| 1. |
- Alkharaan, Hassan, et al.
(författare)
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Persisting Salivary IgG Against SARS-CoV-2 at 9 Months After Mild COVID-19 : A Complementary Approach to Population Surveys
- 2021
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Ingår i: Journal of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 224:3, s. 407-414
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Tidskriftsartikel (refereegranskat)abstract
- Background. Declining humoral immunity in coronavirus disease 2019 (COVID-19) patients and possible reinfection have raised concern. Mucosal immunity, particularly salivary antibodies, may be short lived although long-term studies are lacking. Methods. Using a multiplex bead-based array platform, we investigated antibodies specific to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proteins in 256 saliva samples from convalescent patients 1-9 months after symptomatic COVID-19 (n = 74, cohort 1), undiagnosed individuals with self-reported questionnaires (n = 147, cohort 2), and individuals sampled prepandemic (n = 35, cohort 3). Results. Salivary IgG antibody responses in cohort 1 (mainly mild COVID-19) were detectable up to 9 months postrecovery, with high correlations between spike and nucleocapsid specificity. At 9 months, IgG remained in blood and saliva in most patients. Salivary IgA was rarely detected at this time point. In cohort 2, salivary IgG and IgA responses were significantly associated with recent history of COVID-19-like symptoms. Salivary IgG tolerated temperature and detergent pretreatments. Conclusions. Unlike SARS-CoV-2 salivary IgA that appeared short lived, specific saliva IgG appeared stable even after mild COVID-19, as for blood serology. This noninvasive saliva-based SARS-CoV-2 antibody test with home self-collection may be a complementary alternative to conventional blood serology.
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| 2. |
- Anderson, M, et al.
(författare)
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Detection of Approximal Caries in 5-year-old Swedish Children
- 2005
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Ingår i: Caries Research. - : S. Karger. - 0008-6568 .- 1421-976X. ; 39:2, s. 92-99
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to assess how accurately some commonly used risk factors/risk markers (predictors) for caries development could identify children with and without approximal caries as judged from bitewing radiography. Two hundred and sixtyseven consecutive 5-year-old children from two Swedish cities participated. Three experienced dentists examined the children. The predictors were the overall dmfs (de-cayed, missing and filled surfaces) value (canines and molars), the number of occlusal dmfs, the frequency of intake of between-meal sugary products, visible plaque on free smooth surfaces of second primary molars, toothbrushing habits and (before bitewing examination) an overall judgement by the examining dentist. The mean dmfs value without bitewing examination was 0.40 (SD = 1.22). Twelve percent of the children had at least one dentin lesion and 33% at least one enamel lesion that were detected from bitewing examination only. The gain from adding bitewing examination to clinical examination amounted to a mean of 1.2 approximal enamel and/or dentin lesions. The ability to correctly identify children with approximal caries from the predictors was limited; sensitivity ranged from 0.27 to 0.75 and specificity ranged from 0.41 to 0.93. The single best predictor was the dentist's overall judgement with an average precision of 73%; average sensitivity for the presence of enamel and dentin lesions was 0.48 and for the presence of dentin lesions 0.66. The rest of the predictors added little to the predictive power. It is concluded that 33% of the 5-year-olds, representing a low caries prevalence population, benefited from bitewing examination. The ability to identify these children from the predictors was, however, limited. Copyright (c) 2005 S. Karger AG, Basel.
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| 3. |
- Ihlis, Randi Lynds, et al.
(författare)
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Cone beam computed tomography indications for interdisciplinary therapy planning of impacted canines
- 2023
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 135:1, s. e1-e9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate how cone beam computed tomography (CBCT) affects the therapeutic planning of impacted maxillary canines.Study design: A total of 132 impacted canines from 89 pediatric patients were collected from 3 specialist clinics in Stockholm, Sweden. An interdisciplinary therapy planning team consisting of 5 dental specialists evaluated each case and chose their preferred treatment alternative, initially without and later with CBCT images, to decide whether CBCT was justified for therapy planning. Predefined variables measurable using only 2-dimensional (2D) assessments were analyzed using stepwise logistic regression analyses.Results: The CBCT was considered indicated in 47% of the cases. Additional information from CBCT led to a treatment decision change in 9.8%. Significant 2D predictors for CBCT justification were horizontal canine angulation compared with vertical angulation (odds ratio [OR] = 10.9), extraction strategy involvement (OR = 6.7), and buccally positioned canines compared with palatal (OR = 5.3), central (OR = 25.0), and distal or uncertain positions (OR = 7.7).Conclusions: The benefit-risk assessment of CBCT for impacted canines may be reinforced by performing and applying justification decisions for CBCT acquisition at the therapeutic thinking level. If preliminary treatment planning motivates further in-depth investigation of either root status or tooth location, a CBCT is indicated.
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| 4. |
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| 5. |
- Tewari, Nitesh, et al.
(författare)
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Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation : A systematic review and meta-analysis
- 2024
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Ingår i: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657.
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Forskningsöversikt (refereegranskat)abstract
- This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.
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| 6. |
- Tsilingaridis, Georgios
(författare)
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Inflammatory response in periodontal tissue in children with Down syndrome
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Periodontal diseases are inflammatory diseases affecting the supporting tissues of the teeth. Subjects with Down syndrome have a higher prevalence of periodontal disease compared to healthy controls. Periodontal disease in Down syndrome is considered to be multifactorial, although the aetiology is uncertain. The aim of this thesis was to study the inflammatory response in periodontal tissue in terms of cytokines, prostaglandins, matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in children with Down syndrome as well as in healthy controls. In study I, 18 subjects with Down syndrome and 14 controls were clinically and radiographically examined and matched for age and degree of gingival inflammation expressed as percentage of bleeding on probing (BOP%). In all subjects, gingival crevicular fluid (GCF) was collected from six sites with paper strips, and levels of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), and MMP-9 were analysed using RIA and ELISA kits. BOP% and volume of GCF (μL) were similar in both groups while Down syndrome patients had significantly higher (p<0.05) mean levels of PGE2, LTB4, and MMP-9 in GCF than controls. In study II, PD and BOP% were clinically assessed in subjects with Down syndrome (n=24) and controls (n=29) (both groups, mean age 16.4 yr). The controls were matched for age and BOP% to subjects with Down syndrome. GCF was collected and Bio-Plex cytokine multiplex assays were used to determine levels of interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), and interleukin (IL)-1β, IL-4, -6, -10, -12, and -17. GCF volume (μL) was significantly higher in subjects with Down syndrome (p<0.001) than controls. Mean levels of IL-1β, IL-4, IL-6, IL-10, IL-12, IFN-γ, and TNF-α in GCF were significantly (p<0.005) increased in subjects with Down syndrome compared with controls. The correlation between IFN-γ and IL-4 in GCF in subjects with Down syndrome differed significantly from controls (p<0.01). In study III, 21 adolescents with Down syndrome exhibiting gingivitis (DS-G), 12 subjects with Down syndrome exhibiting periodontitis (DS-P), 26 controls with gingivitis (HC-G), and 8 controls with periodontitis (HC-P) were clinically and radiographically examined. All patients were between ages 11 and 20 yr. GCF was collected from each subject and the amounts of MMP-2, -3, -8, -9 and -13 and of TIMP-1, -2 and -3 were determined with R&D multianalyte kits. The amounts of MMP-2, -3, -8, and -9 and of TIMP-2 in GCF were significantly higher (p<0.005) in the DS-G than the HC-G group. The correlation coefficient between MMP-8 and TIMP-2 also differed significantly (p<0.01) between the DS-G and HC-G groups. In contrast, the correlation coefficients between the MMPs and TIMPs did not differ significantly between the DS-P and the HC-P groups. The DS-P group, however, exhibited significantly (p<0.005) lower amounts of TIMP-2 in GCF compared to the HC-P group. In study IV, children with Down syndrome (n=10) and controls (n=10) were clinically and radiographically examined during dental treatment under general anaesthesia. Peripheral blood and GCF were gathered from each patient and levels of MMP-2, -3, -8 and -9, of TIMP-1, -2 and -3 in serum, and of GCF were determined. Peripheral blood leukocytes were isolated, and the relative amounts (%) of the various cells were determined with flow cytometry. Peripheral blood cells were stimulated with lipopolysaccharide (LPS) from Porphyromonas gingivalis (Pg) and MMP and TIMP levels were measured. Levels of MMP-3 and -8 and TIMP-1 in serum were significantly enhanced (p’s<0.05) in subjects with Down syndrome compared to controls. When peripheral blood leukocytes were cultured in the presence or absence of Porphyromonas gingivalis lipopolysaccharide, MMP-8 levels were significantly (p < 0.05) higher in the Down syndrome group compared to controls. Children with Down syndrome exhibited significant positive correlations of CD8+ T cells with MMP-8 (r=0.630; p=0.050) and MMP-9 (r=0.648; p<0.05) and of CD56+ NK cells with MMP-3 (r=0.828; p<0.005) compared to controls. Conclusions: Subjects with Down syndrome had increased levels of the arachidonic acid metabolites PGE2 and LTB4, the cytokines IL-1β, IL-4, IL-6, IL-10, IL-12, IFN-γ and TNF-α, and of MMP-2, -3, -8 and -9 and TIMP-2 in GCF compared to controls. In addition, the balance between pro- and anti-inflammatory cytokines and between MMPs and TIMPs was altered in subjects with Down syndrome but not in controls. Furthermore, in contrast with controls, no significant differences in MMP and TIMP levels in GCF were observed between Down syndrome patients with gingivitis and periodontitis. This finding might indicate that the inflammatory response in Down syndrome is already upregulated during early stages of periodontal disease. We also demonstrate an association between MMPs and lymphocyte subpopulations (CD8+ T-cells and CD56+ NK-cells), which may facilitate the migration of immune cells into the periodontal tissue. This assumption is well compatible with the higher levels of MMPs in GCF found in Down syndrome subjects. These findings, may contribute to the increased periodontal inflammation demonstrated in this current cohort of Down syndrome subjects.
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| 7. |
- Wikström, Alina, et al.
(författare)
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Endodontic pulp revitalization in traumatized necrotic immature permanent incisors : early failures and long-term outcomes—A longitudinal cohort study
- 2022
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Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 55:6, s. 630-645
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This prospective cohort study evaluates clinical and radiographical outcomes of endodontic pulp revitalization (PR) of traumatized necrotic incisors.Methodology: Pulp revitalization was performed in 75 traumatized necrotic immature incisors from 71 patients. The radiographic outcome measures were continued root formation (width and length), root resorption, apex closure, periapical index, and root development stage. The clinical outcome measures were percussion pain, palpation pain, pathological tooth mobility, swelling, sinus tract, ankylosis, crown discolouration, response to pulp sensitivity test, and subjective pain. Treatment outcomes were categorized as a success based on the absence of clinical symptoms and when radiographic evidence was present for apical healing and continued root development. The performed statistical tests were repeated measures anova, pairwise comparisons of interactions (t-test), McNemar's test, and linear regression model.Results: In 45 of 75 teeth (60%), PR was successful with the resolution of clinical and radiographic signs and continued root development. PR failed due to the absence of bleeding (n = 19) and persistent infection (n = 11). PR showed statistically significant increases in root length (11%), and dentinal wall thickness (30%), root maturation (pre-operative 3.38 [CI 1.88; 4.88]; post-operative 4.04, [CI 2.56; 5.52]) apical closure (71.4%), healing of pre-operative apical periodontitis (100%), and healing of pre-operative inflammatory root resorptions (100%). Three predictive variables for continued root maturation were identified – root development stage at entry (p =.0001, β 0.649), [CI 0.431; 0.867], trauma to the soft tissues (p =.026, β −0.012), [CI −0.0225; −0.015], and pre-operative dentinal wall thickness (p =.009, β −0.001); [CI −0.001; 0.0001].Conclusions: Our findings indicate that PR provides satisfactory clinical and radiographical outcomes in traumatized necrotic incisors. The failed cases were related to lack of bleeding and persistent infections, indicating that new techniques are needed to improve the predictability of PR.
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| 8. |
- Wikström, Alina, et al.
(författare)
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Microbiological assessment of success and failure in pulp revitalization : a randomized clinical trial using calcium hydroxide and chlorhexidine gluconate in traumatized immature necrotic teeth
- 2024
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Ingår i: Journal of Oral Microbiology. - : Taylor & Francis Group. - 2000-2297. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare differences in the disinfection efficacy of calcium hydroxide (CH) and chlorhexidine gluconate (CHD) dressings in pulp revitalization (PR) of traumatized immature necrotic teeth; to investigate the microflora in successful/failed PR and whether bacterial persistence influences the outcomes of PR.Methods: Microbiological assessment of the average bacterial load (CFU/sample) and bacterial diversity (taxa/sample) was performed on 41 teeth at three timepoints (S2-before, S3-after debridement and S5- after root canal dressing).Results: The primary microflora was more diverse in successful cases than in failed. Decreases in CFU/sample and taxa/sample occurred S2 - S3, though new increases occurred at S5 in the CHD subgroup (successful and failed) and CFU/sample in the CH subgroup (failed). At S5, the successful cases showed more bacterial decreases. No specific species was associated with the outcomes with no statistical differences between the disinfection efficacy.Conclusions: There were no statistical differences in CH and CHD efficacy. At S5, microflora persisted in both successful and failed outcomes, but the abundance and diversity increased significantly only in the failed cases. The successful outcomes presented higher diversity and higher decreases of the primary microflora at S5 than the failed outcomes. The abundance and diversity increased significantly at S5 only in failed cases.
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| 9. |
- Wikström, Alina, et al.
(författare)
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Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss : a 20-year longitudinal study
- 2024
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Ingår i: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657.
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aim: To evaluate the long-term survival of immature traumatized incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA-apical plug) and to identify major factors affecting the survival of these teeth.Materials and Methods: Records of 2400 children and adolescents were screened for presence of traumatic dental injuries to immature incisors where endodontic treatment with the two apexification techniques was performed during January 2003 and December 2022, compared to a control group of mature teeth treated with conventional endodontic techniques. The studied variables were age; sex; apexification technique, presence of luxation and hard tissue injuries; preoperative root development stage (RDS), preoperative and postoperative periapical index (PAI), the time-point for tooth loss, and overall survival time in years. Kaplan–Meier estimates were used to graphically present the survival functions and Cox proportional hazard model to calculate hazard ratios (HR, 95% CI).Results: The median survival time was 10 years for calcium hydroxide apexification, 16.1 for MTA-apexification, for luxation injuries other than intrusions and avulsions 15.5 years, for intrusions 12.5 years and for avulsions 6.8 years. The variables with significant negative impact on tooth survival were calcium hydroxide apexification, avulsion and postoperative PAI 3–5. No significant relationships were found for the variables MTA apexification, concussion; subluxation; lateral luxation; extrusion, intrusion, hard tissue injuries, preoperative RDS and PAI scores and postoperative PAI 1–2. After adjustment, the risk for premature tooth loss was 13.5 times higher in calcium hydroxide apexification, approximately 2 to 4 times higher in PAI 3–5, and 5.6 times higher in avulsions.Conclusions: Calcium hydroxide apexification, avulsion, and postoperative PAI 3–5 were identified as prognostic variables with significant negative impact on the risk for premature tooth loss.
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