| 1. |
- Korduner, Eva-Karin, et al.
(författare)
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Prosthodontic decision-making relating to dentitions with compromised molars : the perspective of Swedish General Dental Practitioners
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : Blackwell Munksgaard. - 1365-2842 .- 0305-182X. ; 43:12, s. 967-976
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this investigation was to study the clinical prosthodontic decision-making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in-depth, semi-structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients' needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision-making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues' or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision-making more than the SDA concept. The conflicting results in the prosthetic decision-making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentists own clinical practice.
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| 2. |
- Korduner, Eva-Karin, et al.
(författare)
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The Shortened Dental Arch concept from the perspective of Swedish General Dental Practitioners : a qualitative study
- 2016
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the cognizance of and attitudes towards the Shortened Dental Arch (SDA) concept among Swedish General Dental Practitioners (GDPs) and the application of the SDA concept in their treatment planning using Qualitative Content Analysis. Eleven Swedish GDPs were purposively selected and all agreed to participate. In-depth semi-structured interviews were conducted and covered treatment considerations concerning two patient cases and the participants' reflections regarding pre-formulated statements about the SDA concept. Qualitative content analysis was used to analyze this data. The emerging theme was "the SDA concept is irrelevant" in the sense of the GDPs disregarding treatments providing dentitions with loss of posterior teeth. There was a strong reluctance to extract teeth, without consideration of the SDA concept, and a firmly patient-focused attitude towards the needs, age and financial situation of the patients. Within the limitations of this study, Swedish GDPs show little or no cognizance of the SDA concept and it does not seem to be applied in their treatment planning. The results show that the qualitative methodology can be beneficial for further understanding of cognizance and attitudes towards the SDA concept
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| 3. |
- Boeskov Øzhayat, Esben, et al.
(författare)
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Impairments due to tooth loss and prosthetic expectations in patients from an urban area and a rural area in Sweden. A qualitative study
- 2020
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 47:2, s. 212-220
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore impairments due to tooth loss and expectations of prosthetic replacements in an urban group and a rural group of patients in Sweden. MATERIAL AND METHODS: Semi-structured interviews were performed on 35 partially edentulous patients from prosthodontic specialist clinics located in an urban area and a rural area in Sweden. The interviews focused on impairments due to tooth loss and expectations of prosthetic restorations. Analysis was made using the grounded theory approach, allowing in-depth investigation of the phenomenon. RESULTS: Functional, aesthetic and social impairments were mentioned, and coping strategies (eg chewing differently and laughing less) and modifications (eg age, time and social setting) of the impairments were described. The rural patient group accepted impairments somewhat better than the urban one. Otherwise, there was only minor difference between the groups. Removable prosthodontic restorations were more acceptable among rural patients. Urban patients insisted more often on implant-based restorations and had higher expectations of longevity. Patients with minor impairments still wanted treatment, based on concerns about the future of their dentition. The interviews themselves generated new thoughts in the patients and were thus considered valuable by the patients. CONCLUSIONS: Impairments due to tooth loss and expectations of prosthetic replacements were expressed in the same way in the rural and urban patient groups. However, in the rural population, there was a higher acceptance of impairments and also of removable prosthetic restorations, whereas the urban population expressed a higher demand for implant-based restorations.
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| 4. |
- Gjelvold, Björn, et al.
(författare)
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Intraoral Digital Impression Technique Compared to Conventional Impression Technique : A Randomized Clinical Trial
- 2015
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Ingår i: Journal of Prosthodontics. - : John Wiley & Sons. - 1059-941X .- 1532-849X. ; 25:4, s. 282-287
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To compare digital and conventional impression techniques in a randomized clinical trial; specifically, procedure times, patient-centered outcomes, and clinical evaluation of the restorations. MATERIALS AND METHODS: Forty-eight patients in need of tooth-supported single crowns and/or fixed partial prostheses up to six units were randomly allocated to one of the impression techniques. The procedure times, dentists' and patients' assessments using a visual analog scale (VAS), and clinical evaluation of the restorations were compared between the two groups. RESULTS: The mean total procedure times for digital and conventional impression technique were 14:33 ± 5:27 and 20:42 ± 5:42, respectively (p < 0.0001). Mean impression times were 7:33 ± 3.37 and 11:33 ± 1.56, respectively (p < 0.0001). Mean VAS scores for the dentist's assessment of difficulty (0 to 100; very difficult = 100) were 24.00 ± 18.02 and 48.02 ± 21.21, respectively (p < 0.0001). Mean VAS scores for the patients' assessment of discomfort (0 to 100; very discomforting = 100) was 6.50 ± 5.87 and 44.86 ± 27.13, respectively (p < 0.0001). Occlusal contacts showed a better result for the digital technique. CONCLUSION: The results of this study demonstrated that the digital technique was more efficient and convenient than the conventional impression technique.
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| 5. |
- Korduner, Eva-Karin, et al.
(författare)
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Attitudes toward the shortened dental arch concept among Swedish general dental practitioners
- 2006
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Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 19:2, s. 171-176
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this investigation was to obtain the opinions and assess the attitudes of Swedish general dental practitioners in private practice versus a public health care setting regarding management of patients with a shortened dental arch (SDA). MATERIALS AND METHODS: A questionnaire containing different statements regarding the SDA concept was sent to a random sample of 189 clinicians. Differences between male and female practitioners and between private practitioners (PPs) and those employed by the Public Dental Health Service (PDHS) were tested for statistical significance by the Student t test. RESULTS: The response rate was 54% (102 clinicians). Among the respondents, 62% were men and 38% were women. Fifty-six percent were PPs and 44% were employed by the PDHS. The results showed small differences in attitudes between various groups of practitioners but large individual variations. In general, Swedish general practitioners had a positive attitude toward the SDA concept with respect to oral function and oral comfort. They recognized few risks with a dentition lacking molar support, although female clinicians were more risk conscious. PPs expressed fewer advantages in using the SDA concept than PDHS practitioners with respect to the reduced risk for overtreatment, better patient economy, and the ability for older patients to keep their teeth. CONCLUSION: The results from this questionnaire study indicate that, overall, Swedish general practitioners have an affirmative opinion toward the SDA concept.
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| 6. |
- Korduner, Eva-Karin, et al.
(författare)
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Decision making among Swedish general dental practitioners concerning prosthodontic treatment planning in a shortened dental arch
- 2010
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Ingår i: European Journal of Prosthodontics and Restorative Dentistry. - 0965-7452. ; 18:1, s. 43-47
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Tidskriftsartikel (refereegranskat)abstract
- The purposes of this study were to describe how dentists evaluated the importance of various patient-related items when planning for a treatment in a shortened dental arch, to analyse common dimensions of the decision-making in comparison to other decision situations, and to identify explanatory factors behind these dimensions. A questionnaire containing different statements regarding the shortened dental arch concept was sent to a random sample of Swedish general dentists (n=189), with a response rate of 54%. The dentists were asked to evaluate items to be considered when planning for a prosthetic treatment in a shortened dental arch. Differences between individuals were great as well as between groups of dentists. Especially delivery system but also place of dental education and attitudinal factors were related to the shortened dental arch decision making process.
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| 7. |
- Korduner, Eva-Karin
(författare)
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The Shortened Dental Arch (SDA) concept and Swedish general dental practitioners : attitudes and prosthodontic decision-making
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- 10ABSTRACTA Shortened Dental Arch (SDA) is defined as a dentition where most posterior teeth are missing. The SDA concept, described by Käyser and co-workers in the 1980s, was developed mainly for elderly and high risk-patients, those with poor general health and those with accumulation of dental problems. It was however, proposed as a treatment option based on individual preferences. The SDA concept suggested that a dentition comprising teeth in the anterior and premolar region might meet the requirements of a functional dentition. The aim of this thesis was to study attitudes towards the Shortened Dental Arch (SDA) concept and to explore the factors affecting prosthodontic decision-making, with a focus on the SDA concept, among Swedish General Dental Practitioners (GDPs).Two different research approaches (quantitative and qualitative) were used: a questionnaire study (Study I and II) and an interview study (Study III and IV). The base in the questionnaire study was made up of 102 responses from a random sample of 189 Swedish GDPs. The sample was taken from the membership register of the Swedish Dental Association. Besides questions about gender, age, years in profession and place of dental education, the questionnaire contained questions about factors to be considered when planning for a prosthetic treatment in an SDA. There were also questions related to risks and benefits of an SDA and various statements concerning the SDA concept. For all items the dentists were asked to mark on a Visual Analogue Scale ranging from 0 to 10 with different anchors for each section. The data was described and analyzed in contingency and frequency tables. The treatment planning statements were subjected to principal component analysis. A multiple linear regression analysis was used to study explanatory patterns regarding the assessment of importance for the variables influencing dentists’ choice of treatment in an SDA. Eleven Swedish GDPs were strategically selected for the interview study, the necessary inclusion criterion being that the participant had to have at least one year of practice to ensure experience of treating dentitions without molar support. The in-depth, semi-structured interviews dealt with treatment considerations relating to two patient cases and the participants’ opinions on pre-formulated statements about the SDA concept. Two authentic patient cases were discussed; initially with complete dental arches, and later a final treatment plan based on an SDA. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative Content Analysis was used to analyze the data. The participants of the questionnaire study received a short description of the SDA as an introduction and the participants of the interview study were given a brief explanation of the SDA concept after discussing the two patient cases. Attitudes towards the SDA and the SDA concept, results and conclusionsThe questionnaire study (I) showed that the Swedish GDPs had a positive attitude towards the SDA concept which they also considered carried few risks. There were small differences in attitudes between different groups of dentists (private practice dentists/dentists employed in the public dental health service and male/female dentists) but vast differences in attitudes among individual practitioners. Female practitioners envisaged a higher risk of impaired oral function, periodontitis and TMD in an SDA than male practitioners. Private practice dentists saw fewer advantages in using the SDA concept compared to Public Dental Health Service dentists in terms of reduced risk of overtreatment, better patient costs, and the patients’ ability to keep their own natural teeth as they aged. The results of the interview study (III) showed that none of the GDPs was familiar with the SDA concept of treatment although two dentists had heard the expression SDA before. Swedish GDPs showed little or no cognizance of the concept and they did not appear to apply it in their treatment planning.Prosthodontic decision-making with a focus on SDA and compromised molars, results and conclusionsThe study with a quantitative approach (II) showed that there were vast individual differences when Swedish GDPs ranked the importance of various patient-related items when planning a treatment in an SDA. The results of a factor analysis showed that dental care delivery system, place of dental education and also attitudinal factors influenced the decision-making process in relation to the SDA. The analysis also indicated that it was possible to capture common dimensions (“technical”, “comfort” and “time”) of decision-making in prosthodontics compared to other decision-making situations. The study with a qualitative approach (IV) showed that preserving a dental arch which included molars appeared to be important to Swedish GDPs. The SDA concept did not seem to have any substantial impact on prosthodontic decision-making in relation to dentitions with compromised molars. The dentist’s experience, as well as the advice of colleagues or specialists, together with etiological factors and the patient’s individual situation, influenced decision-making more than the SDA concept. There was a contradictory relevance between the patient’s age and the need for molar support when considering the SDA, mainly due to the individual patient’s need. These conflicting results in the prosthetic decision-making process require further investigation.
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| 8. |
- Korduner, Eva-Karin, et al.
(författare)
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Är korta tandbågar förenligt med god oral funktion hos äldre
- 2003
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Ingår i: Tandläkartidningen. - 0039-6982. ; 95:8, s. 44-49
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Eftersom tandhälsan förbättras och dagens äldre kan förväntas få behålla fler tänder kommer det att ställas större krav på äldretandvården i framtiden. Samtidigt kommer tandvården att ha en begränsad tillgång på tandläkare som förväntas balansera samhällets allt mer restriktiva ekonomiska ersättning till tandvården mot patientens och de anhörigas ökade och därmed kostsammare krav på god funktionell tandvård. Mot denna bakgrund genomfördes en litteraturgenomgång i syfte att närmare kunna presentera sda-konceptet (”The shortened dental archkonceptet”) och dess möjliga kliniska applikation inom äldretandvården. En försiktig extrapolering som baserats på resultat från studier som rör patienter i yngre åldrar visar att ”the shortened dental arch-konceptet” även är tillämpbart inom tandvården för äldre.
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