| 1. |
- Eskafi, M, et al.
(författare)
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A mandibular advancement device reduces sleep disordered breathing in patients with congestive heart failure
- 2004
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 28:4, s. 155-163
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Tidskriftsartikel (refereegranskat)abstract
- Sleep disordered breathing (SDB) including obstructive and central sleep apnoea/ hypopnoea as well as periodic breathing (PB) is common and is believed to increase risk for mortality in patients with congestive heart failure (CHF). Mandibular advancement device (MAD) has widely been recommended for treatment of obstructive sleep apnoea but the method has never been investigated for treatment of SDB in the patients with CHF. The aim with the present study was to examine the effect of MAD intervention on SDB in patients with CHF. The study included 17 male patients, aged 68.4 +/- 5.7 (mean +/- SD) with stable, mild to moderate CHF due to left ventricular systolic dysfunction and with SDB, expressed as apnoea/hypopnoea index (AHI) >= 10. The SDB was examined during a single night using an unattended, portable polysomnographic device in the patients home, prior to and following intervention with a individually adjusted MAD. The SDB was evaluated by calculating AHI, PB expressed as the percentage of the total registration time, oxygen desaturation index (ODI) and snoring time. The AHI was reduced by MAD intervention from 25.1 +/- 9.4 to 14.7 +/- 9.7 (P = 0.003). ODI reduced fro M 21.1 +/- 9.0 to 10.5 +/- 7.8 (P = 0.007) and snoring time decreased from 53 +/- 111 to 18 47 seconds (P = 0.02). PB was reduced from 55.7 +/- 25.6 to 40.4 +/- 26.4 per cent without statistical significance. In conclusion, the MAD intervention may be a feasible method for reducing SDB in patients with stable, mild to moderate CHF and left ventricular systolic dysfunction.
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| 2. |
- Eskafi, Mahmoud, et al.
(författare)
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The effect of mandibular advancement device on pharyngeal airway dimension in patients with congestive heart failure treated for sleep apnoea.
- 2004
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 28:1, s. 41283-41283
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Tidskriftsartikel (refereegranskat)abstract
- Continues positive airway pressure (CPAP) is recommended for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) but is not easily tolerated resulting in poor patient compliance. Mandibular advancement device (MAD) is designed to inhibit pharyngeal airway (PAW) obstruction and may be a valuable alternative. It has been proposed that MAD exerts its effect by increasing PAW dimensions. This has not, however, been clearly demonstrated. The aim of this study was to examine the effect of MAD on PAW dimensions and SA in patients with CHF. Seventeen CHF-patients with mild to moderate heart failure, aged 68 +/- 6 years, (mean +/- SD), range 54-75 years, with sleep apnoea-hypopnea index (AHI) > or = 10 were evaluated. PAW dimensions were studied with and without the MAD, using lateral radiographs in supine position. Nocturnal breathing patterns were studied using a portable polysomnographic device during a single night with and without MAD. A reduction of AHI > or = 30% (arbitrary level) for each individual was regarded as a successful treatment. Mean AHI was reduced from 25.1 +/- 9.4 to 14.7 +/- 9.7 (p = 0.003). The PAW increased in its inferior section in 13 patients (p = 0.0001). AHI decreased > or = 30% in 9 patients (p = 0.003) of whom 8 showed increased PAW dimensions. Reduction of AHI was not significantly related to increased PAW dimensions. In conclusion MAD increased PAW dimensions and reduced SA in patients with CHF. The results may indicate that MAD reduces SA by other mechanism than increasing PAW dimensions.
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| 3. |
- Jansson, Henrik, et al.
(författare)
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Analysis of the interleukin-1 and interleukin-6 polymorphisms in patients with chronic periodontitis. A pilot study
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30:1, s. 17-23
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse whether the interleukin-1 (IL-1) and IL-6 gene polymorphisms were associated with the susceptibility of chronic periodontitis. Genomic DNA was obtained from 20 patients with chronic periodontitis and 31 periodontally healthy subjects. All subjects were of North European heritage. The test subjects were kept in a maintenance program after periodontal treatment but yet showing signs of recurrent disease. Genotyping of the IL-1 alpha[+4845C>T], IL-1 beta [-3954C>T] and IL-6 [-174G>C] polymorphisms was carried out using an allelic discrimination Assay-by-Design method on ABI PRISM 7900 Sequence Detection System. All genotypes were analyzed using the GeneMapper 2.0 software. A similar distribution of Single Nucleotide Polymorphism (SNP) was seen in both groups. Analysis by logistic regression including gender, IL-1 alpha [+4845C>T], IL-1 beta [-3954C>T], IL-6 [-174G>C] genotypes, the composite IL-1 genotype, the combination of the composite IL-1 genotype and the IL-6 -174G>C genotype and adjusting for smoking did not result in any statistically significant difference. SNPs in IL-1 alpha[+4845C>T], IL-1 beta [-3954C>T] and IL-6 [-174G>C] do not seem to increase the susceptibility to chronic periodontitis in this group of subjects.
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| 4. |
- Jönsson, Daniel, et al.
(författare)
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Functional effects of female sex hormones in the periodontium
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30, s. 185-185
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Several studies have addressed the association between changes in the female sex hormones estrogen and progesterone levels and changes in parameters of periodontitis. In order to understand how these hormones affect periodontal health it is of major importance to obtain information on their physiological importance. We have previously shown that periodontal ligament cells (PDL cells) express estrogen receptor beta (ER beta) but not ER alfa immunoreactivity. The PDL cells express no immunoreactivity for progesterone receptors, suggesting that this cell type is not affected by progesterone. Treatment with a physiological concentration (100 nM) of estrogen increases DNA synthesis in human breast cancer cells but has no effect on PDL cell DNA and collagen synthesis. The purpose of this project is to investigate how and by which mechanisms estrogen influences structure and function of the periodontal ligament by affecting PDL cell functional properties. Methods: Human PDL cells were obtained from teeth extracted for orthodontic reasons. The cells were cultured from periodontal tissue explants and used in passages 3-5. Subcellular distribution of ER beta was determined by immunogold electron microscopy and confocal imagining using the mitochondrial selective probe MitoTracker and ER beta immunostaining. Expression of mitochondrial protein cytochrome c oxidase subunit I was investigated using Western blotting. The amounts of IL-6 and c-reactive protein (CRP) were determined by ELISA. Results: Confocal imaging revealed that ER beta immunoreactivity was distributed not only in the nucleus but also in the mitochondria. These results were confirmed using immunogold electron microscopy. Incubation with estrogen down-regulated the mitochondrial enzyme cytochrome c oxidase subunit I expression by about 30%, showing functional significance of mitochondrial ER. Preliminary data show that lipopolysaccharide (LPS) induces IL-6 but not CRP expression in PDL cells. The LPS induced IL-6 production is not affected by estrogen. Conclusion: Our data show that estrogen, preferably via ER beta, affects PDL cell functional properties, suggesting that estrogen and other ER specific ligands may modulate the periodontal tissue structure and function in health and disease.
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| 5. |
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| 6. |
- Liedholm, Rolf, et al.
(författare)
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Patient flows in the care process of mandibular third molar surgery
- 2005
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 29:3, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to describe patient flows in mandibular third molar surgery at ora I and maxillofacial specialist units. Our hypothesis was that there are variations in how care is delivered and that the variations could be explained by inter-individual variations in surgeons' practice,the quality of the radiographs appended to the referral, and the staffing of the specialist units. A flow chart was constructed to simulate all possible patient flows in the care process. The chart begins with treatment planning, which was drawn up based on documents from the referring dentist or another caregiver; continues with the care process at the oral and maxillofacial surgery unit, including surgical consultations and radiological examinations; and ends with surgery. Surgeons at four oral and maxillofacial surgery units in the National Health Service in southern Sweden participated. The intention was to collect data on at least 100 patients who had undergone mandibular third molar surgery at each unit. Data on 361 patients were collected. The radiographs appended to the referral were judged to be inappropriate for the majority of the patients (61%). For 13% of these patients, supplementary radiographic examinations were made at the radiology clinic included in the unit,whilst 48% were examined at the oral and maxillofacial surgery clinic. There were eight different patient flow patterns. In one unit with three surgeons, eight different flow patterns were recorded, indicating an interindividual variation among the surgeons. In a second unit, six different flow patterns were recorded. In the last two units, the patient flows appeared to be the same at each unit, although the predominant patient flows in these two units differed. The number of patient visits to the specialist units ranged between one and three. In three specialist units, most patients were called twice whilst in one specialist unit most patients were called only once, to have the third molar removed. Differences existed in the care process. Overall, the number of patient visits seemed not to depend on whether the preoperative radiographic examination was judged to be appropriate or whether the additional radiographs were made at the radiology clinic.
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| 7. |
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| 8. |
- Rosendahl, Kerstin, et al.
(författare)
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Implant periapical lesion. A case series report.
- 2009
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 33:2, s. 49-58
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Tidskriftsartikel (refereegranskat)abstract
- One complication in implant dentistry is the implant periapical lesion-IPL--which is a lesion around the apex of a stable implant diagnosed radiographically as a radioluscency in the bone at the apical part of an implant.The IPL can perform with or without clinical symptoms such as tenderness, swelling, suppuration and fistulation. This report describes 4 cases of IPL which were treated surgically with sectioning and removal of the affected portion of a stable implant and thorough debridement of the granulomatous tissue around it. This treatment was, up to 4 years after treatment, successful in all 4 cases. It can also from this report be concluded that IPL is a rather rare condition and that it can occur at any stage of implant treatment, in these cases from 4 months up to 11 years after implant installation. Finally there is a discussion about the aetiology of IPL and a comparison to findings in other reports on IPL and it is concluded that it is difficult to claim that there is a single cause to IPL. Rather it is evident that the condition might be a sequel of the summation of many possible causes.This summation exceeds the local biological threshold for the individual patient.
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| 9. |
- Schüttert, Eva Maria, et al.
(författare)
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Orthognathic surgery - postoperative clinical and radiographic follow-up routines at Swedish oral and maxillofacial surgery departments
- 2012
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Ingår i: Swedish Dental Journal. - : Swedish Dental Journal (Sveriges Tandläkarförbund). - 0347-9994. ; 36:3, s. 109-114
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Tidskriftsartikel (refereegranskat)abstract
- Orthognathic surgery is a frequent procedure at Swedish Oral and Maxillofacial Surgery Departments. The number of clinical and radiographic postoperative follow-up examinations and the choice of radiographic methods seem to vary. The intention with this study was to find out when postoperative clinical and radiographic follow-up was performed following orthognathic surgery and the type of radiographic examinations that were used. less thanbrgreater than less thanbrgreater thanIn 2009, all Swedish Oral and Maxillofacial Surgery Departments in the Public Health Service (25 centres) were given a form containing standardized questions on the time for clinical follow-up after orthognathic surgery and the radiographic examinations used. A pilot study on 49 consecutive patients at one of the centres was performed to determine if the postoperative radiographic examinations added additional information, leading to further procedures compared to the clinical observations only. less thanbrgreater than less thanbrgreater thanA one-year follow-up was the most frequently used clinical control reported by 15 centres, and a six-month follow-up, the next most frequent. At 14 of the 15 centres, radiographic examinations were included at the one-year follow-up. A five-year clinical and radiographic follow-up was reported by two centres. One or, at the most, two postoperative radiographic follow-up sessions were reported by 68% of the centres. Profile and panoramic imaging were most often used. In the evaluation of the postoperative handling of the 49 consecutive patients in the pilot study, a radiolucency around a fixation screw noted radiographically was the only additional postoperative radiological finding that resulted in a surgical procedure. less thanbrgreater than less thanbrgreater thanPostoperative clinical and radiographic follow-up routines following orthognathic surgery vary considerably between the Swedish Oral and Maxillofacial Surgery Departments. There appears to be a need for studies on the value of the information, which repeated postoperative clinical and radiographic follow-up controls add in routine medical attendance.
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| 10. |
- Svensson, Roger, et al.
(författare)
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Treatment with local hemostatic agents and primary closure after tooth extraction in warfarin treated patients
- 2013
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 37:2, s. 71-77
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aim of this retrospective study was to assess the frequency of postoperative bleeding in patients on warfarin after tooth removal followed by a complete soft tissue closure of the surgical site. A total of 124 consecutive patients, 69 males and 55 females with a mean age of 71 years (range 28-95 years) were included in this study. Inclusion criteria were patients on warfarin with an INR
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