| 1. |
- Axelsson, Susanna, et al.
(författare)
-
Economic aspects of the detection of occlusal dentine caries.
- 2009
-
Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 67:1, s. 38-43
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the cost of true-positive occlusal dentine caries detection in permanent molars assessed by: (I) visual-tactile examination, (II) visual-tactile examination combined with bitewing radiographs, and (III) selective radiographic examination of patients with lesions detected clinically. A second aim was to analyse the different strategies when the costs of the subsequent restorative care are considered. METHODS: A model analysis was applied owing to the lack of original articles. Sensitivity and specificity were calculated from a systematic review and included in vitro and in vivo studies of medium and high quality. The direct costs for examinations and restorative care were extracted from the costs of the Public Dental Service in Sweden (2006). RESULTS: The diagnostic costs per true-positive finding were dependent on the occurrence of occlusal caries and increased with decreasing prevalence. The strategy by which radiographs were exposed selectively on the basis of findings from visual-tactile examination resulted in higher initial costs compared with the first and second strategies. When the costs of the subsequent restorative care were added, the selective strategy was most beneficial by up to 26% savings per true-positive diagnosis. However, with this selective strategy, more cases of true-positive dentine caries were assumed would remain undetected as compared with the combined strategy with visual-tactile examination and radiographs for all. CONCLUSIONS: The cost for a true-positive caries diagnosis was inversely related to caries occurrence, and different diagnostic strategies may display contrasting outcomes when subsequent restorative care is taken into account.
|
|
| 2. |
- Axelsson, Susanna, et al.
(författare)
-
Effect of combined caries-preventive methods: a systematic review of controlled clinical trials.
- 2004
-
Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 163-9
-
Forskningsöversikt (refereegranskat)abstract
- The aim of this systematic review was to evaluate the caries-preventive effect of combined caries-preventive methods, defined as two or more different interventions in combination, each expected to prevent dental caries. The Medline database was searched for articles published in the period January 1966 to June 2003. Twenty-four controlled studies met the inclusion criteria, and their value as evidence was assessed according to predetermined criteria. The level of evidence for the overall conclusion regarding each method was graded according to the protocol of the Swedish Council on Technology Assessment in Health Care. The scientific evidence for the combination of treatments involving fluoride that had a preventive effect on caries in children and adolescents was graded as moderate. However, for elderly patients the scientific evidence for the caries-preventive effect of different combinations of treatments was found to be incomplete. No conclusion could be drawn regarding the evidence for combinations of treatments being effective for groups at high caries risk, as the results from the identified clinical studies were conflicting.
|
|
| 3. |
|
|
| 4. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
-
Treatment of pulps in teeth affected by deep caries - A systematic review of the literature.
- 2013
-
Ingår i: Singapore dental journal. - : World Scientific Pub Co Pte Lt. - 0377-5291. ; 34:1, s. 1-12
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.STUDY DESIGN: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.RESULTS: No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.CONCLUSIONS: Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.
|
|
| 5. |
|
|
| 6. |
- Frisk, Fredrik, 1971, et al.
(författare)
-
Pulp exposures in adults--choice of treatment among Swedish dentists.
- 2013
-
Ingår i: Swedish dental journal. - : Sveriges tandläkarförbund. - 0347-9994. ; 37:3, s. 153-60
-
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.
|
|
| 7. |
- Källestål, Carina, et al.
(författare)
-
Economic evaluation of dental caries prevention : a systematic review
- 2003
-
Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:6, s. 341-346
-
Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present study was to perform a systematic review of economic evaluations of caries prevention. A search in Medline from 1966 until May 2003 and a manual search in a number of journals identified 154 references, 74 of which were included. There were 17 original studies including an economic evaluation, and these form the basis of the present article. The rest were reviews, model studies and reports concerning economic practice in dentistry. The results show that the reviewed original studies on economic evaluation of caries prevention do not provide support for the economic value of caries prevention. The scarcity of well-conducted studies, as well as contra-dictory evidence in the reviewed articles, makes it difficult to judge the health-economic effect of the studied caries-prevention methods.
|
|
| 8. |
- Lingström, Peter, et al.
(författare)
-
Dietary factors in the prevention of dental caries : a systematic review
- 2003
-
Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 61:6, s. 331-340
-
Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was, systematically, to evaluate the effect of die-tary changes in the prevention of dental caries. A search and analysis strategy was followed, as suggested by the Swedish Council on Tech-nology Assessment in Health Care (SBU). The search strategy for arti-cles published in 1966-2003 was performed using electronic databases and reference lists of articles and selected textbooks. Out of 714 arti-cles originally identified, 18 met the inclusion criteria for a random-ized or controlled clinical trial--at least 2 years’ follow-up and caries increment as a primary endpoint. This included the total or partial substitution of sucrose with sugar substitutes or the addition of pro-tective foods to chewing gum. No study was found evaluating the ef-fect of information designed to reduce sugar intake/frequency as a sin-gle preventive measure. It is suggested that the evidence for the use of sorbitol or xylitol in chewing gum, or for the use of invert sugar, is in-conclusive. No caries-preventive effect was found from adding calcium phosphate or dicalcium phosphate dihydrate to chewing gums. The review clearly demonstrates the need for well-designed randomized clinical studies with adequate control groups and high compliance.
|
|
| 9. |
- Mejàre, Ingegerd, et al.
(författare)
-
Caries-preventive effect of fissure sealants : a systematic review
- 2003
-
Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:6, s. 321-330
-
Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- The objectives of this study were to evaluate systematically the evi-dence of the caries-preventive effect of fissure sealing of occlusal tooth surfaces and to examine factors potentially modifying the effect. The search strategies included electronic databases, reference lists of arti-cles, and selected textbooks. Inclusion criteria were randomized or quasi-randomized clinical trials or controlled clinical trials comparing fissure sealing with no treatment or another preventive treatment in children up to 14 years of age at the start; the outcome measure was caries increment; the diagnostic criteria had been described; and the follow-up time was at least 2 years. Inclusion decisions were taken and grading of the studies was done independently by two of the authors. The main measure of effect was relative risk reduction. Thirteen stud-ies using resin-based or glass ionomer sealant materials were included in the final analysis. The results showed that most studies were per-formed during the 1970s and a single application had been utilized. The relative caries risk reduction pooled estimate of resin-based seal-ants on permanent 1st molars was 33% (relative risk = 0.67; CI = 0.55-0.83). The effect depended on retention of the sealant. In conclu-sion, the review suggests limited evidence that fissure sealing of 1st permanent molars with resin-based materials has a caries-preventive effect. The evidence is incomplete for permanent 2nd molars, premo-lars and primary molars and for glass ionomer cements. Overall, there remains a need for further trials of high quality, particularly in child populations with a low and a high caries risk, respectively.
|
|
| 10. |
- Petersson, Lars G, et al.
(författare)
-
Professional fluoride varnish treatment for caries control: a systematic review of clinical trials.
- 2004
-
Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 170-6
-
Forskningsöversikt (refereegranskat)abstract
- The aim of this paper was systematically to evaluate the caries-preventive effect of professional fluoride varnish treatments. A search of the literature for articles published between 1966 and August 2003 was carried out in electronic databases, reference lists of articles, and selected textbooks in accordance with the strategy of the Swedish Council on Technology Assessment in Health Care. Out of 302 identified papers, 24 randomized and controlled clinical trials comparing fluoride varnish with placebo, no active treatment or other fluoride preventive regimens of at least 2 years' study duration were included. The trials that met the inclusion criteria were assessed independently and systematically by at least two reviewers and scored from A to C according to predetermined criteria for methodology and performance. The main outcome measure was the preventive fraction expressed as a percentage. The results displayed limited evidence (evidence level 3) for the caries preventive effect of topical applications of fluoride varnishes in permanent teeth. The average prevented fraction was 30% (0-69%) when compared with untreated controls. Inconclusive evidence (evidence level 4) was found for fluoride varnish treatment in the primary dentition and in adults. This systematic review reinforces the need for future dinical research of high quality, incorporating modern concepts of dinical performance and evaluation to assess dental caries control using professional fluoride varnish.
|
|
