| 1. |
- 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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| 2. |
- Frisk, Fredrik, 1971, et al.
(författare)
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Pulp exposures in adults--choice of treatment among Swedish dentists.
- 2013
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Ingår i: Swedish dental journal. - : Sveriges tandläkarförbund. - 0347-9994. ; 37:3, s. 153-60
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Tidskriftsartikel (refereegranskat)abstract
- This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
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| 3. |
- Hellén-Halme, Kristina, et al.
(författare)
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Dental digital radiography : a survey of quality aspects
- 2005
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 29:2, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate the experiences of Swedish general dental practitioners (GDPs) with digital radiography and their opinion on the same, particularly regarding quality issues. A letter was sent to all GDPs in private care in Region Skåne, Sweden, asking whether they used digital radiography (n=513). The response rate was 79%. The number of private GDPs who replied that they used digital radiography was 106. The Public Dental Service in Region Skåne listed 33 GDPs who worked with digital radiography. Based on these answers, a questionnaire was sent to the GDPs working with digital radiography (n=139). The questionnaire comprised 27 questions about the dentists, the system of intra-oral digital radiography, and the GDPs’ experiences of and opinions on issues regarding image quality and quality control. The response rate to the questionnaire was 94%. Almost all, 92%, worked with charge-coupled device (CCD) and complementary metal oxide semiconductor (CMOS) sensors. Most GDPs were satisfied with their digital radiographic system. The majority (65%) experienced problems. Detector failure and trouble with the software were common. The GDPs wrote that they used lower exposure times in digital radiography than traditional film radiography. The estimated reduction in exposure time was said to be between 51% and 75%. Thirtyfive per cent continued to use film parallel with digital radiography. The answers indicated that less than half of the equipment (40%) underwent quality control. Quality controls, when conducted, were undertaken once or twice a year, mainly by technicians from the companies that had sold the digital equipment. Based on the results of the questionnaire, there seems to be a need to improve the maintenance and the quality of digital radiography. It is also important that the GDPs become more aware of the problems that can occur when a new technique is introduced and that they develop the skills to handle these problems.
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| 4. |
- Hellén-Halme, Kristina, et al.
(författare)
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Image Quality of Digital and Film Radiographs in Applications Sent to the Dental Insurance Office in Sweden for Treatment Approval
- 2004
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 28:2, s. 77-84
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In July 2002, a new dental insurance program was introduced in Sweden. For all patients over 65 years, prior approval for all prosthetic work would need to be obtained from the Dental Insurance Office. From October to December 2002, 540 cases were randomly selected for evaluation from the 14,624 applications that had been sent from throughout Sweden to the Dental Insurance Office in Lund. Our aims were to appraise the quality of the radiographic examinations and to compare the quality of the digital with the film (X-ray film) radiographs. The radiographic examinations were evaluated as a whole in relation to the proposed treatment and in detail using specific criteria such as density, contrast, unsharpness, angulation, and receptor position error. The quality variables were evaluated as acceptable or unacceptable. A total of 4,687 intra-oral and 206 panoramic radiographs were evaluated. Thirteen per cent of the intra-oral radiographs and 9% of the panoramic radiographs were taken with a digital technique. Most of the digital radiographs—-70% of the intra-oral and 61% of the panoramic radiographs-—were submitted on microdisk. Twentyeight per cent of the intra-oral digital radiographs, however, were submitted on paper. The radiographic quality in 150 cases (28%) were found to be unacceptable for assessment of the proposed treatment. The most common error-—both in digital and X-ray film radiographs-—was in receptor position. Significantly more errors were found in the intra-oral digital radiographs compared to the radiographs taken with X-ray film. Most of the errors in the digital radiographs were detected in the paper copies. In conclusion, it is possible to improve the radiographic quality in applications for treatment approval, and the dentists had more difficulties with the digital technique than with X-ray film.
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| 5. |
- Pigg, Maria, et al.
(författare)
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A comparative analysis of MRI, CBCT and conventional radiography in patients with atypical odontalgia and symptomatic apical periodontitis : preliminary results
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30:4, s. 173-174
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: Atypical odontalgia(AO) is a chronic pain condition located in the teeth and jaws. It has been suggested, that AO is best regarded as a neuropathic pain condition, but knowledge regarding the etiology, diagnostics, and management of AO is not yet satisfactory. This pilot study evaluates the clinical usefulness of more recently developed imaging methods for intraoral pain conditions. The aim is to compare the diagnostic findings using magnetic resonance imaging(MRI) and cone beam computed tomography(CBCT) with the findings from conventional radiography in patients with atypical odontalgia(AO) and symptomatic apical periodontitis(SAP). Material and methods: 12 patients (9 F, 3 M) mean age 50,25 years, range 36 - 63 years participated in the study. The patients were referred to the Orofacial Pain Unit or the Department of Endodontics, Faculty of Odontology, Malmö University. Inclusion criteria for AO were chronic pain (>6 months) located in a region where a tooth had been endodontically or surgically treated, pain with no pathological cause detectable in clinical or radiological examinations. For SAP, the inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in a clinical and radiographic examination. Ten of the patients in the study were diagnosed with AO and two with SAP. The patients were clinically assessed with a qualitative somatosensory examination, a dental examination, an examination of the masticatory system(RDC/TMD), and panoramic and intraoral radiographs. A questionnaire was used to gather information about pain characteristics, psychosocial status(SCL-90), and quality of life. Besides these measures, each patient underwent a CBCT(3D-Accuitomo, J Morita Co) examination and a MRI(Siemens Sonata Vision 1.5 T) examination with and without contrast enhancement. Contrast was enhanced by injections of Magnevist (469 mg/ml, Schering Nordiska). Bone destruction, sclerosis, and signs of inflammation were the main parameters studied. Results: In the preliminary results, average pain intensity was 6.3 on a numerical rating scale(NRS) and average pain duration was 3,6 years. 83% exhibited somatosensory abnormalities. Bone destruction not visible in the intraoral and panoramic radiographs was detected with CBCT in 40% (4/10) of the patients diagnosed with AO, and signs of inflammation were detected in the MRIs of 20% (2/10) of the patients diagnosed with AO. Conclusion: Preliminary findings indicate that CBCT and MRI can provide additional information to conventional radiography in the diagnosis of intraoral orofacial pain. Further studies with larger sample sizes of AO and SAP patients are necessary to determine the clinical relevance of these findings.
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| 6. |
- Vallon, Danila, et al.
(författare)
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Long-term Follow-up of Intra-articular Injections into the Tem-poromandibular Joint in Patients with Rheumatoid Arthritis
- 2002
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 26:4, s. 149-158
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Tidskriftsartikel (refereegranskat)abstract
- A long-term (12 years) follow-up of treatment with intra-articular in-jections into the temporomandibular joint (TMJ) of steroid or non-steroid agents was performed in 21 patients with rheumatoid arthritis (RA) and symptomatic TMJs. The aim of the study was to compare symptoms, signs and radiological appearance of the TMJ initially and at the follow-up in this group of patients. Eleven patients were as-signed to a steroid group and 10 patients to a non-steroid group. Ini-tial and follow-up clinical and radiological examination procedures were the same. The radiological evaluation was based on a grading system using standard reference films. At follow-up, 14 patients re-ported no pain from the TMJ and positive changes in most clinical variables were found in both groups. Radiographic follow-up exami-nation was performed on 12 patients. Initially, all but 4 of the 24 joints had structural bone changes. At follow-up, 2 joints had lower, 11 joints had unchanged and 11 joints had higher radiological grades. Two out of 5 and 3 out of 10 joints in the steroid and non-steroid group, respectively, showed progression of structural bone changes. Among 9 untreated joints, 6 had higher radiological grades and 3 were unchanged. In the 11 TMJs with higher radiological grades at follow-up, there was in most cases moderate progression of erosive changes. The results suggest that the long-term development of symptoms and signs from the TMJ in patients previously treated was good and the long-term progression of joint destruction was low for both steroid and non-steroid agents in this patient group with RA.
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| 7. |
- Wolf, Eva, et al.
(författare)
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Long-term follow-up by means of a questionnaire of 109 patients with long-lasting orofacial pain.
- 2002
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 26:3, s. 125-34
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to follow-up, analyse and compare the pain status after 4-9 years with that at the baseline examination of 109 consecutive patients referred to the Pain Group at the Faculty of Odontology in Malmö, Sweden during the period 1988-1993 due to long-lasting orofacial pain. A further aim was to identify predictive factors of significance for pain alteration. 85 (78%) women with a median age of 51 years and 24 (22%) men with a median age of 60 years were included in the study. A survey of the pain status at the follow-up was conducted by means of a mailed questionnaire. The questionnaire covered the following aspects: pain alteration, pain intensity, pain location, medication and education. After one reminder, the non-responding patients were called for a telephone interview. A response level of 85% was obtained. Significant improvements were noted by the patients in the answers of the questionnaire in mainly three areas; the patients answered individually that pain relief had occurred, pain intensity rated on the VAS was lower at follow-up compared to the baseline examination and a decrease in drug use was reported. The responses indicated pain relief for 75% of the patients. However, only 27% of the patients experienced total disappearance of pain. Medication at baseline with opioids, muscle relaxants with central effect, antidepressants, neuroleptics, hypnotics or sedatives was found to be a predictive factor for persistent pain.
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