demands of dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013
    (English)Article in journal (Other academic) Submitted
    Abstract [en]

    Objective. The aim of the present study was to investigate attitudes to, and demands of dental care, and to assess possible associations with socioeconomic and clinical variables over a period of ten years. A further aim was to investigate the association between OHRQoL assessed by OIDP, and socioeconomic, dental care habits, smoking and oral status. Materials and methods. Three cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1542–2244 individuals, aged 30-85 years, who answered a questionnaire about socio-economic, socio-behavioral factors, oral health-related quality of life were radiographically and clinically examined. Results. The importance of preventive treatment, regular recalls, meeting the same caregiver as on previous visits, and information on treatment cost have become less important. Difficulty in booking treatment time was reported by 17% in 2013, compared with 11% in 2003 and 12% in 2008 (p<0.05). In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (p<0.05). In individuals with temporomandibular disorder (TMD) and manifest caries, information on treatment cost was important, while prevention became less important (p<0.05). Oral impact on daily performance (OIDP) was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and TMD reported OIDP to a significantly higher degree, compared to orally healthy individuals. Conclusion. Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years, and difficulty in booking treatment time was reported more frequently in 2013. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, less than 20 remaining teeth, TMD and manifest caries.

    Keywords
    Dental caries, epidemiology, socio-behavioral, socioeconomic, tobacco, OHRQoL
    National Category
    Dentistry
    Research subject
    Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-280127 (URN)
    Available from: 2016-03-08 Created: 2016-03-08 Last updated: 2016-04-12Bibliographically approved
  • 11.
    Edman, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Publ Dent Hlth Serv, Ctr Oral Rehabil, Falun, Sweden.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Hlth Serv, Gävleborg, Sweden.
    Nordstrom, Birgitta
    Ctr Publ Dent Serv, Falun, Sweden.
    Öhrn, Kerstin
    Sch Educ Hlth & Social Studies, Falun, Sweden.
    Attitudes to dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 20132018In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 16, no 2, p. 257-266Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate attitudes to dental care, and to assess possible associations with socio‐economic and clinical variables over a period of ten years, and to investigate the association between OHRQoL assessed by oral impact on daily performance (OIDP), and socio‐economic, dental care habits, smoking and oral status.

    Materials and methods: Cross‐sectional studies performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1,107‐1,115 dentate individuals, aged 30‐85 years, who answered a questionnaire and who were radiographically and clinically examined were included.

    Results: The importance of preventive treatment, regular recalls and meeting the same caregiver as on previous visits became less important. In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (P<.05). In individuals with manifest caries, information on treatment cost was important, while prevention became less important (P<.05). OIDP was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and temporomandibular disorders (TMD) reported OIDP to a significantly higher degree, compared to orally healthy individuals.

    Conclusion: Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, individuals with less than 20 remaining teeth, TMD and manifest caries.

  • 12.
    Edman, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Nordström, Birgitta
    Public Dental service Falun.
    Öhrn, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Attitudes and demands of dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013Article in journal (Other academic)
    Abstract [en]

    Objective. The aim of the present study was to investigate attitudes to, and demands of dental care, and to assess possible associations with socioeconomic and clinical variables over a period of ten years. A further aim was to investigate the association between OHRQoL assessed by OIDP, and socioeconomic, dental care habits, smoking and oral status. Materials and methods. Three cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1542–2244 individuals, aged 30-85 years, who answered a questionnaire about socio-economic, socio-behavioral factors, oral health-related quality of life were radiographically and clinically examined. Results. The importance of preventive treatment, regular recalls, meeting the same caregiver as on previous visits, and information on treatment cost have become less important. Difficulty in booking treatment time was reported by 17% in 2013, compared with 11% in 2003 and 12% in 2008 (p<0.05). In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (p<0.05). In individuals with temporomandibular disorder (TMD) and manifest caries, information on treatment cost was important, while prevention became less important (p<0.05). Oral impact on daily performance (OIDP) was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and TMD reported OIDP to a significantly higher degree, compared to orally healthy individuals. Conclusion. Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years, and difficulty in booking treatment time was reported more frequently in 2013. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, less than 20 remaining teeth, TMD and manifest caries.

  • 13.
    Edman, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Ctr Oral Rehabil, S-79127 Falun, Sweden..
    Ohrn, K.
    Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden..
    Nordstrom, B.
    Adm Ctr Publ Dent Serv, Falun, Sweden..
    Holmlund, A.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Natl Dent Serv Gavleborg, Gavle, Sweden.;Uppsala Univ Reg Gavleborg, Clin Res Ctr, Gavle, Sweden..
    Hellberg, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Clin Res Ctr, Falun, Sweden..
    Trends over 30years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors: based on epidemiological surveys in Sweden 1983-20132015In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 4, p. 283-291Article in journal (Refereed)
    Abstract [en]

    ObjectiveEpidemiological studies of the prevalence of periodontitis over an extended time using the same methodology to investigate and classify periodontitis are sparse in the literature. Smoking and socio-economic factors have been proven to increase the risk for periodontal disease. The objective of this study was to investigate 30-year time trends, using the same methodology to classify the prevalence and severity in alveolar bone loss (ABL) and to investigate the influence of tobacco and socio-economic factors. MethodsFour cross-sectional epidemiological studies in an adult population were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008 and 2013. Random samples of 787-1133 individuals aged 35-85 who answered a questionnaire about tobacco use and socio-economic factors were radiographically and clinically examined. A number of teeth, ABL and calculus visible on radiographs were registered. The severity of ABL as detected on radiographs was classified into no bone loss, moderate or severe. ResultsThe prevalence of moderate ABL decreased from 45% in 1983 to 16% in 2008, but increased to 33% in 2013 (P<0.05). The prevalence of severe ABL remained the same from 1983 (7%) to 2013 (6%). Calculus visible on radiographs increased from 22% in 2008 to 32% in 2013 (P<0.05). Socio-economic factors had limited impact on the severity of ABL. ConclusionModerate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.

  • 14.
    Edman, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Öhrn, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Nordström, Birgitta
    Public Dental Service, Falun.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population: Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 5, p. 385-392Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this study was to investigate the prevalence of dental caries in an adult population using four different cross-sectional studies over a 30-year period and to assess its possible associations with socio-economic and socio-behavioral factors. Materials and methods. Four cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008, and 2013. Random samples of 1012–2243 individuals, aged 20–85 years, who answered a questionnaire about socio-economic and socio-behavioral factors, were radiographically and clinically examined. Results. The proportion of individuals with at least one decayed surface (DS) was 58% in 1983 and significantly lower, 34% in 2008 (p<0.05) and 33% in 2013; the mean number of DS was 2.0 in 1983 and 1.1 in 2013 in the age group 35 to 75 (p < 0.05). In the age group 85, the mean number of DS was 1.2 in 2008 and 2.4 in 2013. Adjusted for age and number of teeth, irregular dental visits, limited financial resources for dental care, smoking, education below university, male gender, daily medication, and single living were positively and statistically associated with manifest caries. Conclusion. The declining trend in the prevalence of manifest caries seems to be broken. In the oldest age group mean number of DS was higher in 2013 compared with 2008, indicating a possible beginning of an increase.  This needs special attention as this group increases in the population, retaining natural teeth high up in age. Manifest caries was found to be associated with socio-economic and socio-behavioral factors.

  • 15.
    Ek, Rebecca Klingvall
    et al.
    Mid Sweden Univ, Sports Tech Res Ctr, SE-83125 Ostersund, Sweden..
    Hong, Jaan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Backstrom, Mikael
    Mid Sweden Univ, Sports Tech Res Ctr, SE-83125 Ostersund, Sweden..
    Rannar, Lars-Erik
    Mid Sweden Univ, Sports Tech Res Ctr, SE-83125 Ostersund, Sweden..
    Micro- to Macroroughness of Additively Manufactured Titanium Implants in Terms of Coagulation and Contact Activation2017In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 32, no 3, p. 565-574Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to evaluate how as-built electron beam melting (EBM) surface properties affect the onset of blood coagulation. The properties of EBM-manufactured implant surfaces for placement have, until now, remained largely unexplored in literature. Implants with conventional designs and custom-made implants have been manufactured using EBM technology and later placed into the human body. Many of the conventional implants used today, such as dental implants, display modified surfaces to optimize bone ingrowth, whereas custom-made implants, by and large, have machined surfaces. However, titanium in itself demonstrates good material properties for the purpose of bone ingrowth. Materials and Methods: Specimens manufactured using EBM were selected according to their surface roughness and process parameters. EBM-produced specimens, conventional machined titanium surfaces, as well as PVC surfaces for control were evaluated using the slide chamber model. Results: A significant increase in activation was found, in all factors evaluated, between the machined samples and EBM-manufactured samples. The results show that EBM-manufactured implants with as-built surfaces augment the thrombogenic properties. Conclusion: EBM that uses Ti6Al4V powder appears to be a good manufacturing solution for load-bearing implants with bone anchorage. The as-built surfaces can be used "as is" for direct bone contact, although any surface treatment available for conventional implants can be performed on EBM-manufactured implants with a conventional design.

  • 16.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Satisfaction with orthodontic treatment outcome2014In: The Angle orthodontist, ISSN 1945-7103, Vol. 84, no 4, p. 581-587Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To examine factors associated with treatment outcome satisfaction in a group of adolescent patients.

    Materials andMethods:

    One hundred and twenty patients (60 girls and 60 boys; mean age, 14.3 years; standard deviation [SD], 1.73 years) were consecutively recruited. The inclusion criteria for all patients were as follows: adolescents with a permanent dentition in need of orthodontic treatment and a treatment plan involving extractions (two or four premolars) followed by fixed appliances in both jaws. Questionnaire 1, concerning treatment motivation and expectations, was assessed prior to treatment start. Questionnaire 2 was assessed after active treatment and included questions about satisfaction with treatment outcome, quality of care and attention, and perceived pain and discomfort during active treatment.

    Results:

    One hundred and ten patients completed the trial (54 boys and 56 girls; mean age, 16.9 years; SD, 1.78 years). Median values for satisfaction with treatment outcome were generally high. There was a clear correlation (P ≤ .001) between satisfaction with treatment outcome and patients' perception of how well they had been informed and cared for during treatment. Pain and discomfort during treatment also strongly affected treatment satisfaction. Sex, treatment time, and Peer Assessment Rating index pre- and posttreatment as well as expectations for future treatment showed no correlation with treatment satisfaction.

    Conclusions:

    Care and attention was the variable showing the highest correlation with satisfaction with treatment outcome. Patients' perceptions of pain and discomfort during treatment had an overall negative correlation with treatment satisfaction. Satisfaction with treatment outcome is a complex issue and requires further exploration in future research.

  • 17.
    Feldmann, Ingalill
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dental Health Service, Orthodont Clinic, Gävle.
    Bazargani, Farhan
    Postgrad Dent Educ Ctr, Dept Orthodont, Örebro; Malmö Univ.
    Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: A randomized controlled trial2017In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 87, no 3, p. 391-396Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone-borne rapid maxillary expansion (RME) appliances. Materials and Methods: Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. Results: Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0-82) and 3.5 (0-78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0-90) and 2.0 (0-71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. Conclusions: Both tooth-borne and tooth-bone-borne RME were generally well tolerated by the patients during the first week of treatment.

  • 18.
    Feldmann, Ingalill
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Bondemark, Lars
    Department of Orthodontics, Malmö University, Malmö, Sweden.
    The significance of anchorage in orthodontics2015In: Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion: Contemporary applications of orthodontic implants, miniscrew implantsand mini plates / [ed] Moschos A. Papadopoulos, Elsevier, 2015, p. 22-28Chapter in book (Refereed)
  • 19.
    Feldmann, Ingalill
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    List, Thomas
    Bondemark, Lars
    Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial.2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 1, p. 102-8Article in journal (Refereed)
    Abstract [en]

    The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients' perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.

  • 20.
    Feldmann, Ingalill
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    List, Thomas
    Feldmann, Hartmut
    Bondemark, Lars
    Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 4, p. 578-585Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate and compare perceived pain intensity and discomfort between the placement of two different orthodontic anchoring units designed for osseointegration and premolar extraction in adolescent patients. MATERIALS AND METHODS: A total of 120 adolescent patients (60 girls and 60 boys) were recruited and randomized into three groups. Group A underwent installation of an onplant, group B installation of an Orthosystem implant, and group C premolar extraction. Pain intensity and discomfort, analgesic consumption, limitations in daily activities, and functional jaw impairment were evaluated the first evening and one week after the intervention. RESULTS: Pain intensity following surgical installation of an onplant was comparable to the pain intensity experienced after premolar extraction, but there was significantly less pain after surgical installation of an Orthosystem implant compared to installation of an onplant (P = .002) or premolar extraction (P = .007). The protective, vacuum-formed stent caused great discomfort, even more discomfort than the surgical sites following installation of the onplant or the Orthosystem implant. CONCLUSION: The Orthosystem implant was better tolerated than the onplant in terms of pain intensity, discomfort, and analgesic consumption and was, therefore, the anchorage system of choice in a short-term perspective.

  • 21. Fellows, Jeffrey L.
    et al.
    Gordan, Valeria V.
    Gilbert, Gregg H.
    Rindal, D. Brad
    Qvist, Vibeke
    Litaker, Mark S.
    Benjamin, Paul
    Flink, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Pihlstrom, Daniel J.
    Johnson, Neil
    Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: Multiple-regression modeling of observational clinical data from The National Dental PBRN2014In: American Journal of Dentistry, ISSN 0894-8275, Vol. 27, no 2, p. 91-99Article in journal (Refereed)
    Abstract [en]

    Purpose: Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods: Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results: Network dentists from five regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (P< 0.05) by patient age and race/ethnicity, dentists' use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (P< 0.05) by dentist race/ethnicity, network region, and practice type.

  • 22.
    Flink, Håkan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Publ Dent Hlth Vastmanland, Publ Dent Clin Sala, Vasteras, Sweden..
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Malmo Univ, Fac Odontol, Malmo, Sweden..
    Arnetz, Judy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Michigan State Univ, Dept Family Med, E Lansing, MI 48824 USA..
    Birkhed, Dowen
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Cariol, Gothenburg, Sweden..
    Patient-reported outcomes of caries prophylaxis among Swedish caries active adults in a long-term perspective2016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 1, p. 101-110Article in journal (Refereed)
    Abstract [sv]

    Syftet med studien var att undersöka patientrapporterade utfallsmått för kariesprofylax och jämföra dem med tidigare dokumenterade journaldata. Ett frågeformulär skickades till 134 kariesaktiva (CA) och 40 kariesinaktiva (CI) vuxna patienter vid folktandvården i Sala, och besvarades av 69%. Frågorna gällde patientupplevelser relaterat till kariesprofylax avseende: 1) behandlingar och rekommendationer vid tandvårdsbesök, 2) genomförd egenvård, och 3) upp-levd effekt och förhoppningar om önskat resultat. Svaren analyserades i förhållande till kliniska data, som hämtades retrospektivt ur patienternas tandvårdsjournaler. Medelvärdet för upp-följningstiden var > 16 år. Information angående karies och profylax (p=0.01) samt rekommen-dationer om egenvård (p=0.04) hade oftare givits till CA än till CI-gruppen. Kompletterande undersökningar och rekommendation av extra riskprofylax var mer vanligt förekommande hos CA-gruppen (p<0.001). CA-patienterna hade även mer ofta gjort extra ansträngningar för att undvika karies genom att ändra matvanor (p<0.001), förbättra munhygien (p=0.04) och använt extra fluor (p=0.001). I CA-gruppen upplevde 60% att de trots sina extra profylaxinsatser inte blivit kariesfria, och 40% var inte nöjda med resultatet. De flesta patienter (>90%) satte dock stort värde till kariesprofylax som förväntades att kunna minska antalet kariesangrepp. Patientrapporterade utfallsmått för kariesprofylax överensstämde med journaldata. Både tandläkare och de kariesaktiva patienterna i denna studie var medvetna om behovet av extra profylax. De kariesaktiva patienterna hade genomfört mer extra profylax, men många hade ej upplevt att de blev kariesfria.

  • 23. Franco-Tabares, Sebastian
    et al.
    Stenport, Victoria Franke
    Hjalmarsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Prosthodont Dent Mat Sci, Medicinaregatan 12F, SE-40530 Gothenburg, Sweden.
    Johansson, Carina B
    Limited Effect of Cement Material on Stress Distribution of a Monolithic Translucent Zirconia Crown: A Three-Dimensional Finite Element Analysis.2018In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 31, no 1, p. 67-70Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The literature shows that the performance of densely sintered zirconia single crowns seems to be unaffected by the cement material. The purpose of this study was to evaluate the effects of various cement materials on the stress distribution in a monolithic translucent zirconia crown.

    MATERIALS AND METHODS: A crown-cement-dentin complex was modeled. Six cements were evaluated: zinc phosphate, glass-ionomer, resin-modified glass-ionomer, dual-cure resin, calcium aluminate-based, and a theoretical or conceptual cement with mechanical properties close to those of dentin (ie, monoblock cement).

    RESULTS: While varying stress concentrations were found within the cements, the stress concentrations in the crown and dentin were consistent irrespective of cement material.

    CONCLUSION: Within the limitations of this study, it can be concluded that cement material had a negligible effect on stress distribution in the monolithic zirconia crown.

  • 24.
    Ganzer, Niels
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Gävle.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Gävle.
    Bondemark, Lars
    Malmo Univ, Fac Odontol, Dept Orthodont, Malmo, Sweden..
    Letters From Our Readers: Re: Response to: Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial. The Angle Orthodontist; 2016; 86: 891-899.2017In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 87, no 3, p. 483-484Article in journal (Other academic)
  • 25.
    Ganzer, Niels
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Box 57, SE-80102 Gavle, Sweden..
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Dent Serv Reg Gavleborg, Dept Orthodont, Box 57, SE-80102 Gavle, Sweden..
    Bondemark, Lars
    Malmo Univ, Fac Odontol, Dept Orthodont, Malmo, Sweden..
    Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial2016In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 86, no 6, p. 891-899Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate and compare the experience of pain and discomfort between insertion of miniscrews and premolar extractions in adolescent patients. Materials and Methods: A total of 80 adolescents were recruited and randomized into groups A and B. Both groups were treated with extraction of the upper first premolars and fixed appliance. Beyond the fixed appliance, patients in group A received anchorage reinforcement with miniscrews. Miniscrews were inserted buccally between the second premolar and first molar when space closure started. Space closure was performed as en masse retraction with immediate loading by 150-g coil springs. Pain, discomfort, impact on daily activities, and functional jaw impairment were assessed with patient-reported questionnaires. Questionnaires were filled in at baseline, the evening after tooth extraction, 1 week after tooth extraction, the evening after screw placement, and 1 week after screw placement. Results: Patients reported significantly lower levels of pain (P < .001) and discomfort (P = .012) after screw placement compared with premolar extractions. The ability to drink (P = .035) and the ability to take a big bite (P < .001) were also significantly less disturbed in the evening after screw placement. During the first week after screw placement, the impact on leisure time activities was significantly lower (P = .015) compared with premolar extractions. Conclusion: The use of miniscrews in adolescents can be recommended from a pain and discomfort perspective.

  • 26. Gottlieb, Assaf
    et al.
    Daneshjou, Roxana
    DeGorter, M
    Bourgeois, S
    Svensson, PJ
    Wadelius, Mia
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Deloukas, P
    Montgomery, SB
    Altman, RB
    Cohort-specific imputation of gene expression improves prediction of warfarin dose for African Americans2017In: Genome Medicine, ISSN 1756-994X, E-ISSN 1756-994X, Vol. 9, no 1, article id 98Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Genome-wide association studies are useful for discovering genotype-phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into "gene level" effects.

    METHODS: Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions. Here, we introduce a method that improves dose prediction by integrating tissue-specific gene expression. In particular, we use drug pathways and expression quantitative trait loci knowledge to impute gene expression-on the assumption that differential expression of key pathway genes may impact dose requirement. We focus on 116 genes from the pharmacokinetic and pharmacodynamic pathways of warfarin within training and validation sets comprising both European and African-descent individuals.

    RESULTS: We build gene-tissue signatures associated with warfarin dose in a cohort-specific manner and identify a signature of 11 gene-tissue pairs that significantly augments the International Warfarin Pharmacogenetics Consortium dosage-prediction algorithm in both populations.

    CONCLUSIONS: Our results demonstrate that imputed expression can improve dose prediction and bridge population-specific compositions.

    MATLAB code is available at https://github.com/assafgo/warfarin-cohort.

  • 27.
    Grybauskas, Simonas
    et al.
    Vilnius Implantol Ctr, LT-01205 Vilnius, Lithuania..
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Razukevicius, Dainius
    Kaunas Implantol Ctr, Kalnieciu 247, Kaunas, Lithuania..
    Kharazmi, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Cent Hosp Vasteras, Dept Oral & Maxillofacial Surg, SE-72189 Vasteras, Sweden..
    Entrapment of soft tissue: a new technique to improve the stability of malar augmentation with hydroxyapatite2016In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 54, no 7, p. 826-827Article in journal (Refereed)
  • 28.
    Hallman, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Strandkvist, Tomas
    Bone replacement following dental trauma prior to implant surgery: present status2009In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 25, no 1, p. 2-11Article, review/survey (Refereed)
    Abstract [en]

    Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has increased. Today, a substantial number of biomaterials are available on the market, but only a few are well documented. The user should be aware that these biomaterials have different properties: resorbable or non-resorbable, time of resorption and resorption mechanism. The purpose of this review is to describe the function of various bone substitutes and indications for their use in reconstructive implant surgery and to give an overview of the current situation.

  • 29. Hedlund, Camilla
    et al.
    Feldmann, Ingalill
    Success rate, costs and long-term stability of treatment with activator/headgear combinations2016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 1, p. 67-77Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to evaluate treatment outcome with activator-headgear combinations carried out by general dental practitioners, overall costs, long-term stability and patients' satisfaction with treatment outcome. Patients who were recommended to start treatment in 2006 were included in this study (n=97). Inclusion criteria were:Class II Division with at least half a cusp width distal molar relationship, overjet >= 6 mm and presence of dental records. Data were collected, pre-treatment, post-treatment and 3 years after treatment for those with favorable outcome. Patients at follow-up completed a questionnaire about satisfaction with treatment outcome, perceived pain and discomfort during treatment, and subjective need for additional treatment. Eighty-five patients were analyzed, 52 boys and 33 girls (mean age 11.2 years SD 1.39). Thirty-five patients had successful treatment outcome,15 partially successful and 35 had an unsuccessful outcome. Total costs for all 85 patients amounted to SEK 1405000 including both direct and indirect costs. Thirty-eight patients participated in the 3-year follow-up. Treatment outcomes were then categorized as successful in 28 patients, partially successful in 9 patients and patient was judged as unsuccessful. Median values on VAS (0-100) for overall satisfaction with treatment and treatment outcome were high, 78 and 84 respectively. Median value for perceived pain and discomfort during treatment was 42. Just over half of the patients had a favorable treatment outcome. Patients with favorable outcome were stable over time and satisfied with treatment.

  • 30.
    Hjalmarsson, Lars
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Gheisarifar, Maryam
    Jemt, Torsten
    A systematic review of survival of single implants as presented in longitudinal studies with a follow-up of at least 10 years2016In: European Journal of Oral Implantology, ISSN 1756-2406, E-ISSN 1756-2414, Vol. 9, no 2, p. S155-S162Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Placement of single implants is one of the most common applications for implant treatment. Millions of patients have been treated worldwide with osseointegrated implants and many of these patients are treated at a young age with a long expected remaining lifetime. Therefore longterm evidence for such treatment is important.

    AIM: To report patient treatment, implant and implant-supported single crown survival over at least a 10-year period of follow-up.

    MATERIAL AND METHODS: After reviewing long-term publications, included by Jung et al (2012), a complementary PubMed search was performed using the same search strategy for the period September 2011 to November 2014. Data on implant and single implant crown treatment survival were compiled from included studies.

    RESULTS: Four new publications were identified from the 731 new titles. They were added to an earlier list of five manuscripts by Jung et al (2012) , which were already included. Accordingly, nine publications formed the database of available long-term evaluations. The database consisted of 421 patients altogether, provided with 527 implants and 522 single crowns. From the 367 patients that were followed-up for at least 10 years (87%), altogether 502 implants were still in function at the completion of the studies (95.3%), supporting 432 original and 33 remade single implant crowns. Based on patient level and implant level data, implant survival reached 93.8% and 95.0%, respectively. The corresponding survival rate for original crown restorations was 89.5%.

    CONCLUSIONS: Single implant treatment is a predicable treatment over a 10-year period of time, with no indication of obvious changes in implant failure rate between 5 and 10 years. However, replacement of new single crowns must be considered during the follow-up as part of regular maintenance. Compared to the number of treated patients worldwide, the available numbers with a follow-up of 10 years was low.

  • 31.
    Holmlund, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Holm, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Lind, Lars
    Number of Teeth as a Predictor of Cardiovascular Mortality in a Cohort of 7,674 Subjects Followed for 12 Years2010In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 81, no 6, p. 870-876Article in journal (Refereed)
    Abstract [en]

    Background: That oral health is related to the development of different cardiovascular disorders is reported in a number of studies. This study investigates if different parameters of oral health are associated with future mortality in different cardiovascular disorders in a dose-dependent manner. Methods: A total of 7,674 subjects (3,300 males and 4,374 females; age range 20 to 89 years) received a dental examination by specialists in periodontology between the years 1976 and 2002. Number of remaining teeth, severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were evaluated in relation to cause of death. Results: During a median follow-up period of 12 years, 629 of the subjects died. For 299 subjects the cause of mortality was cardiovascular disease (CVD); 167 of these subjects died from coronary heart disease (CHD); 83 died from stroke; and 49 died from aortic aneurysm or congestive heart failure. The causes of death for the remaining 330 subjects were other than CVD. After adjustment for age, gender, and smoking, number of remaining teeth predicted in a dose-dependent manner all-cause mortality and mortality in CVD and in CHD (P <0.0001 for all), but not mortality from stroke (P = 0.15). Cox regression analysis revealed a seven-fold increased risk for mortality from CHD in subjects with <10 teeth compared to those with >25 teeth. Severity of periodontal disease, number of deepened periodontal pockets, and bleeding on probing were not related to mortality in a dose-dependent manner after adjustment for confounders. Conclusion: This fairly large, prospective study with a long follow-up period presents for the first time a dose-dependent relationship between number of teeth and both all-cause and CVD mortality, indicating a link between oral health and CVD, and that the number of teeth is a proper indicator for oral health in this respect.

  • 32.
    Hong, Jaan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Kurt, Seta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Clinical Immunology.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    A Hydrophilic Dental Implant Surface Exhibit Thrombogenic Properties In Vitro2013In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 15, no 1, p. 105-112Article in journal (Refereed)
    Abstract [en]

    Background:

    Surface modifications of dental implants have gained attention during several years and the thrombotic response from blood components with these materials has become more important during recent years.

    Purpose:

    The aims of this study were to evaluate the thrombogenic response of whole blood, in contact with clinically used dental surfaces, Sandblasted Large grit Acid etched titanium (SLA) and Sandblasted Large grit Acid etched, and chemically modified titanium with hydrophilic properties (SLActive).

    Methods:

    An in vitro slide chamber model, furnished with heparin, was used in which whole blood came in contact with slides of the test surfaces. After incubation (60-minute rotation at 22 rpm in a 37°C water bath), blood was mixed with ethylenediaminetetraacetic acid (EDTA) or citrate, further centrifuged at +4°C. Finally, plasma was collected pending analysis.

    Results:

    Whole blood in contact with surfaces resulted in significantly higher binding of platelets to the hydrophilic surface, accompanied by a significant increase of contact activation of the coagulation cascade. In addition, the platelet activation showed a similar pattern with a significant elevated release of β-TG from platelet granule.

    Conclusions:

    The conclusion that can be drawn from the results in our study is that the hydrophilic modification seems to augment the thrombogenic properties of titanium with implications for healing into bone of, that is titanium dental implants.

  • 33.
    Horie, Masafumi
    et al.
    Univ Tokyo, Grad Sch Med, Dept Resp Med, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan.;Univ Tokyo, Div Hlth Serv Promot, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan.;RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan..
    Yamaguchi, Yoko
    Nihon Univ, Sch Dent, Dept Biochem, Chiyoda Ku, 1-8-13 Kanda Surugadai, Tokyo 1018310, Japan.;Nihon Univ, Sch Dent, Dent Res Ctr, Div Funct Morphol,Chiyoda Ku, 1-8-13 Kanda Surugadai, Tokyo 1018310, Japan..
    Saito, Akira
    Univ Tokyo, Grad Sch Med, Dept Resp Med, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan.;Univ Tokyo, Div Hlth Serv Promot, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan..
    Nagase, Takahide
    Univ Tokyo, Grad Sch Med, Dept Resp Med, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan..
    Lizio, Marina
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan..
    Itoh, Masayoshi
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Prevent Med & Diag Innovat Program, 2-1 Hirosawa, Wako, Saitama 3510198, Japan..
    Kawaji, Hideya
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Prevent Med & Diag Innovat Program, 2-1 Hirosawa, Wako, Saitama 3510198, Japan..
    Lassmann, Timo
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan..
    Carninci, Piero
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan..
    Forrest, Alistair R. R.
    RIKEN Ctr Life Sci Technol, DGT, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;Univ Western Australia, Harry Perkins Inst Med Res, QEII Med Ctr, Nedlands, WA, Australia.;Univ Western Australia, Med Res Ctr, Nedlands, WA, Australia..
    Hayashizaki, Yoshihide
    RIKEN Yokohama Inst, Omics Sci Ctr, Tsurumi Ku, 1-7-22 Suehiro Cho, Yokohama, Kanagawa 2300045, Japan.;RIKEN Prevent Med & Diag Innovat Program, 2-1 Hirosawa, Wako, Saitama 3510198, Japan..
    Suzutani, Tatsuo
    Fukushima Med Univ, Sch Med, Dept Microbiol, 1 Hikariga Oka, Fukushima, Fukushima 9601295, Japan..
    Kappert, Kai
    Charite, Inst Lab Med Clin Chem & Pathobiochem, Cardiovasc Res Ctr, Berlin, Germany..
    Micke, Patrick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Ohshima, Mitsuhiro
    Ohu Univ, Sch Pharmaceut Sci, Dept Biochem, Misumido 31-1, Koriyama, Fukushima 9638611, Japan..
    Transcriptome analysis of periodontitis-associated fibroblasts by CAGE sequencing identified DLX5 and RUNX2 long variant as novel regulators involved in periodontitis2016In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 6, article id 33666Article in journal (Refereed)
    Abstract [en]

    Periodontitis is affecting over half of the adult population, and represents a major public health problem. Previously, we isolated a subset of gingival fibroblasts (GFs) from periodontitis patients, designated as periodontitis-associated fibroblasts (PAFs), which were highly capable of collagen degradation. To elucidate their molecular profiles, GFs isolated form healthy and periodontitis-affected gingival tissues were analyzed by CAGE-seq and integrated with the FANTOM5 atlas. GFs from healthy gingival tissues displayed distinctive patterns of CAGE profiles as compared to fibroblasts from other organ sites and characterized by specific expression of developmentally important transcription factors such as BARX1, PAX9, LHX8, and DLX5. In addition, a novel long non-coding RNA associated with LHX8 was described. Furthermore, we identified DLX5 regulating expression of the long variant of RUNX2 transcript, which was specifically active in GFs but not in their periodontitis-affected counterparts. Knockdown of these factors in GFs resulted in altered expression of extracellular matrix (ECM) components. These results indicate activation of DLX5 and RUNX2 via its distal promoter represents a unique feature of GFs, and is important for ECM regulation. Down-regulation of these transcription factors in PAFs could be associated with their property to degrade collagen, which may impact on the process of periodontitis.

  • 34. Isacsson, Göran
    et al.
    Nohlert, Eva
    Fransson, Anette M C
    Bornefalk-Hermansson, Anna
    Wiman Eriksson, Eva
    Ortlieb, Eva
    Trepp, Livia
    Avdelius, Anna
    Sturebrand, Magnus
    Fodor, Clara
    List, Thomas
    Schumann, Mohamad
    Tegelberg, Åke
    Use of bibloc and monobloc oral appliances in obstructive sleep apnoea: a multicentre, randomized, blinded, parallel-group equivalence trial.2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210Article in journal (Refereed)
    Abstract [en]

    Background: The clinical benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that the two types of appliances are equally effective in treating OSA.

    Objective: To compare the efficacy of monobloc versus bibloc appliances in a short-term perspective.

    Patients and methods: In this multicentre, randomized, blinded, controlled, parallel-group equivalence trial, patients with OSA were randomly assigned to use either a bibloc or a monobloc appliance. One-night respiratory polygraphy without respiratory support was performed at baseline, and participants were re-examined with the appliance in place at short-term follow-up. The primary outcome was the change in the apnoea-hypopnea index (AHI). An independent person prepared a randomization list and sealed envelopes. Evaluating dentist and the biomedical analysts who evaluated the polygraphy were blinded to the choice of therapy.

    Results: Of 302 patients, 146 were randomly assigned to use the bibloc and 156 the monobloc device; 123 and 139 patients, respectively, were analysed as per protocol. The mean changes in AHI were -13.8 (95% confidence interval -16.1 to -11.5) in the bibloc group and -12.5 (-14.8 to -10.3) in the monobloc group. The difference of -1.3 (-4.5 to 1.9) was significant within the equivalence interval (P = 0.011; the greater of the two P values) and was confirmed by the intention-to-treat analysis (P = 0.001). The adverse events were of mild character and were experienced by similar percentages of patients in both groups (39 and 40 per cent for the bibloc and monobloc group, respectively).

    Limitations: The study shows short-term results with a median time from commencing treatment to the evaluation visit of 56 days and long-term data on efficacy and harm are needed to be fully conclusive.

    Conclusion: In a short-term perspective, both appliances were equivalent in terms of their positive effects for treating OSA and caused adverse events of similar magnitude.

    Trial registration: Registered with ClinicalTrials.gov (#NCT02148510).

  • 35.
    Isehed, Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Umea Univ, Dept Odontol Mol Periodontol, Umea, Sweden.; Gavle Cty Hosp, Dept Periodontol, Gavle, Sweden.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Cty Hosp, Dept Periodontol, Gavle, Sweden.
    Renvert, Stefan
    Kristianstad Univ, Dept Hlth Sci, Kristianstad, Sweden.;Trinity Coll Dublin, Sch Dent Sci, Dublin, Ireland.;Blekinge Inst Technol, Karlskrona, Sweden..
    Svenson, Björn
    Postgrad Dent Educ Ctr, Dept Oral Radiol, Orebro, Sweden.;Univ Orebro, Sch Hlth & Med Sci, Fac Med & Hlth, Orebro, Sweden..
    Johansson, Ingegerd
    Umea Univ, Dept Odontol Cariol, Umea, Sweden..
    Lundberg, Pernilla
    Umea Univ, Dept Odontol Mol Periodontol, Umea, Sweden..
    Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis. A randomized controlled trial2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 10, p. 863-873Article in journal (Refereed)
    Abstract [en]

    Objective: This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri-implantitis alone or in combination with enamel matrix derivative (EMD).

    Methods: Twenty-six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD. Bone level (BL) change was primary outcome and secondary outcomes were changes in pocket depth (PD), plaque, pus, bleeding and the microbiota of the peri-implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months.

    Results: In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD, the number of osseous walls in the peri-implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram-/anaerobic microbial flora and presence of bleeding and pus, with a cross-validated predictive capacity (Q(2)) of 36.4%. Similar, but statistically non-significant, trends were seen for BL, PD, plaque, pus and bleeding in univariate analysis.

    Conclusion: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.

  • 36.
    Isehed, Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Umea Univ, Dept Mol Periodontol, Umea, Sweden;Gavle Cty Hosp, Publ Dent Hlth Cty Council Gavleborg, Dept Periodontol, Gavle, Sweden.
    Svenson, Bjorn
    Orebro Univ, Postgrad Dent Educ Ctr, Orebro, Sweden;Orebro Univ, Sch Hlth & Med Sci, Orebro, Sweden.
    Lundberg, Pernilla
    Umea Univ, Dept Mol Periodontol, Umea, Sweden;Gavle Cty Hosp, Publ Dent Hlth Cty Council Gavleborg, Dept Periodontol, Gavle, Sweden.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Surgical treatment of peri-implantitis using enamel matrix derivative, an RCT: 3-and 5-year follow-up2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 6, p. 744-753Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the clinical and radiographic outcomes 3 and 5years after the surgical treatment of peri-implantitis per se or in combination with an enamel matrix derivative (EMD). Materials and Methods: At baseline, 29 patients were randomized to surgical treatment with adjunctive EMD or no EMD. One year after the surgical treatment of peri-implantitis, 25 patients remained eligible for survival analyses at the 3- and 5-year follow-up. The primary outcomes were implant loss and bone level (BL) change measured on radiographs, and the secondary outcomes, bleeding on probing, pus and plaque at each implant were analysed in 18 and 14 patients at the 3- and 5-year follow-up, respectively. Results: After exclusion of four patients who discontinued the study, at the 3-year follow-up, 13 (100%) implants survived in the EMD group, and 10 of 12 (83%) in the non-EMD group. At the 5-year follow-up, 11 of 13 (85%) implants in the EMD group and nine of 12 (75%) in the non-EMD group survived. In multivariate modelling, BL changes and EMD treatment were positively associated with implant survival. Similarly, the same trend was seen in univariate analysis. Conclusions: An exploratory analysis suggests that adjunctive EMD is positively associated with implant survival up to 5 years, but larger studies are needed.

  • 37.
    Jabbari, Fatima
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Wiklander, Laila
    Eastman Inst, Publ Dent Hlth Serv, Specialist Dent Care, Dept Oral & Maxillofacial Radiol, Stockholm, Sweden..
    Reiser, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Uppsala Cty Council, Publ Dent Hlth, Dept Orthodont, Uppsala, Sweden..
    Hakelius, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Nowinski, Daniel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up2018In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 55, no 2, p. 173-179Article in journal (Refereed)
    Abstract [en]

    Objective: To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height. Design: Observational follow-up study. Setting: Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden. Patients: 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate. Interventions: Clinical examination, CBCT, and occlusal radiographs. Main Outcome Measurements: Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up. Results: The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total (P = .045) and by subgroup with dental restoration (P = .0078). This was positively correlated with the gingival bleeding index (GBI) (r = 0.51, P = .0008) and presence of dental restorations in the cleft area (r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT. Conclusion: Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.

  • 38.
    Jalouli, Miranda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Jalouli, Jamshid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Hasséus, Bengt
    Öhman, Jenny
    Hirsch, Jan M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Sand, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Nested PCR for detection of HSV-1 in oral mucosa2015In: Medicina Oral, ISSN 1698-4447, E-ISSN 1698-6946, Vol. 20, no 6, p. E664-E669Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It has been estimated that 15%-20% of human tumours are driven by infection and inflammation, and viral infections play an important role in malignant transformation. The evidence that herpes simplex virus type 1 (HSV-1) could be involved in the aetiology of oral cancer varies from weak to persuasive. This study aimed to investigate by nested PCR (NPCR) the prevalence of HSV-1 in samples from normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma (OSCC).

    MATERIAL AND METHODS: We investigated the prevalence of HSV-1 in biopsies obtained from 26 fresh, normal oral mucosa from healthy volunteers as well as 53 oral leukoplakia and 27 OSCC paraffin-embedded samples. DNA was extracted from the specimens and investigated for the presence of HSV-1 by nested polymerase chain reaction (NPCR) and DNA sequencing.

    RESULTS: HSV-1 was detected in 14 (54%) of the healthy samples, in 19 (36%) of the oral leukoplakia samples, and in 14 (52%) of the OSCC samples. The differences were not statistically significant.

    CONCLUSIONS: We observed a high incidence of HSV-1 in healthy oral mucosa, oral leukoplakia, and OSCC tissues. Thus, no connection between OSCC development and presence of HSV-1 was detected.

  • 39.
    Jarmar, Tobias
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Palmquist, Anders
    Branemark, Rickard
    Hermansson, Leif
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Engqvist, Håkan
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.
    Thomsen, Peter
    Characterization of the surface properties of commercially available dental implants using scanning electron microscopy, focused ion beam, and high-resolution transmission electron microscopy2008In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 10, no 1, p. 11-22Article in journal (Refereed)
    Abstract [en]

    Background: Since osseointegration of the respective implant is claimed by all manufacturing companies, it is obvious that not just one specific surface profile including the chemistry controls bone apposition. Purpose: The purpose was to identify and separate out a particular set of surface features of the implant surfaces that can contribute as factors in the osseointegration process. Material and Methods: The surface properties of several commercially available dental implants were extensively studied using profilometry, scanning electron microscopy, and transmission electron microscopy. Ultrathin sections prepared with focused ion beam microscopy (FIB) provided microstructural and chemical data which have not previously been communicated. The implants were the Nobel Biocare TiUnite (R) (Nobel Biocare AB, Goteborg, Sweden), Nobel Biocare Steri-Oss HA-coated (Nobel Biocare AB, Yorba Linda, CA, USA), Astra-Tech OsseoSpeed (TM) (Astra Tech AB, Molndal, Sweden), Straumann SLA (R) (Straumann AG, Waldenburg, Switzerland), and the Branemark Integration Original Fixture implant (Branemark Integration, Goteborg, Sweden). Results: It was found that their surface properties had differences. The surfaces were covered with crystalline TiO2 (both anatase and rutile), amorphous titanium oxide, phosphorus doped amorphous titanium oxide, fluorine, titanium hydride, and hydroxyapatite, respectively. Conclusion: This indicates that the provision of osseointegration is not exclusively linked to a particular set of surface features if the implant surface character is a major factor in that process. The studied methodology provides an effective tool to also analyze the interface between implant and surrounding bone. This would be a natural next step in understanding the ultrastructure of the interface between bone and implants.

  • 40.
    Johansson, Ann-Katrin
    et al.
    Univ Bergen, Dept Clin Dent Cariol, Fac Med & Dent, N-5009 Bergen, Norway..
    Johansson, Anders
    Univ Bergen, Dept Clin Dent Prosthodont, Fac Med & Dent, N-5009 Bergen, Norway..
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Norring, Claes
    Stockholm Cty Council, Karolinska Inst, Stockholm Ctr Eating Disorders, R&D Unit,Ctr Psychiat Res, Stockholm, Sweden.;Univ Bergen, Dept Clin Dent Community Dent, Fac Med & Dent, N-5009 Bergen, Norway..
    Astrom, Anne Nordrehaug
    Univ Bergen, Dept Clin Dent Community Dent, Fac Med & Dent, N-5009 Bergen, Norway..
    Tegelberg, Ake
    Postgrad Dent Educ Ctr, Orebro, Sweden.;Malmo Univ, Fac Odontol, Malmo, Sweden..
    Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, article id 124Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods: In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results: The participation rate was 40 % (47 % women and 53 % men). Their knowledge about ED was often retrieved from common media sources and the greater part of the participants reported they had seen very few patients with ED during their professional career. Female dentists reported superior knowledge about ED compared to males, but the former experienced greater difficulties to inform about the condition. Referrals of the patient to other health facilities were significantly more common among female compared to male dentists. The majority of dentists (76 %) reported a need of more education related to ED management. Conclusions: The Norwegian dentists in this study reported limited clinical experience and insufficient knowledge regarding ED. There is therefore a need to increase both undergraduate and continuing education in this field, which can improve preventive and management measures that a dentist can provide for ED patients.

  • 41. Jonasson, Anette
    et al.
    Eriksson, Christer
    Jenkinson, Howard F.
    Källestål, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Johansson, Ingegerd
    Stromberg, Nicklas
    Innate immunity glycoprotein gp-340 variants may modulate human susceptibility to dental caries2007In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 7, p. 57-Article in journal (Refereed)
    Abstract [en]

    Background: Bacterial adhesion is an important determinant of colonization and infection, including dental caries. The salivary scavenger receptor cysteine-rich glycoprotein gp-340, which mediates adhesion of Streptococcus mutans (implicated in caries), harbours three major size variants, designated gp-340 I to III, each specific to an individual saliva. Here we have examined the association of the gp-340 I to III polymorphisms with caries experience and adhesion of S. mutans. Methods: A case-referent study was performed in 12-year-old Swedish children with high (n = 19) or low (n = 19) caries experiences. We measured the gp-340 I to III saliva phenotypes and correlated those with multiple outcome measures for caries experience and saliva adhesion of S. mutans using the partial least squares (PLS) multivariate projection technique. In addition, we used traditional statistics and 2-year caries increment to verify the established PLS associations, and bacterial adhesion to purified gp-340 I to III proteins to support possible mechanisms. Results: All except one subject were typed as gp-340 I to III (10, 23 and 4, respectively). The gp-340 I phenotype correlated positively with caries experience (VIP = 1.37) and saliva adhesion of S. mutans Ingbritt (VIP = 1.47). The gp-340 II and III phenotypes tended to behave in the opposite way. Moreover, the gp-340 I phenotype tended to show an increased 2-year caries increment compared to phenotypes II/III. Purified gp-340 I protein mediated markedly higher adhesion of S. mutans strains Ingbritt and NG8 and Lactococcus lactis expressing AgI/II adhesins (SpaP or PAc) compared to gp-340 II and III proteins. In addition, the gp-340 I protein appeared over represented in subjects positive for Db, an allelic acidic PRP variant associated with caries, and subjects positive for both gp-340 I and Db tended to experience more caries than those negative for both proteins. Conclusion: Gp-340 I behaves as a caries susceptibility protein.

  • 42. Jäderberg, Sylvia
    et al.
    Feldmann, Ingalill
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Engström, Christer
    Removable thermoplastic appliances as orthodontic retainers: a prospective study of different wear regimens2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 4, p. 475-479Article in journal (Refereed)
    Abstract [en]

    The aim of this prospective study was to evaluate and compare stability after 6 months of Essix retainer use. Patients' perceptions of wearing the retainer were also evaluated. A total of 69 patients, 53 girls and 16 boys [mean age 15.7 years, standard deviation (SD) 1.96], were included in the study and randomized into two groups with different wear regimens; full-time wear for 3 months and thereafter at night (group A) compared to full-time wear for 1 week and thereafter at night only (group B). Sixty patients completed the study and thus, group A comprised 30 maxillary retainers and 18 mandibular retainers and group B 30 maxillary and 18 mandibular retainers. Little's irregularity index (LII), overjet, and overbite were measured at debond (T(1)) and after 6 months (T(2)). Differences within and between groups were analysed with a Mann-Whitney test. At T(2), all patients completed a questionnaire in order to evaluate their experience of wearing an Essix retainer and how they complied with the given instructions.

    Differences in LII during T(1)-T(2) were 0.44 and 0.49 mm for group A and B, respectively, but with no significant difference between the groups. There were also no significant changes in overjet and overbite within or between the groups during T(1)-T(2). According to the responses to the questionnaire, the retainer was well tolerated by the patients. It was therefore concluded that the Essix retainer is sufficient for maintaining the results after orthodontic treatment and that night-time wear is adequate.

  • 43.
    Jönsson, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Behavioural Medicine Perspectives for Change and Prediction of Oral Hygiene Behaviour: Development and Evaluation of an Individually Tailored Oral Health Educational Program2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour.

    Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status.

    Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour.

    These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment.

    List of papers
    1. An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis
    Open this publication in new window or tab >>An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis
    2009 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 3, p. 166-175Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis. Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse. Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period. Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

    Place, publisher, year, edition, pages
    Oxford: Wiley-Blackwell, 2009
    Keywords
    behavioural medicine; experimental single-case design; oral hygiene behaviour; periodontitis; social cognitive strategies
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-111541 (URN)10.1111/j.1601-5037.2008.00350.x (DOI)000207895100003 ()
    Projects
    Behavioural medicine perspectives for change and prediction of oral hygiene behaviour
    Available from: 2009-12-16 Created: 2009-12-16 Last updated: 2017-12-12Bibliographically approved
    2. The effectiveness of an individually tailored oral health educational programme on oral hygiene behaviour in patients with periodontal disease: a blinded randomized-controlled clinical trial (one-year follow-up)
    Open this publication in new window or tab >>The effectiveness of an individually tailored oral health educational programme on oral hygiene behaviour in patients with periodontal disease: a blinded randomized-controlled clinical trial (one-year follow-up)
    2009 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, no 12, p. 1025-1034Article in journal (Refereed) Published
    Abstract [en]

    Aim   To evaluate the effectiveness of an individually tailored oral health   educational programme for oral hygiene self-care in patients with   chronic periodontitis compared with the standard treatment.   Material and Method   A randomized, evaluator-blinded, controlled trial with two different   active treatments were used with 113 subjects (60 females and 53 males)   randomly allocated to an experimental or a control group. The   individually tailored oral health educational programme was based on   cognitive behavioural principles and the individual tailoring for each   participant was based on participants' thoughts, intermediate, and   long-term goals, and oral health status. The effect of the programmes   on gingivitis [gingival index (GI)], oral hygiene [plaque indices (PlI)   and self-report], and participants' global rating of treatment was   evaluated 3 and 12months after oral health education and non-surgical   treatment.   Results   Between baseline and the 12-month follow-up, the experimental group   improved both GI and PlI more than the control group. The mean   gain-score difference was 0.27 for global GI [99.2% confidence interval   (CI): 0.16-0.39, p < 0.001] and 0.40 for proximal GI (99.2% CI:   0.27-0.53, p < 0.001). The mean gain-score difference was 0.16 for   global PlI (99.2% CI: 0.03-0.30, p=0.001), and 0.26 for proximal PlI   (99.2% CI: 0.10-0.43, p < 0.001). The subjects in the experimental   group reported a higher frequency of daily inter-dental cleaning and   were more certain that they could maintain the attained level of   behaviour change.   Conclusion   The individually tailored oral health educational programme was   efficacious in improving long-term adherence to oral hygiene in   periodontal treatment. The largest difference was for interproximal   surfaces.

    Place, publisher, year, edition, pages
    Oxford: Wiley-Blackwell, 2009
    Keywords
    adherence, behavioural medicine, cognitive behavioural strategies, oral health educational programme, oral hygiene behaviour, periodontitis
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-111540 (URN)10.1111/j.1600-051X.2009.01453.x (DOI)000271777400005 ()19930092 (PubMedID)
    Projects
    Behavioural medicine perspectives for change and prediction of oral hygiene behaviour
    Available from: 2009-12-16 Created: 2009-12-16 Last updated: 2017-12-12Bibliographically approved
    3. Evaluation of an individually tailored oral health educational programme on periodontal health
    Open this publication in new window or tab >>Evaluation of an individually tailored oral health educational programme on periodontal health
    2010 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, no 10, p. 912-919Article in journal (Refereed) Published
    Abstract [en]

    Aim: To evaluate an individually tailored oral health educational programme (ITOHEP) on periodontal health compared with a standard oral health educational programme. A further aim was to evaluate whether both interventions had a clinically significant effect on non-surgical periodontal treatment at 12-month follow-up. Material and Method: A randomized, evaluator-blinded, controlled trial with 113 subjects (60 females and 53 males) randomly allocated into two different active treatments was used. ITOHEP was based on cognitive behavioural principles and motivational interviewing. The control condition was standard oral hygiene education (ST). The effect on bleeding on probing (BoP), periodontal pocket depth, "pocket closure" i.e. percentage of periodontal pocket >4 mm before treatment that were <5 mm after treatment, oral hygiene [plaque indices (PlI)], and participants' global rating of oral health was evaluated. Preset criteria for PlI, BoP, and "pocket closure" were used to describe clinically significant non-surgical periodontal treatment success. Results: The ITOHEP group had lower BoP scores 12-month post-treatment (95% confidence interval: 5-15, p<0.001) than the ST group. No difference between the two groups was observed for "pocket closure" and reduction of periodontal pocket depth. More individuals in the ITOHEP group reached a level of treatment success. Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success. Conclusions: ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment.

    Keywords
    Randomized controlled trial; Oral hygiene behaviour; Periodontitis; Cognitive behavioural strategies; clinical significance
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-111554 (URN)10.1111/j.1600-051X.2010.01590.x (DOI)000281636300007 ()
    Projects
    Behavioural medicine perspectives for change and prediction of oral hygiene behaviour
    Available from: 2009-12-16 Created: 2009-12-16 Last updated: 2017-12-12Bibliographically approved
    4. Self-Efficacy Predicts Future Oral Hygiene Self-care Behavior
    Open this publication in new window or tab >>Self-Efficacy Predicts Future Oral Hygiene Self-care Behavior
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    When oral health interventions for behavior change are evaluated psychological outcomes ought to be included. The study evaluate the effects of two different oral hygiene interventions on attitudes, subjective norms and self-efficacy, and examined the predictive value of these individual factors for interdental cleaning (IC), plaque control (PlI) and bleeding on probing 12-months after non-surgical periodontal treatment Participants (n=113) were randomly allocated to an experimental or a control group. The experimental intervention was an individually tailored treatment based on participants’ cognitions and beliefs, behavioral goals, and oral health status. In the experimental group, the intention to perform IC daily increased. High self-efficacy (SE) scores at baseline predicted daily IC and PlI scores ≤ 20%, 12-month after treatment. Individuals with low SE had a higher probability of attaining a successful level of oral hygiene if treated with experimental intervention rather than standard treatment.

    Keywords
    Randomized controlled trial; Oral hygiene behavior; Periodontitis; Cognitive behavioral strategies; Theory of Reasoned Action
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-111535 (URN)
    Available from: 2009-12-16 Created: 2009-12-16 Last updated: 2015-11-23Bibliographically approved
  • 44.
    Jönsson, Birgitta
    et al.
    Uppsala University. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Oscarson, Nils
    Öhrn, Kerstin
    Self-Efficacy Predicts Future Oral Hygiene Self-care BehaviorManuscript (preprint) (Other academic)
    Abstract [en]

    When oral health interventions for behavior change are evaluated psychological outcomes ought to be included. The study evaluate the effects of two different oral hygiene interventions on attitudes, subjective norms and self-efficacy, and examined the predictive value of these individual factors for interdental cleaning (IC), plaque control (PlI) and bleeding on probing 12-months after non-surgical periodontal treatment Participants (n=113) were randomly allocated to an experimental or a control group. The experimental intervention was an individually tailored treatment based on participants’ cognitions and beliefs, behavioral goals, and oral health status. In the experimental group, the intention to perform IC daily increased. High self-efficacy (SE) scores at baseline predicted daily IC and PlI scores ≤ 20%, 12-month after treatment. Individuals with low SE had a higher probability of attaining a successful level of oral hygiene if treated with experimental intervention rather than standard treatment.

  • 45.
    Jönsson, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Öhrn, Kerstin
    Högskolan Dalarna.
    Oscarson, Nils
    Socialstyrelsen, Stockholm.
    Lindberg, Per
    An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis2009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 3, p. 166-175Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis. Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse. Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period. Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

  • 46.
    Karasneh, Jumana A.
    et al.
    Jordan Univ Sci & Technol, Dept Oral Med & Oral Surg, Fac Dent, Irbid, Jordan..
    Al Habashneh, Rola A.
    Jordan Univ Sci & Technol, Dept Prevent Dent, Fac Dent, Irbid, Jordan..
    Marzouka, Nour Aldain S.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Thornhill, Martin H.
    Univ Sheffield, Sch Clin Dent, Unit Oral & Maxillofacial Med & Surg, Sheffield, S Yorkshire, England..
    Effect of cigarette smoking on subgingival bacteria in healthy subjects and patients with chronic periodontitis2017In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 17, article id 64Article in journal (Refereed)
    Abstract [en]

    Background: Cigarette smoking is known to increase the risk of periodontal destruction and developing chronic periodontitis ( CP). It is also reported to affect the subgingival bacterial profile among CP patients. However, studies on the effect of smoking on the bacterial profile among healthy subjects are still limited. Therefore, the aim of this study was to investigate the impact of smoking on the subgingival bacterial profile in both healthy adults and CP patients. Methods: Subgingival plaque samples were collected from CP patients ( 30 nonsmokers and 9 smokers) and healthy subjects ( 37 non- smokers and 18 smokers). Genomic DNA was extracted and 25 bacterial species were detected using PCR of 16S rRNA. Comparing smokers to non- smokers from each group was conducted using chi2 and binary logistic regression analysis. Results: After correcting for confounding factors, the odds of having Slackia exigua, Selenomonas sputigena and Campylobacter rectus was higher among healthy smokers ( ORadj = 10.1, 6.62 and 5.62 respectively). While for CP group, the highest odds were observed for Treponema amylovorum, Treponema medium, Slackia exigua and Treponema vincentii ( ORadj = 20.7, 7.97, 6.37 and 5.37 respectively) and the increase in Treponema amylovorum was statistically significant ( p = 0.05). Conclusion: Smoking affects the subgingival bacterial profile in healthy individuals and is responsible for the depletion of beneficial bacteria and the increase in periodontopathogenic bacteria. In the CP patient group, our study suggests that subgingival bacteria ( particularly Treponema species) make a more substantial contribution in the etiology of CP among non- smokers. Further studies using a larger sample set and more sensitive and quantitative techniques ( such as real - time PCR) are needed to enhance our understanding of the exact effect of smoking on subgingival biofilm.

  • 47. Kassapidou, Maria
    et al.
    Franke Stenport, Victoria
    Hjalmarsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Johansson, Carina B
    Cobalt-chromium alloys in fixed prosthodontics in Sweden2017In: Acta Biomaterialia Odontologica Scandinavica, ISSN 0001-5369, E-ISSN 2333-7931, Vol. 3, no 1, p. 53-62Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to compile the usage of Co-Cr alloys in fixed prosthodontics (FP) among dental laboratories in Sweden.

    Methods: From March to October 2015, questionnaires were sent to 542 registered dental laboratories in Sweden. The questionnaires were divided in two parts, one for fixed dental-supported prosthodontics (FDP) and one for fixed implant-supported prosthodontics (FIP). Reminders were sent three times.

    Results: In total of 542 dental laboratories, 55% answered the questionnaires. Most dental laboratories use Co-Cr in FP, 134 (74%) in FDP and 89(66%) in FIP. The laboratories used Co-Cr alloys of various compositions in the prostheses, 35 for FDP and 30 for FIP. The most commonly used Co-Cr alloys for tooth-supported FDPs were (a) Wirobond® 280, (b) Cara SLM and (c) Wirobond® C. For implant-supported frameworks the frequently used alloys were: (a) Cara SLM, (b) Cara Milled and (c) Wirobond® 280. Except for the difference in composition of these alloys, they were also manufactured with various techniques. In tooth-supported prostheses the dominating technique was the cast technique while newer techniques as laser-sintering and milling were more commonly reported for implant-supported constructions. A fourth technique; the ‘pre-state’ milling was reported in FDP.

    Conclusion: More than 30 different Co-Cr alloys were reported as being used in FP. Thus, there is a need for studies exploring the mechanical and physical behavior and the biological response to the most commonly used Co-Cr alloys.

  • 48.
    Khalifeh, Iman
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Determination of self association constant between bovine insulin molecules by capillary zone electrophoresis2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Capillary electrophoresis (CE) is an analytical technique that is very useful for investigating processes that modify the charge and mass of proteins and polypeptide pharmaceuticals. This report explores the ability of CE to determine the aggregation constant between insulin molecules. Bovine insulin is a polypeptide (Mw=5733, pI = 5.3) that has two α-amino groups (Gly and Phe) and one ε–amino group (Lys). Analysis of concentration dependence of electrophoretic mobility of insulin at different conditions yields the association constant for dimerization of insulin. The association constant estimates how tight the peptide molecules are associated. The association constant is a useful factor to evaluate the purity of a peptide or protein sample.

    The association reaction of bovine insulin molecules was found to be favoured by temperature. The association constants were 7200 M -1, 8000 M -1, and 36000 M -1 at 15 oC, 25 oC and 35 oC, respectively. The interactions between the peptide molecules increase at higher temperature, resulting in stronger association. The association constant was estimated to be 3000 M -1in the presence of dioxane (5%, w/v %) at 25 oC. However, the interaction sites remain to be explored.

  • 49.
    Kharazmi, M.
    et al.
    Cent Hosp Västerås, Dept Oral & Maxillofacial Surg, Västerås, Sweden.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Early removal of sequestrum in patients affected by medication-related osteonecrosis of the jaw2018In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 56, no 3, p. 237-238Article in journal (Other academic)
  • 50.
    Kharazmi, M.
    et al.
    Cent Hosp Västerås, Dept Oral & Maxillofacial Surg, Västerås, Sweden.
    Hallberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Secondary sinus lift: viable technique for when a membrane is raised without a graft, and fails2018In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 56, no 3, p. 234-235Article in journal (Other academic)
123 1 - 50 of 101
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