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  • Albrektsson, Tomas, et al. (författare)
  • On crestal/marginal bone loss around dental implants.
  • 2012
  • Ingår i: The International journal of prosthodontics. - 0893-2174. ; 25:4, s. 320
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Recently published reports(1-5) as well as a consensus statement(6) have suggested an alarming increase in inflammatory responses around dental implants that are accompanied by variable levels of marginal bone loss. These responses are popularly referred to as an escalating disease entity-so-called "peri-implantitis." This emerging mindset poses serious questions for the long-term viability of the osseointegration technique if the condition indeed exists in a primary form. However, the bulk of the existing literature related to osseointegration has not described peri-implant gingivitis with accompanying marginal bone changes in such dramatic terms. In fact, it has been well documented that failure to induce and maintain long-term osseointegration actually occurs in less than 5% of treated patients. Moreover, clinical outcome studies have not routinely described complications related to progressive soft or hard tissue deterioration. Consequently, the current emphasis on the significance of peri-implant bone loss represents either an ignored phenomenon or is an overtly pessimistic interpretation of or emphasis on a somewhat rarely occurring event. In an effort to determine which of these dichotomous occurrences more closely resembles the truth, an independent initiative sought to evaluate questions related to soft and hard tissue damage adjacent to dental implants.
  • Frisk, Fredrik, et al. (författare)
  • Pulp exposures in adults--choice of treatment among Swedish dentists.
  • 2013
  • Ingår i: Swedish dental journal. - 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 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.
  • Andersson, Bodil T., et al. (författare)
  • Radiographers' areas of professional competence related to good nursing care
  • 2008
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 22:3, s. 401-409
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.
  • Ketelhuth, Daniel, et al. (författare)
  • Identification of a danger-associated peptide from apolipoprotein B100 (ApoBDS-1) that triggers innate proatherogenic responses
  • 2011
  • Ingår i: Circulation. - 1524-45390009-7322. ; 124:22, s. 2433-431-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background- Subendothelial deposited low-density lipoprotein particles are a known inflammatory factor in atherosclerosis. However, the causal components derived from low-density lipoprotein are still poorly defined. Apolipoprotein B100 (ApoB100) is the unexchangeable protein component of low-density lipoprotein, and the progression of atherosclerosis is associated with immune responses to ApoB100-derived peptides. In this study, we analyzed the proinflammatory activity of ApoB100 peptides in atherosclerosis. Methods and Results- By screening a peptide library of ApoB100, we identified a distinct native peptide referred to as ApoB100 danger-associated signal 1 (ApoBDS-1), which shows sequence-specific bioactivity in stimulation of interleukin-8, CCL2, and interleukin-6. ApoBDS-1 activates mitogen-activated protein kinase and calcium signaling, thereby effecting the expression of interleukin-8 in innate immune cells. Ex vivo stimulation of carotid plaques with ApoBDS-1 enhances interleukin-8 and prostaglandin E(2) release. Furthermore, we demonstrated that ApoBDS-1-positive peptide fragments are present in atherosclerotic lesions using immunoassays and that low-molecular-weight fractions isolated from plaque show ApoBDS-1 activity inducing interleukin-8 production. Conclusions- Our data show that ApoBDS-1 is a previously unrecognized peptide with robust proinflammatory activity, contributing to the disease-promoting effects of low-density lipoprotein in the pathogenesis of atherosclerosis.
  • Del Corso, Marco, et al. (författare)
  • Current Knowledge and Perspectives for the Use of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in Oral and Maxillofacial Surgery Part 1: Periodontal and Dentoalveolar Surgery
  • 2012
  • Ingår i: Current Pharmaceutical Biotechnology. - 1389-2010. ; 13:7, s. 1207-1230
  • Tidskriftsartikel (refereegranskat)abstract
    • Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In periodontology and dentoalveolar surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this first article, we describe and discuss the current published knowledge about the use of PRP and PRF during tooth avulsion or extraction, mucogingival surgery, Guided Tissue Regeneration (GTR) or bone filling of periodontal intrabony defects, and regeneration of alveolar ridges using Guided Bone Regeneration (GBR), in a comprehensive way and in order to avoid the traps of a confusing literature and to highlight the underlying universal mechanisms of these products. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the systematic use of L-PRF (Leukocyte- and Platelet- Rich Fibrin) clots and membranes during tooth avulsion, cyst exeresis or the treatment of gingival recessions by root coverage. The use of L-PRF also allowed to define new therapeutic principles: NTR (Natural Tissue Regeneration) for the treatment of periodontal intrabony lesions and Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges. In periodontology, this field of research will soon find his golden age by the development of user-friendly platelet concentrate procedures, and the definition of new efficient concepts and clinical protocols.
  • Fröjd, Victoria, et al. (författare)
  • Effect of nanoporous TiO2 coating and anodized Ca2+ modification of titanium surfaces on early microbial biofilm formation.
  • 2011
  • Ingår i: BMC oral health. - 1472-6831. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The soft tissue around dental implants forms a barrier between the oral environment and the peri-implant bone and a crucial factor for long-term success of therapy is development of a good abutment/soft-tissue seal. Sol-gel derived nanoporous TiO2 coatings have been shown to enhance soft-tissue attachment but their effect on adhesion and biofilm formation by oral bacteria is unknown. METHODS: We have investigated how the properties of surfaces that may be used on abutments: turned titanium, sol-gel nanoporous TiO2 coated surfaces and anodized Ca2+ modified surfaces, affect biofilm formation by two early colonizers of the oral cavity: Streptococcus sanguinis and Actinomyces naeslundii. The bacteria were detected using 16S rRNA fluorescence in situ hybridization together with confocal laser scanning microscopy. RESULTS: Interferometry and atomic force microscopy revealed all the surfaces to be smooth (Sa≤0.22 μm). Incubation with a consortium of S. sanguinis and A. naeslundii showed no differences in adhesion between the surfaces over 2 hours. After 14 hours, the level of biofilm growth was low and again, no differences between the surfaces were seen. The presence of saliva increased the biofilm biovolume of S. sanguinis and A. naeslundii ten-fold compared to when saliva was absent and this was due to increased adhesion rather than biofilm growth. CONCLUSIONS: Nano-topographical modification of smooth titanium surfaces had no effect on adhesion or early biofilm formation by S. sanguinis and A. naeslundii as compared to turned surfaces or those treated with anodic oxidation in the presence of Ca2+. The presence of saliva led to a significantly greater biofilm biovolume but no significant differences were seen between the test surfaces. These data thus suggest that modification with sol-gel derived nanoporous TiO2, which has been shown to improve osseointegration and soft-tissue healing in vivo, does not cause greater biofilm formation by the two oral commensal species tested than the other surfaces.
  • Halldin, Anders, et al. (författare)
  • The effect of static bone strain on implant stability and bone remodelling
  • 2011
  • Ingår i: Bone. - 8756-3282. ; 49:4, s. 783-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Bone remodeling is a process involving both dynamic and static bone strain. Although there exist numerous studies on the effect of dynamic strain on implant stability and bone remodeling, the effect of static strain has yet to be clarified. Hence, for this purpose, the effect of static bone strain on implant stability and bone remodeling was investigated in rabbits. Based on Finite Element (FE) simulation two different test implants, with a diametrical increase of 0.15 mm (group A) and 0.05 mm (group B) creating static strains in the bone of 0.045 and 0.015 respectively, were inserted in the femur (group A) and the proximal tibia metaphysis (groups A and B respectively) of 14 rabbits to observe the biological response. Both groups were compared to control implants, with no diametrical increase (group C), which were placed in the opposite leg. At the time of surgery, the insertion torque (ITQ) was measured to represent the initial stability. The rabbits were euthanized after 24 days and the removal torque (RTQ) was measured to analyze the effect on implant stability and bone remodeling. The mean ITQ value was significantly higher for both groups A and B compared to group C regardless of the bone type. The RTQ value was significantly higher in tibia for groups A and B compared to group C while group A placed in femur presented no significant difference compared to group C. The results suggest that increased static strain in the bone not only creates higher implant stability at the time of insertion, but also generates increased implant stability throughout the observation period.
  • Petersson, Gunnel H, et al. (författare)
  • Comparing caries risk factors and risk profiles between children and elderly.
  • 2004
  • Ingår i: Swedish dental journal. - 0347-9994. ; 28:3, s. 119-28
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of this study were to compare the caries risk profiles of children and elderly, the actual annual caries increment and the impact of some selected caries related factors. Another aim was to find out if there were gender differences among the participants. The risk profiles were created by a computerised risk assessment program, the Cariogram, which evaluates data and presents the weighted and summarized result as one figure, illustrating the ‘percent chance of avoiding caries’ in the future. Methods: The Cariogram was earlier evaluated in two longitudinal studies for its capacity to assess caries risk. One study comprised about 400 children, 10-11 years of age and the other study included about 150 elderly (age 55, 65 and 75). At baseline, information on past caries experience, diet, oral hygiene and use of fluoride was obtained. Saliva analyses included mutans streptococci and lactobacilli, buffering capacity and secretion rate. The caries risk was assessed and the participants were divided into five groups according to the calculated Cariogram risk profiles. After two and five years, respectively, caries was re-evaluated and the incidence was compared with the predictions. Results: The Cariogram risk predictions were statistically in agreement with the actual caries increment. Fifty percent of the children, but only two percent of the elderly appeared in the lowest caries risk group. Of the elderly, 26.4% belonged to the highest caries risk group versus 3.1% of the children. The median value ‘chance of avoiding caries’ was 44% for the elderly and 80% for the children. The main Cariogram sectors contributing to the observed higher caries risk among elderly was the bacterial components in combination with higher susceptibility. Individual factors contributing significantly to the higher risk profiles for the adults compared to the children were higher plaque scores, higher counts of mutans streptococci and lower buffering capacity. Conclusion: comparing the risk profiles of the children and the elderly showed that the elderly were at a higher risk developing caries lesions. Overall one may say that the risk for caries, as assessed by the Cariogram, was twice as high for the elderly.
  • Simonpieri, Alain, et al. (författare)
  • Current Knowledge and Perspectives for the Use of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in Oral and Maxillofacial Surgery Part 2: Bone Graft, Implant and Reconstructive Surgery
  • 2012
  • Ingår i: Current Pharmaceutical Biotechnology. - 1389-2010. ; 13:7, s. 1231-1256
  • Tidskriftsartikel (refereegranskat)abstract
    • Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In bone graft, implant and reconstructive surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this second article, we describe and discuss the current published knowledge about the use of PRP and PRF during implant placement (particularly as surface treatment for the stimulation of osseointegration), the treatment of peri-implant bone defects (after peri-implantitis, during implantation in an insufficient bone volume or during immediate post-extraction or post-avulsion implantation), the sinuslift procedures and various complex implant-supported treatments. Other potential applications of the platelet concentrates are also highlighted in maxillofacial reconstructive surgery, for the treatment of patients using bisphosphonates, anticoagulants or with post-tumoral irradiated maxilla. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the use of L-PRF (Leukocyte- and Platelet-Rich Fibrin) clots and membranes during the regeneration of peri-implant bone defects, during the sinus-lift procedure and during complex implant-supported rehabilitations. The use of L-PRF allowed to define a new therapeutic concept called the Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges at the gingival and bone levels. As it is illustrated in this article, the NBR principles allow to push away some technical limits of global implant-supported rehabilitations, particularly when combined with other powerful biotechnological tools: metronidazole solution, adequate bone substitutes and improved implant designs and surfaces (for example here AstraTech Osseospeed or Intra-Lock Ossean implants). As a general conclusion, we are currently living a transition period in the use of PRP and PRF in oral and maxillofacial surgery. PRPs failed to prove strong strategic advantages that could justify their use in daily practice, and the use of most PRP techniques will probably be limited to some very specific applications where satisfactory results have been reached. Only a few simple, inexpensive and efficient techniques such as the L-PRF will continue to develop in oral and maxillofacial surgery in the next years. This natural evolution illustrates that clinical sciences need concrete and practical solutions, and not hypothetical benefits. The history of platelet concentrates in oral and maxillofacial surgery finally demonstrates also how the techniques evolve and sometimes promote the definition of new therapeutical concepts and clinical protocols in the today's era of regenerative medicine.
  • Hultin, Margareta, et al. (författare)
  • Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 543-552
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract PURPOSE: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. RESULTS: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. CONCLUSIONS: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.
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