| 1. |
- Aludden, Hanna, 1984, et al.
(författare)
-
Histological and radiological outcome after horizontal guided bone regeneration with bovine bone mineral alone or in combination with bone in edentulous atrophic maxilla: A randomized controlled trial
- 2024
-
Ingår i: CLINICAL ORAL IMPLANTS RESEARCH. - 0905-7161 .- 1600-0501.
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB).Materials and MethodsEighteen edentulous patients with an alveolar ridge of <= 4 mm were included in this split-mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation.ResultsThe gained widths were 4.9 (+/- 2.4) mm (100:0) and 4.5 (+/- 2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (+/- 1.3) mm (100:0) and 4.6 (+/- 2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (+/- 23.8) (100:0) and 38.2% (+/- 23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (+/- 10.7) (100:0) and 46.4% (+/- 11.3) (90:10), DBBM were 31.6% (+/- 12.6) (100:0) and 35.4% (+/- 14.8) (90:10), and non-mineralized tissue were 17.6% (+/- 11.7; 100:0) and 18.2% (+/- 18.2) (90:10). No significant differences were evident between in any evaluated parameters.ConclusionsThere were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing.
|
|
| 2. |
- Berlin, Marie, et al.
(författare)
-
Dental health care utilization among young adults who were in societal out-of-home care as children : a Swedish national cohort study
- 2018
-
Ingår i: International Journal of Social Welfare. - : John Wiley & Sons. - 1369-6866 .- 1468-2397. ; 27:4, s. 325-336
-
Tidskriftsartikel (refereegranskat)abstract
- We used Swedish national registers to analyse dental health care among young adults with childhood experience of out‐of‐home care (OHC), in Cox regression analyses. All 1.7 million Swedish residents born in 1980–1994 were included, of whom 4% had been in OHC. The population was followed up in the Dental Health Register from age 20 to 29, during the period 2009–2014. We found that persons with short or long OHC experience made emergency dental care visits more often than their majority‐population peers: 17–23% versus 9–10%, (adjusted Hazard ratios [HR:s] 1.60–2.02); they more often had tooth extractions, 9–12% versus 3% (HR:s 2.33–3.03); but less regularly visited a dentist for planned check‐ups, 61–77% versus 80–87% (HR:s 0.76–0.78). Since dental health in young adulthood reflects dental health and dental care in childhood, the findings of this study call for improved preventive dental health care for children in OHC.
|
|
| 3. |
- Cederlund, Andreas, et al.
(författare)
-
Caries treatment in Swedish adults : effectiveness, costs and equity. A 4-year follow-up study of data from the Swedish national dental health register
- 2016
-
Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 223-234
-
Tidskriftsartikel (refereegranskat)abstract
- Planering och styrning av tandvård på nationell nivå bör baseras på utvärderingar av jämlik fördelning, effektivitet och kostnader. Med inrättandet av tandhälsoregistret vid Socialstyrelsen öppnas möjligheter för studier av tandvårdens processer och resultat. Syftet med studien var att utifrån två identifierade kohorter longitudinellt följa och analysera frekvens och kostnader för ny fyllning eller tandkrona på tidigare restaurerad tand (omgörningar) samt relationen mellan förebyggande tandvårdsåtgärder i relation till reparativ och restaurativ tandvård orsakad av karies. Med hjälp av tandhälsoregistret studerades två kohorter omfattande den vuxna befolkningen. En longitudinell modell användes för uppföljning. I den första kohorten följdes 1 878 887 tänder hos 1 088 923 patienter mellan 42 och 48 månader. I den andra kohorten följdes 1 703 147 patienter under en period av mellan 48 och 54 månader. Fördelning av tandvård för olika åldersgrupper visade att kohorterna var representativa för hela patientgruppen. Fördelning av tandvårdsbesök varierade mellan 140 och 160 räknat per 1 000 invånare trots olika geografiska förutsättningar. Resultaten baserade på den första kohorten visar att 76% av tänderna inte fick någon ytterligare åtgärd med fyllning eller tandkrona under uppföljningsperioden, och att för resterande 24% av tänderna fick 77% endast en ny åtgärd. Det förelåg ingen könsskillnad, däremot skillnader på upp till tre intakta tänder mellan olika regioner. Resultat från den andra kohorten visade heller ingen könsskillnad. De genomsnittliga kostnaderna för reparativa åtgärder på grund av karies ökade gradvis i relation till ökade kostnader för förebyggande åtgärder. Vidare var kostnaderna för reparativa åtgärder lägre ju längre tid som följde mellan förebyggande åtgärder. Det nationella tandhälsoregistret utgör en värdefull källa för forskning om tandvård. Longitudinella registerdata för reparationer och preventiva åtgärder kan användas för att studera effektivitet, kostnader och jämlik fördelning av tandvård. Resultaten har en potential för förbättrad styrning av tandvården.
|
|
| 4. |
- Cederlund, Andreas
(författare)
-
Dentin surface conditioning : the role of collagen in dentin bonding
- 2002
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Preparation of dental cavities inevitably produces a thin layer of smear, which covers dentin and enamel surfaces. This smear layer, which is between 1 and 10 gm thick, consists of hydroxyapatite, denatured collagen and remnants of cariogenic bacteria. If left untouched, it will weaken the bond between filling material and cavity wall. Thus, etching of cavity walls has been recommended since the mid-1950's. In addition to removing smear, adds demineralize peri- and intertubular dentin and expose collagen fibers. The concept of a hybrid layer as part of adhesive restorative dentistry introduced by Nakabayashi and co-workers in 1982 relies on infiltration of the exposed collagen fibres by a primer. However, recent results have indicated that acids operating at low pH such as phosphoric acid may dissolve not only the mineral component of dentin but also the collagenous matrix. The overall aim of the studies on which the present thesis is based was to investigate how cavity preparation may modify the quality of the dentin surface and its bonding properties. The shear strength of bonding to dentin etched with EDTA was tested after the efficacy of EDTA in removing smear and exposing collagen had been confirmed. To test the significance of collagen for dentin bonding, surfaces with an ascending amount of collagen were prepared. The following conclusions represent the most significant findings: · Acid etching altered the collagen structure and showed a less homogenous appearance compared to the collagen etched with EDTA, which showed distinct cross-striated pattern with no apparent difference to the non-etched control. · By combining of two different etchants, EDTA on dentin and phosphoric acid on enamel, the structures on each tissue surface could be optimized for retention compared to any single one of the two etchants applied to both tissues of the cavity walls. · Caries excavation using CarisolvTM always resulted in a smear layer, covering surfaces of the cavity.. Residual caries, predominantly in the enamel dentin interface, were found in six of ten cavities excavated with CarisolvTm. · Shear strength for All Bond 2 bonded to dentin was significantly increased then the dentin was treated with EDTA-gel compared to phosphoric acid etching. · A smear-free dentin surface showing abundant fiber structures and patent dentin tubuli compared to a smear-free dentin surface showing traces of fiber structures and clearly outlined dentin tubuli provided a significantly better surface for dentin bonding. These surfaces were consistently the result of EDTA treatment regardless of exposure time, while, phosphoric acid treatment, the current clinically accepted standard dentin etching treatment resulted in fewer and also compromised collagen fibers in the dentin surface. · Similarly, a smear-covered dentin surface provided a dentin surface with less optimal bonding characteristics comparable to a phosphoric acid etched and Na0Cl-treated surface. · The importance of an intact collagenous fiber network is further emphasized by the results in which Na0Cl was used to remove all traces of denuded collagen fibers resulting in no significant difference between phosphoric add or EDTA treatment. These results also lend support to the theory that an intact denuded collagen network provides a significantly better environment for resin penetration and entanglement, thus increasing the thickness of the hybrid layer. Thus, the present thesis has shown an essential role of an intact collagen network in dentin cavity surfaces for optimizing bond strength of adhesive restorations. In this context, EDTA treatment has been shown to meet all clinical requirements of a dentin conditioner.
|
|
| 5. |
- Cederlund, Andreas
(författare)
-
Expression and regulation of antimicrobial peptides in mucosal immunity
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Antimicrobial polypeptides (AMPs) are effector molecules of the innate immune defense. AMPs are mainly expressed in epithelial cells and immune cells, providing the first line of defense to infection as direct antimicrobials. In addition, many AMPs display immunomodulatory functions in both the adaptive and innate immune system. Thus, a tight control of AMP-expression is necessary for a functional immune response. In this thesis the antimicrobial polypeptide armament of neutrophils (PMNs) was evaluated for its activity against four human pathogens S. aureus, H. influenzae, M. catarrhalis and C. albicans. We observed a high degree of redundancy in antimicrobial activity for a majority of the AMPs. Still, some polypeptides exhibited a more specific activity against individual pathogens. This suggests that PMNs are equipped with a repertoire of antimicrobial peptides and proteins with broad activities, underscoring the importance of PMNs in the host response. In a clinical study the expressions of cathelicidin LL-37 and α-defensins HNP1-3 were quantified in nasal fluids of patients with primary immunodeficiencies (PIDs). Healthy controls and most PID patients responded to pathogens with increased levels of AMPs in their nasal fluid. Interestingly, in patients with common variable immune deficiency (CVID) and Hyper IgE syndrome (HIES), the levels of AMPs did not increase in response to pathogens. Thus, there is a dysregulation in AMP-release in CVID and HIES patients, which may explain why these patients suffer from frequent respiratory tract infections. Furthermore, we have detected an induced expression of AMPs by human breast milk in colonic epithelial cell lines. We isolated and characterized the inducing compound as lactose and noted that the inducing effect of the gene encoding LL-37 (CAMP) was dependent on intact p38 mitogen-activated protein kinase and c-Jun N-terminal kinase signaling. A strong synergistic effect on CAMP expression in HT-29 cells was observed in stimulations with lactose and phenylbutyrate or butyrate. This synergistic effect was further dissected by a proteomic approach. The subsequent pathway analysis of the proteomic results indicated that eleven pathways were activated. By using the novel CAMP gene reporter system we confirmed that the pathways of thyroid hormone receptor and retinoid X receptor (TR/RXR) activation, eicosanoid signaling and steroid biosynthesis were associated with the regulation of CAMP. In summary, AMPs exhibit both a large redundancy and strict specificity with regards to microbial killing. This may be relevant for certain disease conditions, where AMPs are lacking or dysregulated. Endogenous molecules, such as lactose and thyroid hormones are inducers of AMPs. In light of the wide-spread antibiotic resistance, attempts to strengthen epithelial barriers are highly warranted and the data presented here provide a concrete rationale for such studies.
|
|
| 6. |
- Cederlund, Ella, et al.
(författare)
-
Characterization of new medium-chain alcohol dehydrogenases adds resolution to duplications of the class I/III and the sub-class I genes
- 2011
-
Ingår i: Chemico-Biological Interactions. - : Elsevier Science B.V., Amsterdam.. - 0009-2797 .- 1872-7786. ; 191:03-jan
-
Tidskriftsartikel (refereegranskat)abstract
- Four additional variants of alcohol and aldehyde dehydrogenases have been purified and functionally characterized, and their primary structures have been determined. The results allow conclusions about the structural and evolutionary relationships within the large family of MDR alcohol dehydrogenases from characterizations of the pigeon (Columba livia) and dogfish (Scyliorhinus canicula) major liver alcohol dehydrogenases. The pigeon enzyme turns out to be of class I type and the dogfish enzyme of class III type. This result gives a third type of evidence, based on purifications and enzyme characterization in lower vertebrates, that the classical liver alcohol dehydrogenase originated by a gene duplication early in the evolution of vertebrates. It is discernable as the major liver form at about the level in-between cartilaginous and osseous fish. The results also show early divergence within the avian orders. Structures were determined by Edman degradations, making it appropriate to acknowledge the methodological contributions of Pehr Edman during the 65 years since his thesis at Karolinska Institutet, where also the present analyses were performed.
|
|
| 7. |
- Hallman, Mats, et al.
(författare)
-
A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation. Results after 6 to 8 months of healing.
- 2001
-
Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 12:2, s. 135-143
-
Tidskriftsartikel (refereegranskat)abstract
- Biopsies were taken from 16 out of 20 consecutive referral patients 6 to 8 months after maxillary sinus floor augmentation with a mixture of bovine hydroxyapatite (BH), autogenous bone particles and fibrin glue. Four days prior to biopsy retrieval the patients were given a single dose of tetracycline to label bone forming sites. Fluorescence microscopy of 100 microm thick sections revealed active bone formation in conjunction with the BH particles in 14 of 15 specimens analysed. Light microscopy and morphometry of ground sections from 16 patients showed various amounts of mineralised bone tissue in all except one specimen. In the latter case, the BH particles were encapsulated by a dense fibrous connective tissue. Sections from the augmented areas were occupied by non-mineralized tissue (54.1+12.6%), lamellar bone (21.2+24.5%), BH particles (14.5+10.3%) and woven bone (10.2+13.4%). The non-mineralized tissue seen in bone forming areas consisted of a loose connective tissue, rich of vessels and cells, and in the periphery of a more dense fibrous connective tissue. Woven bone with large and scattered osteocyte lacunae was bridging between the BH particles and the lamellar trabecular bone. There were no signs of resorption of the BH particles. The lamellar bone appeared to have originated from the recipient site and was seldom in contact with the BH particles. It is concluded that the tested implant material has bone conducting properties. The bone associated with the BH particles after 6 to 8 months of healing was mainly woven.
|
|
| 8. |
- Hultin, Margareta, et al.
(författare)
-
Dental implant procedures contribution to the total antibiotic use in Swedish dentistry. A register-based study
- 2023
-
Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:2
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To study the influence of demographic and organizational factors to antibiotic utilization in dental implant surgery in Sweden. Material and methods Descriptive statistics regarding antibiotic prescription between 2009 and 2019 was retrieved from two national registers, the Swedish Prescribed Drug Register and the Dental Health register, both administered by the National Board of Health and Welfare. Results During the years 2009-2019 a significant decrease of the proportion of prescriptions of systemic antibiotics in conjunction with implant surgical procedures occurred in all patient groups where the most common procedure was the insertion of a single implant. The proportion of dental visits when implant surgical treatment was performed which resulted in a prescription of antibiotics decreased significantly from 1/3 to approximately 1/5. However, comparing Public and Private dental care providers, the reduction was significantly greater in Public dental care. Patients with low level of education in urban regions, treated in Private dental clinics were more likely to receive antibiotics in conjunction to implant surgery compared to other groups. Phenoxymethylpenicillin is the most widely used substance in conjunction with implant surgery. Conclusion There is still room for improvement in reduction of antibiotic prescriptions in conjunction to implant surgical procedures in Sweden.
|
|
| 9. |
- Kirkinen, Tita, et al.
(författare)
-
Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden
- 2023
-
Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:8, s. 615-621
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives This study evaluates the agreement of data on dental caries between electronic dental records and data retrieved from the national SKaPa-registry (Swedish Quality Registry for caries and periodontal disease), with special reference to e/M in deft/DMFT.Methods In a random sample of 500 6- and 12-year-old children having received dental care in 2014 in the county region of Värmland, Sweden, the diagnostic accuracy of data in electronic dental records with corresponding data obtained from the SKaPa-registry was compared by using Cohen’s Kappa and Intraclass correlation coefficient (ICC).Results For dft/DFT the Kappa was 0.95, and ICC 0.98 (total population). For deft/DMFT in the total population the Kappa was 0.80 and ICC 0.96. For 6-year-olds (deft) the Kappa was 0.89 and ICC 0.99 and for 12-year-olds (DMFT) the Kappa was 0.70, and ICC 0.83. The corresponding figures for Kappa and ICC when excluding individuals without caries (deft/DMFT = 0) were: Total population 0.63 and 0.94; 6-year-olds 0.79 and 0.99; 12-year-olds 0.42 and 0.68.Conclusion Agreement between data in the dental records and SKaPa was very high for dft/DFT confirming that transfer from the dental records to the SKaPa-registry is safe and correct. As the accuracy of deft/DMFT was considerably lower than for dft/DFT we advise against using deft/DMFT data from SKaPa for research purposes at this point.
|
|
| 10. |
- Kirkinen, Tita
(författare)
-
Dental health and dental care in children in out-of-home care
- 2023
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- More than 26,000 children and young people are placed in out-of-home care in Sweden every year. Several studies show that children placed in out of home care have poorer health during childhood and are generally in poorer physical condition later in life. The overall aim of this thesis was to study dental health and dental care in children in out-of-home care (OHC), through registry-based research. Paper I was a registry-based study of dental health care utilisation among young adults who as children had been placed in societal out-of-home care. These young adults had more emergency dental visits and more extractions and fewer regular scheduled dental check-ups than their peers who had never experienced OHC.Paper II was a systematic review/HTA to evaluate organisational models intended to ensure that children and young people in out-of-home care will receive health and dental care. We were unable to identify any study, of low or medium risk of bias, which examined the effects of organisational models on provision of health and dental care for children and young people in foster care and in institutions.Papers III and IV were validation studies of the Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa), undertaken to determine the accuracy of the registry and whether it was appropriate for application in the next study (Paper V) and for other research purposes. For dft/DFT, the validation studies showed high agreement between the data in the patient records and the SKaPa registry. However, e/M in deft/DMFT was shown to be uncertain.Paper V was a registry-based study linking different registries, to investigate dental health and dental care in children in OHC. This study showed that children in OHC have more caries and undergo fewer dental health assessments than those who have never been placed in OHC. There was a difference in dental health examinations before and after the year 2017, with higher frequencies of assessments after the legislative amendment in 2017. However, differences remain.
|
|
