| 1. |
- Criten, Sladjana, et al.
(författare)
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Oral health status among 60-year-old individuals born in 1941-1943 and 1954-1955 and 81-year-old individuals born in 1922-1924 and 1933-1934, respectively : a cross-sectional study
- 2022
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Ingår i: Clinical Oral Investigations. - : Springer Berlin/Heidelberg. - 1432-6981 .- 1436-3771. ; :11, s. 6733-6742
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study aimed to analyze the oral health status of four different birth cohorts: two cohorts of 60-year-olds born in 1941-1943 and 1954-1955 and 2 cohorts of 81-year-olds born in 1920-1922 and 1933-1934. Material and methods The study was based on data from an ongoing longitudinal population project, The Swedish National Study on Aging and Care (SNAC). Oral health status was repeatedly examined clinically and radiographically in 2001-2003 and 2014-2015, including 60- and 81-year-olds, in total 412 individuals. Statistical analyses were performed using independent-samples t test and Pearson's chi(2) test. Results More individuals were dentate in 2014-2015 compared to 2001-2003 in the two age groups: 60 and 81 years (p < 0.001 for both). The mean number of teeth increased in the 60-year-olds from 24.2 to 27.0 and in the 81-year-olds from 14.3 to 20.2. The numbers of at least one intact tooth increased for both age groups (p < 0.001 and p < 0.004, respectively). In the age groups 81 years, there was an increase in having at least one PPD >= 6 mm (p < 0.016) and bone loss >= 5 mm (p < 0.029) between the two examinations. No such differences were found in the age groups of 60 years. Conclusion Over 13 years, oral health improved for both 60- and 81-year-old age groups. The most significant changes were in the 81-year-olds where oral health had improved except for periodontal status.
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| 2. |
- Götrick, Bengt, et al.
(författare)
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Effects of amphetamine on salivary secretion
- 2009
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Ingår i: European Journal of Oral Sciences. - : Wiley InterScience. - 0909-8836 .- 1600-0722. ; 117:3, s. 218-223
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Tidskriftsartikel (refereegranskat)abstract
- Amphetamine induces xerogenic effects, but its mechanism of action and xerogenic potency are unknown. In the current in vivo study on the rat parotid gland, the effects of amphetamine on reflex-evoked and acetylcholine-evoked salivation were examined in the absence and presence of adrenergic and dopaminergic antagonists. Under anaesthesia, amphetamine increased the secretion of salivary fluid and the amount of protein therein in response to acetylcholine. Phentolamine abolished the increase in salivary flow and had no effect on the salivary protein concentration, whereas propranolol only reduced the salivary protein concentration. Reflex activation of the secretion evoked a well-maintained level of secretion that was reduced by amphetamine [50% inhibitory dose (ID50) 1.9 ± 0.1 mg kg−1 intravenously); the salivary protein concentration was increased in the presence of amphetamine. Phentolamine and haloperidol reduced the amphetamine-inhibitory effect on the reflex-evoked fluid response, whereas propranolol had no effect on the fluid response. The xerogenic effect of amphetamine is mainly exerted by central mechanisms involving α-adrenoceptors, while, indirectly, amphetamine causes secretion of protein by inducing the release of noradrenaline from glandular nerve terminals.
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| 3. |
- Götrick, Bengt, et al.
(författare)
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Oral pilocarpine for treatment of opioid-induced oral dryness in healthy adults.
- 2004
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Ingår i: Journal of dental research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 83:5, s. 393-7
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Tidskriftsartikel (refereegranskat)abstract
- Pilocarpine induces a profuse flow of saliva when administered orally, but effects on drug-induced oral dryness have not been examined. The aim of this trial was to investigate if pilocarpine increases production of saliva in individuals suffering from dry mouth due to treatment with opioids. Sixty-five individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol (50 mg t.d.s.) to induce oral dryness, and were thereafter assigned to one of three groups. Secretion rate of saliva was measured before and after tramadol, and after the oral administration of pilocarpine (5 mg), placebo, or no treatment. Baseline characteristics did not differ among the groups (mean +/- SEM: 0.37 +/- 0.06 mL/min), and tramadol lowered the secretion at the same level in all groups (0.15 +/- 0.02 mL/min). Pilocarpine increased the flow above that observed with placebo (0.66 +/- 0.19 vs. 0.15 +/- 0.02 mL/min). Thus, pilocarpine re-establishes the flow of saliva in the state of tramadol-induced oral dryness.
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| 4. |
- Götrick, Bengt, et al.
(författare)
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The xerogenic potency and mechanism of action of tramadol inhibition of salivary secretion in rats.
- 2004
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Ingår i: Archives of oral biology. - : Elsevier BV. - 0003-9969 .- 1879-1506. ; 49:12, s. 969-73
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Tidskriftsartikel (refereegranskat)abstract
- Tramadol is a centrally acting analgesic with weak opioid agonist properties, which also has monoaminergic activity, exerted via inhibition of neuronal uptake of serotonin and norepinephrine. Tramadol is generally well tolerated and the most common adverse events are nausea, dizziness, drowsiness, sweating, vomiting and dry mouth. Currently it was examined by which principal mechanism tramadol induces oral dryness. The effects of intravenous administration (+/-)-tramadol were studied in rats on the flow of saliva in response to a peripheral cholinergic stimulus or to reflex activation involving the relay of impulses in the central nervous system. In pentobarbitone-anaesthetized rats, the salivary secretion to acetylcholine (0.1-10 micromol/kg IV) was increased by up to 110% by tramadol (1-5 mg/kg IV) and the protein concentration therein by up to 400%. The administration alpha- and beta-adrenoceptor antagonists resulted in almost identical acetylcholine-evoked responses as in the absence of tramadol. The secretory response to the application of citric acid on the tongue of the rat was reduced by 38% and by 64%, respectively, at 5 and 10 mg/kg IV of tramadol (p < 0.05-0.01). Thus, tramadol exerts its principal xerogenic effect by activating inhibitory pathways in the central nervous system and has no anticholinergic effect on the salivary glands at dosages that may be clinically relevant. Furthermore, the tramadol-induced increase of the acetylcholine-evoked secretion occurred at a glandular level and depended most likely on a release of noradrenaline from glandular nerve terminals.
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| 5. |
- Hallmer, Fredrik, et al.
(författare)
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Incidence of and risk factors for medication-related osteonecrosis of the jaw in women with breast cancer with bone metastasis : a population-based study
- 2020
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 130:3, s. 252-257
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to prospectively determine the incidence of medication-related osteonecrosis of the jaw (MRONJ) and define risk factors in patients with metastatic breast cancer treated with zoledronic acid and/or denosumab.STUDY DESIGN: In a prospective cohort study performed in Region Skåne, Sweden, from January 1, 2012, until December 31, 2015, all patients with breast cancer who had radiographic evidence of bone metastases and were treated with zoledronic acid or denosumab were included and followed up until May 31, 2018.RESULTS: Of the 242 patients, MRONJ developed in 16 (6.6%) during the 77 months of study. The incidence of MRONJ in patients treated with zoledronic acid was 4.1%, and in patients treated with denosumab, it was 13.6%. The risk of MRONJ was higher in patients on denosumab than in those treated with zoledronic acid (P = .011). Corticosteroid use was associated with a decreased risk of MRONJ (P = .008), and diabetes was associated with an increased risk of MRONJ (P = .02).CONCLUSIONS: The incidence of MRONJ is 6.6% (>3 times higher) in denosumab-treated patients with breast cancer compared with that in patients treated with zoledronic acid. Corticosteroid use decreased the risk of MRONJ.
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| 6. |
- Hallmer, Fredrik, et al.
(författare)
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Prevalence, initiating factor, and treatment outcome of medication-related osteonecrosis of the jaw-a 4-year prospective study
- 2018
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 126:6, s. 477-485
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Medication-related osteonecrosis of the jaw (MRONJ) has a wide range of prevalence, and a standard therapy has not yet been established. The aim of this study was to analyze the prevalence and initiating factors of MRONJ and the outcomes of surgical therapy. STUDY DESIGN: In a prospective cohort study, all patients diagnosed with MRONJ in the Region of Skane, in Sweden, were included. Predictor variables (comorbidity, site, stage, gender) and initiating factors (tooth extraction, periodontitis) were recorded. Surgical treatment was sequestrectomy or block resection, and the outcome variable was healing after 2 months. To estimate the prevalence, data on the use of bisphosphonate and denosumab were used. RESULTS: Fifty-five patients with MRONJ were identified. The prevalence of MRONJ was 0.043% among patients treated with oral bisphosphonates, 1.03% among those on intravenous bisphosphonates and 3.64% in those on high-dose denosumab. Periodontal disease preceded development of MRONJ in 41 patients. Fifty patients were treated surgically and followed up for at least 2 months. Remission or healing occurred in 80% of patients treated with sequestrectomy and in 92.5% of patients treated with block resection. CONCLUSIONS: The prevalence of MRONJ in Sweden is low. Periodontitis is the most common initiating factor. The outcome of treatment of MRONJ is healing in most patients treated surgically.
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| 7. |
- Johansson, Krister, et al.
(författare)
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Impact of direct oral anticoagulants on bleeding tendency and postoperative complications in oral surgery : a systematic review of controlled studies
- 2023
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 135:3, s. 333-346
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The recommendations for the management of direct oral anticoagulants (DOACs) in oral surgery are inconsistent. The present review evaluated whether DOACs increase the risk of bleeding during oral surgery and postoperative complications.STUDY DESIGN: The patients undergoing oral surgery and receiving a DOAC were compared with the patients receiving a DOAC different from the exposure, a vitamin K antagonist (VKA), or no anticoagulant. Three electronic databases were searched for eligible clinical trials and systematic reviews. The risk of bias was assessed, data were extracted, a meta-analysis was done, and the Grading of Recommendations, Assessment, Development and Evaluations certainty-of-evidence ratings were determined.RESULTS: Three clinical trials comparing patients receiving DOAC medication with patients on a VKA were eligible. A meta-analysis of bleeding 7 days postoperatively detected no significant differences between patients continuing DOAC or VKA medication during and after surgery. All of the point estimates favored uninterrupted DOAC over VKA therapy. Tranexamic acid was topically administered to some patients.CONCLUSIONS: Based on an interpreted trend among 3 studies with mixed patient populations, the risk of bleeding during the first 7 postoperative days may be lower for patients on uninterrupted DOAC than VKA therapy (⨁⨁⭘⭘), but the effect size of the risk is unclear. 80 of 274 included patients experienced postoperative bleeding.
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| 8. |
- Johnsson, Martin, 1983, et al.
(författare)
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In vivo studies of effects of antidepressants on parotid salivary secretion in the rat
- 2016
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Ingår i: Archives of Oral Biology. - : Pergamon Press. - 0003-9969 .- 1879-1506. ; 67, s. 54-60
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Tidskriftsartikel (refereegranskat)abstract
- Tricyclic antidepressants (TCA) are well-known xerogenic drugs, while antidepressants such as selective serotonin reuptake inhibitors (SSRI) are considered less xerogenic. The antimuscarinic effect of the TCAs has been considered to be the principal mechanism causing a dry mouth. Although the muscarinic receptor is commonly targeted by xerogenic pharmaceuticals, the salivation reflex arc may be affected at other levels as well. We currently wondered whether or not antidepressants exert an inhibition of the salivary reflex not only at the glandular level but at a central level as well. In this study, the effects of a TCA (clomipramine), a SSRI (citalopram) and a serotonin-noradrenaline reuptake inhibitor (SNRI; venlafaxine) were examined on reflex- (0.5 M citric acid applied on the tongue) and methacholine-evoked salivary secretion. While all three compounds inhibited citric acid-evoked secretion (-40 to -60% at 5 mg/kg i.v. of the antidepressants), only clomipramine inhibited methacholine-evoked secretion (-30% at 5 mg/Icg i.v.). On the contrary, both citalopram and venlafaxine increased the methacholine-evoked secretion (+44 to 49%). This was particularly obvious for the salivary protein output (>200%). In the presence of alpha- and beta-adrenoceptor antagonists, the citalopram- and venlafaxine-induced increases were reduced. Thus, antidepressants irrespective of type may exert xerogenic effects by inhibiting the salivary reflex in the central nervous system. However, while TCAs may also hamper the secretory response by antimuscarinic effects, the SSRI and the SNRI groups of pharmaceuticals seem to lack this additional xerogenic mechanism indicating a better therapeutic profile and better opportunities for pharmacological treatment of drug-induced xerostomia.
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| 9. |
- Looström, Henning, et al.
(författare)
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Tramadol-induced oral dryness and pilocarpine treatment : Effects on total protein and IgA
- 2011
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Ingår i: Archives of Oral Biology. - : Elsevier Ltd. - 0003-9969 .- 1879-1506. ; 56:4, s. 395-400
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Tidskriftsartikel (refereegranskat)abstract
- Pilocarpine induces a profuse flow of saliva, and it may re-establish saliva production in cases of drug-induced oral dryness. The aim of the study (a sub-study to the previous trial investigating the pilocarpine fluid effects in individuals suffering from drug-induced dry mouth) was to search for saliva quality changes induced by the treatments. Sixty-five individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol to induce oral dryness. Secretion rate was measured before and after tramadol, and then after pilocarpine, placebo, or no treatment. All saliva was analyzed for its protein and IgA content in the pilocarpine (n=15) and placebo groups (n=12). At baseline, the flow of saliva was 0.47±0.05ml/min, the protein output 0.17±0.2mg/min and the IgA output 0.022±0.002mg/min. After tramadol treatment (50mg 3×/day over two days), the flow was reduced by 64%, protein output by 52% and the IgA output by 38%. While placebo treatment did not affect any of the variables, the flow was 120%, the protein output 193% and the IgA output 83% of the baseline characteristics after pilocarpine treatment (5mg). Thus, the pilocarpine-induced increase in the flow rate in the state of tramadol-induced oral dryness results in saliva with a well preserved protein concentration but with a decrease in IgA concentration. However, compared to baseline, there was neither a decrease in output nor in concentration of IgA.
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| 10. |
- Milosavljevic, Aleksandar, et al.
(författare)
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A questionnaire-based study evaluating differences between dental students in Paris (F) and Malmö (SE) regarding diagnosis and treatment decisions of patients with different severity levels of periodontal diseases.
- 2018
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Ingår i: European journal of dental education. - : John Wiley & Sons. - 1396-5883 .- 1600-0579. ; 22:3, s. e392-e399
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate differences between last-year dental students in Paris (F) and Malmö (SE) Dental Schools, in regard to their judgement and decision-making within periodontology. Ninety-six last-year dental students from Paris and 45 from Malmö participated in a questionnaire study based on four patient cases: (i) Patient case with generalised alveolar bone loss but no signs of inflammation (Well-maintained), (ii) Patient case with generalised alveolar bone loss and signs of inflammation (Periodontitis), (iii) Patient case with no alveolar bone loss and no signs of inflammation (Healthy) and (iv) Patient case with no alveolar bone loss but with signs of inflammation (Gingivitis). Through multiple-choice questions, the students judged each case as healthy or diseased proposed a diagnosis and treatment measures and estimated the treatment time for each patient. Furthermore, they assessed the prognosis of each patient in case of no treatment. Based on a response rate of 83%, the majority in both groups judged all the patients as diseased. More Paris students diagnosed the healthy and the gingivitis case as having periodontitis (P < .05). Furthermore, a larger number of students from Paris recommended several treatment measures and estimated longer treatment times for all the cases (P < .05) and estimated a higher risk for disease progression for the healthy and the gingivitis case (P < .05). Significant variation between students from Paris and Malmö Dental Schools in regard to judgement and decision-making was observed; this may in turn imply that there is still need of improving consistency amongst undergraduate educations in periodontology in Europe.
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