| 1. |
- Nakamoto, T, et al.
(författare)
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Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density : untrained general dental practitioners’ diagnostic performance
- 2003
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 14:8, s. 659-664
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The detection of postmenopausal women with low bone mineral density (BMD) is an important strategy to reduce the incidence of osteoporotic fracture. Recent studies suggested that incidental findings on dental panoramic radiographs may be used as a tool to detect women with low BMD. However, little is known whether this finding is sufficiently assessed by untrained general dental practitioners (GDPs). The purpose of this study was to investigate: (1) the observer agreement and (2) the diagnostic efficacy in detecting women with low BMD, when untrained GDPs assess the appearance (normal or eroded) of the mandibular inferior cortex on dental panoramic radiographs of postmenopausal women. Twenty-seven GDPs were asked to classify the appearance of the mandibular inferior cortex on dental panoramic radiographs of 100 postmenopausal women who had completed BMD assessments of the lumbar spine and of the femoral neck. Intra- and inter-observer agreements were analyzed with kappa statistics. The diagnostic efficacy (sensitivity, specificity and predictive values) was analyzed by comparing two groups classified by the mandibular inferior cortex (women with normal and women with eroded mandibular inferior cortex) with those classified by BMD (women with normal BMD and women with osteopenia or osteoporosis). The mean sensitivity and specificity were 77 % and 40 %, respectively, when BMD of the lumbar spine was used as standard and 75 % and 39 %, respectively, when BMD of the femoral neck comprised the standard. Nineteen untrained GDPs (70 %) presented a moderate to almost perfect intra-observer agreement. We conclude that dental panoramic radiograph may be used in clinical dental practice to identify postmenopausal women who have undetected low BMD and should undergo further testing with bone densitometry.
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| 2. |
- Davidson, Thomas, et al.
(författare)
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Reimbursement systems influence prosthodontic treatment of adult patients
- 2015
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 73:6, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.
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| 3. |
- Hultin, M., et al.
(författare)
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Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL
- 2012
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Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 25:6, s. 543-552
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health-related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.
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| 6. |
- Eriksen, Harald M, et al.
(författare)
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The oral ecosystem : implications for education
- 2006
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Ingår i: European journal of dental education. - : Wiley. - 1396-5883 .- 1600-0579. ; 10:4, s. 192-196
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Tidskriftsartikel (refereegranskat)abstract
- We propose a model that is applicable to oral health education. The model describes the oral cavity in a complexity-based ecological context. This concept includes the premise that factors from different organisational levels (biological, individual, community, society) interact in a complex way with the potential to 'stress' the ecosystem and thereby provoke changes. This mode of action complies with the understanding of the oral cavity as a complex adaptive system. An ecological model is actively used in the undergraduate problem-based curriculum at the Faculty of Odontology, Malmo University, Sweden and has recently been applied as a conceptual basis for the new dental curriculum being established at the University of Tromso in Northern Norway. The purpose is to encourage and promote an ecological, health-oriented view and to stimulate reflections on premises for oral health and diseases in an integrated context.
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| 7. |
- Ernberg, M, et al.
(författare)
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Examina och utbildning inom svensk odontologisk forskning
- 2003
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Ingår i: Tandläkartidn. ; 95:9, s. 54-59
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- En internationell utvärdering visade för några år sedan att Sverige riskerar att förlora sin position som världsledande nation inom odontologisk forskning. För att få en uppfattning om förändringarna inom forskarutbildningen och den postdoktorala meriteringen samlades data för 1990-2001 in från fakulteterna, Statistiska Centralbyrån samt Högskoleverket. Avsikten var att undersöka antalet forskarutbildade tandläkare, mångfalden bland doktoranderna och de som disputerat samt deras nuvarande anställningsform. Materialet jämfördes sedan med tidigare data. I medeltal avlade 25 personer per år doktorsexamen åren 1990-2001. Antalet har minskat under senare år. En majoritet av dem som avlade doktorsexamen hade odontologisk bakgrund. Relativt få har meriterat sig för en fortsatt akademisk karriär. 32 studerande påbörjade forskarutbildning åren 1991-2001. Andelen doktorander med annan akademisk grundexamen än odontologisk ökar. Sedan 1999 har forskningsvolymen minskat med motsvarande en hel fakultets forskningsvolym. Vi drar därför slutsatsen att kunskapsutvecklingen inom svensk odontologi riskerar att stagnera samt att fakulteternas behov av lärare till högre akademiska tjänster liksom folktandvårdens behov av handledare inom specialistutbildningen inte kommer att kunna tillgodoses i framtiden.
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| 10. |
- Knutsson, K, et al.
(författare)
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Pathoses associated with mandibular third molars subjected to removal
- 1996
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Ingår i: ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS. - : MOSBY-YEAR BOOK INC. ; 82:1
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives. To measure the prevalence oi disease of mandibular third molars referred for removal and to estimate the risk for development of pathoses for two cues. Study design. A prospective cohort study on molars subjected to removal was performed. The
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| 11. |
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| 12. |
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| 14. |
- Nordenram, G., et al.
(författare)
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Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: A systematic review with meta-synthesis
- 2013
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 71:3-4, s. 937-951
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Forskningsöversikt (refereegranskat)abstract
- Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.
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| 19. |
- Rohlin, Madeleine, et al.
(författare)
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Treatment of Adult Patients with Edentulous Arches: A Systematic Review
- 2012
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Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 25:6, s. 553-567
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. Materials and Methods: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). Results: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. Conclusions: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism. Int J Prosthodont 2012;25:553-567
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| 20. |
- Sunnegårdh-Grönberg, Karin, et al.
(författare)
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Treatment of Adult Patients with Partial Edentulism: A Systematic Review
- 2012
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Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 25:6, s. 568-581
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this systematic review was to identify and critically appraise published studies of treatment methods used in general practice to rehabilitate adult patients with single tooth loss or partial edentulism, with special emphasis on outcomes reported after at least 5 years of follow-up. Materials and Methods: Three databases were searched using specified indexing terms. Publications were included if the study design, research questions, and sample size satisfied pre-established criteria. Reference lists of relevant publications and systematic reviews were also searched. The quality of evidence was classified according to the GRADE system as high, moderate, low, or very low. Results: The search yielded 7,675 titles, of which 1,130 were read in full text. A final total of 15 publications were deemed eligible for inclusion: 5 of moderate quality and 10 of low quality. The five studies of moderate quality were all related to implant-based treatment. The 5-year survival rates for implant-supported single crowns and prostheses were 91% and 94.7%, respectively (implant survival rates: 98.5% and 94.9%, respectively). The underlying scientific evidence was low in quality. No relevant publications were identified regarding the economic aspects of treatment. Conclusion: Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss or partial edentulism. Int J Prosthodont 2012;25:568-581.
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| 21. |
- Taguchi, Akira, et al.
(författare)
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Visual assessment of non-eroded thin cortex on panoramic radiographs in identifying women with osteoporosis : Osteoporosis Screening Project in Dentistry (OSPD)
- 2009
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Ingår i: Programme and abstract book. ; , s. 65-65
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction The presence of an eroded or thinned cortex of the mandible on panoramic radiographs may be useful in identifying women with osteoporosis. However, little is known as to whether a non-eroded thin cortex predicts osteoporosis. Objective To clarify whether visual assessment of non-eroded thin cortex increases the diagnostic efficacy of identifying women with osteoporosis. Materials and methods Of 60 observers who participated in OSPD (Taguchi et al., Bone, 2008), 41 observers visually assessed non-eroded thin cortex in addition to Klemetti’s index (KI) for 100 panoramic radiographs on the OSPD website via the Internet twice with approximately a two-week interval. The area under the receiver operating characteristics curves (AUROC) in identifying women with osteoporosis by both KI and non-eroded thin cortex was calculated on two occasions; non-eroded thin cortex was included in “class 1 of KI (decreased probability of osteoporosis)” or “class 3 of KI (increased probability of osteoporosis)”. Mean AUROC was compared between these two occasions with paired ttest. Results In the first series of observations, the mean AUROC significantly increased when noneroded thin cortex was considered as a sign of increased probability of osteoporosis (mean +/- SD, 0.68 +/- 0.08 vs. 0.70 +/- 0.07, P=0.011). In the second set of observations, the result was unchanged (0.68 +/- 0.09 vs. 0.71 +/- 0.08, P<0.001). Conclusions and discussion Visual identification of a non-eroded thin cortex on panoramic radiographs may increase the diagnostic efficacy of identifying women with osteoporosis.
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| 22. |
- Winning, Tracey, et al.
(författare)
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Evidence-based care and the curriculum
- 2008
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Ingår i: European journal of dental education. - : Wiley. - 1396-5883 .- 1600-0579. ; 12:Suppl 1, s. 48-63
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- An evidence-based (EB) approach has been a significant driver in reforming healthcare over the past two decades. This change has extended across a broad range of health professions, including oral healthcare. A key element in achieving an EB approach to oral healthcare is educating our practitioners, both current and future. This involves providing opportunities integrated within simulated and actual clinical settings for practitioners to learn and apply the principles and processes of evidence-based oral healthcare (EBOHC). Therefore, the focus of this discussion will be on ways in which EBOHC and associated research activities can be implemented into curricula, with the aim of improving patient care. This paper will initially define the scope of EBOHC and research, what these involve, why they are important, and issues that we need to manage when implementing EBOHC. This will be followed by a discussion of factors that enable successful implementation of EBOHC and research into curricula. The paper concludes with suggestions on the future of EBOHC and research in curricula. Key recommendations related to curricula include strengthening of the culture of a scientific approach to education and oral healthcare provision; complete integration of EBOHC into the curriculum at all levels; and faculty development to implement EBOHC based on their needs and evidence of effective approaches. Key recommendations to support implementation and maintenance of EBOHC include recognition and funding for high-quality systematic reviews and development of associated methodologies relevant for global environments; building global capacity of EBOHC researchers; research into improving translation of effective interventions into education and healthcare practice, including patient-reported outcomes, safety and harms, understanding and incorporation of patient values into EB decision-making, economic evaluation research specific to oral healthcare and effective methods for changing practitioner (faculty) behaviours; and extend access to synthesized research in 'user friendly' formats and languages tailored to meet users' needs. Realizing these recommendations may help to improve access to effective healthcare as a basic human right.
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