| 1. |
- Fransson, Helena, et al.
(författare)
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There is a paucity of economic evaluations of prediction methods of caries and periodontitis : A systematic review
- 2021
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Ingår i: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:3, s. 385-398
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Direct cost for methods of prediction also named risk assessment in dentistry may be negligible compared with the cost of extensive constructions. On the other hand, as risk assessment is performed daily and for several patients in general dental practice, the costs may be considerable. The objective was to summarize evidence in studies of economic evaluation of prognostic prediction multivariable models and methods of caries and periodontitis and to identify knowledge gaps (PROSPERO registration number: CRD42020149763). Material and methods: Four electronic databases (PubMed, Web of Science, The Cochrane Library, NHS Economic Evaluation Database) and reference lists of included studies were searched. Titles and abstracts were screened by two reviewers in parallel. Full-text studies reporting resources used, costs and cost-effectiveness of prediction models and methods were selected and critically appraised using a protocol based on items from the CHEERS checklist for economic evaluations and the CHARMS checklist for evaluation of prediction studies. Results: From 38 selected studies, six studies on prediction fulfilled the eligibility criteria, four on caries and two on periodontitis. As the economic evaluations differed in method and perspective among the studies, the results could not be generalized. Our systematic review revealed methodological shortcomings regarding the description of predictive models and methods, and particularly of the economic evaluation. Conclusions: The systematic review highlighted a paucity of economic evaluations regarding methods or multivariable models for prediction of caries and periodontitis. Our results indicate that what we currently practice using models and methods to predict caries and periodontitis lacks evidence regarding cost-effectiveness.
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| 2. |
- Andersson, Helena, et al.
(författare)
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Walking football for Health - physiological response to playing and characteristics of the players.
- 2023
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Ingår i: Science and medicine in football. - : Routledge. - 2473-3938 .- 2473-4446. ; , s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.
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| 3. |
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| 4. |
- Bergström, Malin, et al.
(författare)
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Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:2, s. 294-300
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Joint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned.METHODS: In this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure.RESULTS: Children in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families.CONCLUSION: Joint physical custody arrangements were not associated with more psychological symptoms in children aged 3-5, but longitudinal studies are needed to account for potential preseparation differences.
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| 5. |
- Bjorndal, Lars, et al.
(författare)
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Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy
- 2010
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 118:3, s. 290-297
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Tidskriftsartikel (refereegranskat)abstract
- Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (−22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.
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| 6. |
- Bjørndal, Lars, et al.
(författare)
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Randomised clinical trial on deep caries excavation 3-5 yr follow-up
- 2012
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Ingår i: Journal of dental research. - : Sage Publications. ; 91:Spec Iss b
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Long term follow-up data based on randomised clinical trials are needed in relation to deep caries treatment. The aim of the present trial is to investigate the beneficial and harmful long term effects of stepwise excavation during two visits versus one completed excavation of deep caries in permanent teeth in adults. Methods: Consecutive patients contacting clinical units in Sweden and Denmark were included. The trial is a centrally randomised patient- and observer-blinded multicenter trial, with two parallel intervention groups. A sample size calculation showed that 134 patients were needed in each group. Taking dropouts into account, a total of 314 patients fulfilled well-defined inclusion and exclusion criteria and were centrally block-randomised stratified by age and pain. Inclusion criteria: (i) Person ≥ 18 yrs having deep caries with or without pain (ii) x-ray showing primary caries into the inner 1/4 of the dentin, with the presence of a radiopaque zone at the pulpal wall. Success was defined as unexposed pulp with sustained pulp vitality without apical radiolucency after follow-up. Blinded evaluation of 1½ follow-up has previously been carried out in 106 patients (stepwise excavation group) and 93 patients (direct complete excavation) (Bjørndal et al. 2010, EJOS). Results: At 3-5 yr follow up there was a statistically significantly higher success with stepwise excavation [difference: 11.5%, 95% confidence interval (0.5; 22.2)] versus a direct complete excavation procedure, being similarly with the short term follow-up data. 53.3% (n = 102) of the material has been controlled and no significant differences were noted between the two intervention groups in terms of patients not yet controlled, lost patients and failures (Table). Conclusion: A stepwise excavation procedure still seems preferable after a long term follow up and presumably related to the reduced risk of exposing the inflamed pulp associated with deep caries.
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| 7. |
- Bjørndal, Lars, et al.
(författare)
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Randomized Clinical Trials on Deep Carious Lesions : 5-Year Follow-up
- 2017
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Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 96:7, s. 747-753
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Tidskriftsartikel (refereegranskat)abstract
- Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1-26.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up (ClinicalTrials.gov NCT00187837 and NCT00187850).
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| 8. |
- Bjørndal, Lars, et al.
(författare)
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Treatment of vital pulp conditions
- 2018
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Ingår i: Textbook of Endodontology. - : Wiley-Blackwell. - 9781119057314 - 9781119057369 ; , s. 79-100
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Brodén, Joséphine, et al.
(författare)
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Cost-effectiveness of pulp capping and root canal treatment of young permanent teeth
- 2019
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:4, s. 2751-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To contribute with information on cost-effectiveness of pulp capping and root canal treatment of posterior permanent vital teeth in children and adolescents with pulp exposures due to caries. MATERIAL AND METHODS: Cost-effectiveness by means of a Markov simulation model was studied in a Scandinavian setting. In a simulated 12-year-old patient, treatment of pulpal exposure of a permanent tooth, either by the initial treatment pulp capping or root canal treatment, was followed for 9 years until the patient was 21. The model was based on outcome data obtained from published literature and cost data based on reference prices. RESULTS: In the simulated case, with the annual failure probalility (AFP) of 0.034 for pulp capping, the total cost for an initial treatment with pulp capping and any anticipated following treatments during the 9 years, was 367 EUR lower than for a root canal treatment as the initial treatment. After an initial treatment with pulp capping 10.4% fewer teeth, compared with initial root canal treatment, were anticipated to be extracted. Pulp capping was thus considered to be the cost-effective alternative. The sensitivity analyses showed that the AFP of a tooth requiring a root canal treatment after an initial pulp capping needed to be 0.2 before root canal treatment may be considered being the cost-effective treatment. CONCLUSIONS: This model analysis indicated initial treatment by pulp capping to be cost-effective compared to root canal treatment in children and adolescents with pulp exposures due to caries.
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| 10. |
- Brodén, Joséphine, et al.
(författare)
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Direct pulp capping procedures versus root canal treatment in young permanent vital teeth with pulp exposures due to caries : A systematic review
- 2016
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Ingår i: American Journal of Dentistry. - : Mosher & Linder. - 0894-8275. ; 29:4, s. 201-206
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To evaluate the available evidence on pulp capping procedures and root canal treatment in young permanent teeth with vital pulps exposed by caries. Methods: The study was conducted as a systematic review of the literature. Three databases, PubMed, Web of Knowledge, and The Cochrane Library were searched. Reference lists of relevant articles were hand searched. The quality of all relevant publications was rated. Results: Ten original scientific studies were included in the review. The quality was rated as low in all studies. The search failed to disclose any article directly comparing pulp capping and root canal treatment. The level of evidence was insufficient to draw any conclusions regarding the effectiveness of the two treatment concepts. High success rates are reported for pulp capping procedures in exposure due to caries, though it is not possible to compare them to success rates of root canal treatment. The review confirms the lack of high quality studies on the treatment of young permanent teeth with cariously exposed pulps.
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