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2.
  • Çaglar, E, et al. (författare)
  • Effect of yoghurt with Bifidobacterium DN-173010 on salivary mutans streptococci and lactobacilli
  • 2005
  • Ingår i: Acta odontologica Scandinavica. ; 63:6, s. 317-320
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract. Probiotic bacteria are thought to reduce the risk of disease. Previous studies have suggested that lactobacilli-derived probiotics in dairy products may affect the oral ecology but the effect of bifidobacteria has not previously been reported. The aim of the present study was to examine whether or not a short-term consumption of yogurt containing bifidobacteria would affect the salivary levels of mutans streptococci and lactobacilli in young adults. A double blind, randomized crossover study was performed and 21 healthy subjects were followed over four periods. During period 2 and 4 (two weeks each), they ingested 200 g yogurt containing Bifidobacterium DN-173 010 once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and washout periods, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits. A statistically significant reduction (p<0.05) of salivary mutans streptococci was recorded after the probiotic yogurt consumption, which was in contrast to the controls. A similar trend was seen for lactobacilli but this decrease failed to reach statistical significance. In conclusion, probiotic bifidobacteria in yogurt may reduce the levels of selected caries-associated microorganisms in saliva.
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3.
  • Hallström, Hadar, et al. (författare)
  • Probiotic supplements and debridement of peri-implant mucositis : a randomized controlled trial
  • 2015
  • Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 74:1, s. 60-66
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis.Materials and methods.Forty-nine adult patients with peri-implant mucositis were consecutively recruited after informed consent. After initial mechanical debridement and oral hygiene instructions, the patients received a topical oil application (active or placebo) followed by twice-daily intake of lozenges (active or placebo) for 3 months. The active products contained a mix of two strains of Lactobacillus reuteri. Patients were clinically monitored and sampled at baseline and after 1, 2, 4, 12 and 26 weeks. The clinical end-points were pocket-probing depth (PPD), plaque index (PI) and bleeding on probing (BOP). In addition, the subgingival microbiota was processed with checkerboard DNA-DNA hybridization and samples of gingival crevicular fluid (GCF) were analyzed for selected cytokines with the aid of multiplex immunoassays.Results.After 4 and 12 weeks, all clinical parameters were improved in both the test and the placebo group. PPD and BOP were significantly reduced compared with baseline (p < 0.05), but no significant differences were displayed between the groups. The clinical improvements persisted 3 months after the intervention. No major alterations of the subgingival microflora were disclosed and the levels of inflammatory mediators in GCF did not differ between the groups.Conclusions.Mechanical debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo.
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4.
  • Mejàre, I, et al. (författare)
  • Caries risk assessment. A systematic review.
  • 2014
  • Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 72:2, s. 81-91
  • Forskningsöversikt (refereegranskat)abstract
    • Abstract Objective. To assess the ability of multivariate models and single factors to correctly identify future caries development in pre-school children and schoolchildren/adolescents. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion criteria. Abstracts and full-text articles were assessed independently by two reviewers. The quality of studies was graded according to the QUADAS tool. The quality of evidence of models and single predictors was assessed using the GRADE approach. Results. Ninety original articles fulfilled the inclusion criteria. Seven studies had high quality, 35 moderate and the rest poor quality. The accuracy of multivariate models was higher for pre-school children than for schoolchildren/adolescents. However, the models had seldom been validated in independent populations, making their accuracy uncertain. Of the single predictors, baseline caries experience had moderate/good accuracy in pre-school children and limited accuracy in schoolchildren/adolescents. The period of highest risk for caries incidence in permanent teeth was the first few years after tooth eruption. In general, the quality of evidence was limited. Conclusions. Multivariate models and baseline caries prevalence performed better in pre-school children than in schoolchildren/adolescents. Baseline caries prevalence was the most accurate single predictor in all age groups. The heterogeneity of populations, models, outcome criteria, measures and reporting hampered the synthesis of results. There is a great need to standardize study design, outcome measures and reporting of data in studies on caries risk assessment. The accuracy of prediction models should be validated in at least one independent population.
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8.
  • Hallström, Hadar, et al. (författare)
  • Effect of a chlorhexidine-containing brush-on gel on peri-implant mucositis
  • 2017
  • Ingår i: International Journal of Dental Hygiene. - : Blackwell Munksgaard. - 1601-5029 .- 1601-5037. ; 15:2, s. 149-153
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim was to evaluate the effect of a chlorhexidine-containing brush-on gel when used as supplement to oral hygiene instructions and mechanical debridement, on peri-implant mucositis in adults. Materials and methods: The study group consisted of 38 adults (48-87 years.) with peri-implant mucositis that were consecutively enrolled in three private clinics after informed consent. The study employed a double-blind controlled design with two parallel arms. After baseline registrations, oral hygiene reinforcement and mechanical debridement, the patients were randomly allocated to either a test group with once daily tooth brushing with an oral care brush-on gel containing 0.2% chlorhexidine digluconate (Cervitec Gel) or a control gel group. The duration of the intervention was 12 weeks. The primary outcome was bleeding on probing (BOP) and secondary endpoints were local plaque score (LPS) and pocket probing depth (PPD). Results: The groups were balanced at baseline. The daily use of the chlorhexidine-containing gel resulted in reduced BOP after 4 and 12 weeks compared with the control group (P < 0.05). The PPD was significantly reduced (P < 0.05) after 12 weeks compared to baseline in the test group, but not in the control group. No side effects or adverse events were reported. Conclusion: The present findings indicated moderate but significant improvements of clinical parameters when mechanical debridement was combined with a self-applied oral care brush-on gel for the management of peri-implant mucositis.
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9.
  • Hallström, Hadar, et al. (författare)
  • Effect of probiotic lozenges on inflammatory reactions and oral biofilm during experimental gingivitis
  • 2013
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 71:3-4, s. 828-833
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. Probiotic bacteria have been introduced for prevention and treatment of periodontal diseases. The aim was to assess if daily oral administration of probiotic bacteria could influence the inflammatory response and the composition of supragingival plaque in an experimental gingivitis model. Materials and methods. Eighteen healthy female adults volunteered after informed consent. A double-blind randomized placebo-controlled cross-over design was used. The buccal surface of first molars was used as experimental sites. A mouth-guard covering the first premolar to second molar was used when brushing, preventing accidental cleaning during 3 weeks of plaque accumulation. Lozenges containing L. reuteri (ATCC55730 and ATCC PTA5289) or placebo were taken twice a day. During the run-in and washout periods, professional tooth cleaning was performed 5 days/week. At baseline and follow-up, plaque index, gingival index and bleeding on probing were recorded. Samples of gingival crevicular fluid (GCF) were analysed for concentration of seven inflammatory mediators. Bacterial samples were processed with checkerboard DNA/DNA-hybridization. Results. All subjects presented a local plaque accumulation and developed manifest gingivitis at the test sites during the intervention periods. The volume of GCF increased in both groups but was statistically significant only in the placebo group (p < 0.05). The concentrations of IL1-beta and IL-18 increased significantly (p < 0.05), while IL-8 and MIP1-beta decreased (p < 0.05). No differences were displayed between test and placebo. Likewise, the microbial composition did not differ between the groups. Conclusion. Daily intake of probiotic lozenges did not seem to significantly affect the plaque accumulation, inflammatory reaction or the composition of the biofilm during experimental gingivitis.
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10.
  • Ullbro, Christer, et al. (författare)
  • Phenotypic Variation and Allelic Heterogeneity in Young Patients with Papillon-Lefèvre Syndrome.
  • 2006
  • Ingår i: Acta Dermato-Venereologica. ; 8, s. 3-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressive periodontitis. The aim of the study was to identify underlying cathepsin C mutations in 39 subjects with Papillon-Lefèvre syndrome and to explore any phenotypic associations. Genotyping and mutation analyses were performed using standard molecular techniques, and dermatological and oral characteristics were assessed with a semiquantitative clinical score. Three genotypes were present at microsatellite marker D11S1780 and two underlying mutations were identified. The most common genotype (183/183) was associated with an 815G → C mutation in exon 6 resulting in an arginine to proline change at amino acid 272 (R272P). Patients with the 173/173 genotype revealed an exon 7 G300D mutation resulting in a glycine to aspartic acid change at amino acid 300. The mutation in a family with 189/189 genotype remained unknown. A significant difference in hyperkeratosis of the feet was found between the patients with mutations G300D and R272P (p <0.05), but not regarding hands or periodontal condition. Young girls displayed significantly less palmoplantar hyperkeratosis ( p <0.05) than young boys. In conclusion, considerable phenotypic heterogeneity was observed within the two cardinal mutations and in the 189/189 genotype.
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11.
  • Anderson, M, et al. (författare)
  • Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial
  • 2016
  • Ingår i: Caries research. - : S. Karger AG. - 1421-976X .- 0008-6568. ; 50:1, s. 17-23
  • Tidskriftsartikel (refereegranskat)abstract
    • This study evaluated whether toddlers in an extended preventive program of semiannual fluoride varnish applications from 1 year of age had a lower incidence of caries than those undergoing a standard program. A cohort of 1-year-old children (n = 3,403) living in multicultural areas of low socioeconomic standing in Stockholm participated in a cluster-randomized controlled field trial with two parallel arms. The children attended 23 dental clinics. Using the ICDAS II criteria, the examiners recorded caries at baseline and after 1 and 2 years. The children in the reference group received a standardized oral health program once yearly between 1 and 3 years of age. The children in the test group received the same standard program supplemented with topical applications of fluoride varnish every 6 months. We compared the test group and the reference group for the prevalence and increment of caries. At baseline, 5% of the children had already developed caries (ICDAS II 1-6). We reexamined the children after 1 year (n = 2,675) and after 2 years (n = 2,536). Neither prevalence nor caries increment differed between the groups. At 3 years of age, 12% of the children had developed moderate and severe carious lesions (ICDAS II 3-6), with a mean increment of 0.5 (SD 2.4) in the test group and 0.6 (SD 2.2) in the reference group. In conclusion, semiannual professional applications of fluoride varnish, as a supplement to a standard oral health program, failed to reduce caries development in toddlers from high-risk communities.
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  • Benteke, M, et al. (författare)
  • Population- vs. risk-based applications of fissure sealants in first permanent molars: a 13-year follow-up.
  • 2006
  • Ingår i: Oral health & preventive dentistry. ; 4:151-156
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To evaluate and compare the long-term outcome of a population-based and a risk-based strategy of applying fissure sealants in newly erupted first permanent molars. DESIGN AND SETTING: Retrospective cohort study in primary dental care. MATERIALS AND METHODS: Four hundred and ninety-six subjects from two cohorts were included. In group P (n = 236), routine applications of fissure sealants were conducted while sealants were placed on the basis of subjective criteria in Group R (n = 260). Data of applications, maintenance, decay, restorations, extractions, and cumulative time of applications from six to 19 years were extracted from the dental records and bite-wing radiographs by two of the authors simultaneously. The main outcome measures were the total caries prevalence at the age of 19 years as well as the fate of each sealed and non-sealed occlusal surface. RESULTS: In group P, 87.7% of all first permanent molars were sealed compared with 20.2% in group R. There was no statistically significant difference concerningthe total DFT at 19 years of age between the groups (mean 3.5 +/- 3.8 vs. 3.7 +/- 3.4). Considering the occlusal surfaces of the first permanent molars only, a statistically significant treatment effect was demonstrated in group P with an odds ratio of 4.6 (95% CI: 3.0 - 6.7; p < 0.05). The absolute risk reduction was 36.3% and the number needed to treat was 2.8. In Group R, no statistically significant treatment effect was disclosed (OR = 1.3; 95% CI: 0.9 - 1.7; risk reduction 5.5%). CONCLUSION: This 13-year follow-up showed that population-based applications of fissure sealants in first permanent molars shortly after eruption showed a statistically significant treatment effect on the occlusal surfaces at the age of 19 years, which was in contrast to findings from a cohort in which sealants were applied on the basis of an individual risk-based strategy. There were, however, no significant differences concerning the total caries experience between the two cohorts
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13.
  • Björnström, H, et al. (författare)
  • Fluoride levels in saliva and dental plaque after consumption of snacks prepared with fluoridated salt.
  • 2004
  • Ingår i: European journal of paediatric dentistry. ; 5:1, s. 41-5
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To determine the concentration of fluoride in saliva and supragingival dental plaque at designated time intervals after consumption of snacks prepared with a standardised amount of fluoridated salt. STUDY DESIGN: The investigation had a single blind prospective crossover design. METHODS: A group of 11 healthy young adults volunteered to participate after verbal and written information and consent. After a 1-week fluoride depletion period, the subjects consumed popcorn prepared with either fluoridated (250 mg/kg) or non-fluoridated salt during 30 minutes. Unstimulated whole saliva and samples of supragingival plaque were collected before consumption (baseline) and at 30, 60 and 120 minutes after the intake. Fluoride concentration was determined with a fluoride-specific electrode and the post-ingestion levels were compared with baseline by ANOVA. RESULTS: In saliva, the mean fluoride concentrations at baseline ranged from 0.021 to 0.027 mg/L and after the 30 minutes consumption of fluoride prepared snacks a 15-fold increase (p<0.001) was found. The same pattern was disclosed in the plaque samples. In both saliva and plaque, the fluoride levels remained significantly elevated after 2 hours (p<0.001 and p<0.05, respectively). CONCLUSION: Consumption of snacks prepared with fluoridated table salt resulted in significantly increased fluoride levels in saliva and supragingival plaque for a period of at least two hours.
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14.
  • Boustedt, Katarina, et al. (författare)
  • A prospective study of perinatal and metabolic risk factors for early childhood caries
  • 2020
  • Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 109:11, s. 2356-2361
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim To study the relationship between early childhood caries and perinatal and metabolic risk factors in a cohort of preschool children. Methods The study population consisted of 208 children followed from birth to 6.5 years. We extracted the perinatal factors from medical records and questionnaires and assessed the occurrence of caries at the age of 5 years. Indicators of the metabolic syndrome (waist circumference, blood pressure, fasting insulin, glucose and dyslipidaemia) were recorded at 6.5 years of age. Results Infants born moderately to late preterm and infants born small for gestational age were more likely to have early childhood caries at 5 years of age (relative risk 4.2 and 2.3, respectively; P < .05). The presence of metabolic risk factors according to the IDEFICS monitoring levels did not differ between children with or without caries but a statistically significant correlation was found between the fasting glucose values and the number of decayed or filled teeth (r = 0.18; P < .05). Conclusion Being born preterm or small for gestational age increased the risk of early childhood caries. Preschool children with caries had higher fasting glucose levels but no other signs of the metabolic syndrome.
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15.
  • Boustedt, K., et al. (författare)
  • Free sugars and early childhood caries development: a prospective cohort study
  • 2022
  • Ingår i: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805. ; 23:5, s. 829-833
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To investigate the impact of giving children younger than 2 years foods and beverages with free sugars on the prevalence of early childhood caries at 5 years. Materials and methods The study group consisted of 208 children (105 boys and 103 girls) with a complete set of data on nursing, diet and caries from birth to 5 years. We collected feeding habits and dietary data through structured questionnaires at 6, 12, 18 and 24 months and the presence of decayed (d), missed (m) and filled (f) teeth was scored according to the WHO criteria at five years of age. We processed data with chi-square tests and expressed as relative risk (RR) with 95% confidence intervals. Results At the age of 5 years, 22% of the children had caries. Intake of fruit juice with meals (RR 2.3) and cookies or biscuits at 24 months of age (RR 2.4), as well as fast food consumption at least once every week (RR 2.9), more than doubled the risk for early childhood caries (p < 0.05). Conclusions Within the limitations of the present study, we found a relationship between consumption of free sugars early in life and dental caries prevalence at 5 years. It therefore seems important to embrace and emphasise the current sugar recommendations in primary and dental care to educate caregivers to avoid serving free sugars to their children before the age of 2 years.
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16.
  • Boustedt, Katarina, et al. (författare)
  • Influence of mode of delivery, family and nursing determinants on early childhood caries development: a prospective cohort study
  • 2018
  • Ingår i: Acta Odontol Scand. - : Informa UK Limited. - 1502-3850. ; 76:8, s. 595-599
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Conflicting results exist regarding mode of delivery and caries. We investigated the influence of the mode of delivery and selected family- and nursing factors during the first 2 years of life on the prevalence of dental caries at 5 years. MATERIALS AND METHODS: 551 infants were invited to a prospective medical study with focus on growth and overweight prevention. The parents of 346 infants (179 boys and 167 girls) accepted this invitation and at the age of 2-years, 336 of them agreed to dental check-ups and salivary samplings. At the ages of three and five years, 302 (90%) and 292 children (87%) could be re-examined with respect to caries by one of two calibrated examiners. All stages of caries lesions were scored on tooth and surface level. Background maternal and nursing data were collected semiannually through validated questionnaires and interviews. RESULTS: The caries prevalence (initial + cavitated lesions) was 5.6% at 3 years of age and 18.9% at 5 years. The 5-year-olds delivered with caesarian section displayed a significantly elevated risk of having caries (relative risk [RR] 2.2; 95% confidence interval (CI) 1.4-3.6; p < .05). Parental smoking and siblings with caries were the most influential family determinants (p < .05) while drinking juice to meals at 2 years of age (p < .05) was most outstanding among the nursing factors (p < .05). CONCLUSIONS: In this cohort, the mode of delivery (caesarian section) had a significant impact on the risk of early childhood caries (ECC) but also other family and infant nursing determinants were related to the development of the disease.
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17.
  • Boustedt, K., et al. (författare)
  • Is the mode of childbirth delivery linked to the prevalence of early childhood caries? A systematic review and meta-analysis
  • 2021
  • Ingår i: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805. ; 22, s. 765-772
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The mode of childbirth delivery can influence the child’s future health and the aim of this study was to explore the association between the delivery mode and the prevalence of early childhood caries. Methods: We searched the PubMed, Google Scholar and Cochrane databases up to September 15, 2020. Two independent reviewers screened the papers for relevance, extracted data and assessed the risk of bias with the Newcastle–Ottawa Scale. We performed a random effects meta-analysis to pool the prevalence of early childhood caries according to the mode of delivery. Results: The authors included 11 studies in the review, comprising 47,688 children with vaginal delivery and 10,994 with caesarean section (C-section). The publication years ranged from 1997 to 2020 and included birth cohorts, cross-sectional, register-based and case–control studies. We assessed three publications with low or moderate risk of bias. The median caries prevalence in the C-section group was 56.4% compared to 45.9% in the vaginal group and this difference was statistically significant (p < 0.05). The pooled overall odds ratio was 1.48 (95% CI 1.07–2.05) indicating a weak but statistically significant trend towards a higher caries occurrence among children delivered with C-section. The certainty of this finding was low due to heterogeneity and inconsistencies across the studies. Conclusion: We found a weak but inconsistent association between the mode of delivery and the prevalence of early childhood caries. Further studies based on representative, prospective cohorts reporting a standardized core outcome set are required to answer the research question with higher certainty. © 2021, The Author(s).
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18.
  • Boustedt, Katarina, et al. (författare)
  • Tooth brushing habits and prevalence of early childhood caries: a prospective cohort study
  • 2020
  • Ingår i: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805. ; 21, s. 155-159
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To study the relationship between the tooth-brushing habits during the preschool ages and caries prevalence at the age of 5 years and to investigate a possible association with the mode of delivery. METHODS: The study population consisted of 336 children that were orally examined at 2, 3 and 5 years. All stages of caries were scored on tooth and surface level. Data on tooth brushing behaviour were collected through semi-structured interviews. RESULTS: At 5 years, the attrition rate was 13.1%. The total caries prevalence (cavitated and non-cavitated lesions) was 18.9%. The vast majority of the parents assisted their child with the brushing and 98% used fluoride toothpaste. The relative risk (RR) for caries was significantly (p < 0.05) increased for "tooth brushing less than twice daily" at two (RR 2.1, 95% CI 1.3-3.3, p < 0.01) and 3 years (RR 3.6, 95% CI 2.0-6.7; p < 0.001). Likewise, reporting "major/minor difficulties to perform tooth brushing" at 2 and 3 years was significantly related to caries development at the age of five (RR 1.5, 95% CI 1.0-2.4, p < 0.05 and RR 2.5, 95% CI 1.4-4.3; p < 0.01). We found no significant association between the tooth brushing habits and the mode of delivery. CONCLUSIONS: Less than twice daily tooth-brushing and difficulties to perform the procedure during the first preschool years were significant determinants of caries prevalence at the age of 5 years. Health professionals should, therefore, give special attention and assist parents to improve and optimize their tooth brushing behaviour during the preschool years.
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19.
  • Çaglar, E, et al. (författare)
  • Salivary mutans streptococci and lactobacilli levels after ingestion of the probiotic bacterium Lactobacillus reuteri ATCC 55730 by straws and tablets.
  • 2006
  • Ingår i: Acta odontologica Scandinavica. ; :64, s. 314-318
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Previous studies have suggested that lactobacilli-derived probiotics in dairy products may affect oral ecology, but the impact of different vehicles of ingestion has received little attention. The aim of the present study was to investigate the effect of the probiotic bacterium Lactobacillus reuteri ATCC 55730 on the levels of salivary mutans streptococci and lactobacilli in young adults when ingested by two different delivery systems. MATERIAL AND METHODS: The material comprised 120 healthy young adults (21-24 years) and a placebo-controlled study design with parallel arms was utilized. The subjects were randomly assigned to four equally sized groups: group A drank 200 ml of water through a prepared straw containing L. reuteri ATCC 55730 once daily for 3 weeks, while group B took 200 ml water through a placebo straw during the same period. Group C was given one tablet containing L. reuteri ATCC 55730 once daily for 3 weeks, while group D received placebo tablets without bacteria. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits at baseline and 1 day after the final ingestion. RESULTS: A statistically significant reduction of the mutans streptococci levels was recorded after ingestion of the probiotic bacteria via the straw (p<0.05) and the tablets (p<0.01), which was in contrast to the placebo controls. A similar but non-significant trend was seen for lactobacilli. CONCLUSIONS: A short-term daily ingestion of lactobacilli-derived probiotics delivered by prepared straws or lozenges reduced the levels of salivary mutans streptococci in young adults.
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22.
  • Hasslöf, Pamela, et al. (författare)
  • Prevention of Recurrent Childhood Caries with Probiotic Supplements : A Randomized Controlled Trial with a 12-Month Follow-Up
  • 2022
  • Ingår i: Probiotics and Antimicrobial Proteins. - : Springer. - 1867-1306 .- 1867-1314. ; 14, s. 384-390
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to evaluate the effect of drops containing probiotic bacteria on the recurrence of dental caries in preschool children. The study employed a randomized, placebo-controlled, double-blinded design with two parallel arms. 38 preschool children were enrolled after comprehensive restorative treatment under general anesthesia or conscious sedation (baseline), and they were followed up after 6 and 12 months. Parents of children in the test group were instructed to give 5 daily drops containing two strains of Limosilactobacillus reuteri (DSM 17938 and ATCC PTA 5289) at bedtime. The placebo drops were identically composed but lacked bacteria. The duration of the intervention was 12 months. The primary endpoint was recurrence of new caries lesions on subject level (yes/no), and secondary endpoints were presence of dental plaque and gingivitis. We found high rate of recurrent moderate and extensive lesions after 12 months (67%) but there were no significant differences between the groups. We observed no beneficial effects on dental plaque or gingival inflammation. The findings were however uncertain and inconclusive due to lack of power, a consequence of the COVID-19 pandemic. ClinTrials.gov Identifier: (NCT04929340), June 18, 2021; retrospectively registered.
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23.
  • Hedberg, Maria, et al. (författare)
  • Sugar fermentation in probiotic bacteria : an in vitro study
  • 2008
  • Ingår i: Oral Microbiology and Immunology. - 0902-0055 .- 1399-302X. ; 23:6, s. 482-485
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Food supplemented with probiotic bacteria is a rapidly growing sector of the market. The aim of the present study was to evaluate and compare the acid production of selected probiotic strains available in commercial products.METHODS: Six Lactobacillus strains (Lactobacillus plantarum 299v and 931; Lactobacillus rhamnosus GG and LB21; Lactobacillus paracasei subsp. paracasei F19, and Lactobacillus reuteri PTA 5289) were cultivated at 37 degrees C in an anaerobic atmosphere on Man, Rogosa, Shape (MRS) agar for 48 h or MRS broth for 16 h. After centrifugation, the cells were washed and resuspended in sterile phosphate-buffered saline and immediately subjected to a fermentation assay with 12 different carbohydrates (nine sugars and three sugar alcohols) in microtiter plates with a pH indicator. The plates were examined for color changes after 24, 48, and 72 h of incubation under aerobic and anaerobic conditions. Three scores were used: negative (pH > 6.8); weak (pH 5.2-6.8), and positive (pH < 5.2). The strains were characterized with the API 50 CH system to confirm their identity.RESULTS: L. plantarum fermented all the sugars except for melibiose, raffinose, and xylitol. Both L. rhamnosus strains were generally less active although L. rhamnosus GG was slightly more active than strain LB21 in the 5% CO(2) setting. The latter strain exhibited negative reactions for sucrose, maltose, arabinose, and sorbitol under anaerobic conditions. The assays with L. paracasei and L. reuteri had negative or weak reactions for all tested sugars under both aerobic and anaerobic conditions.CONCLUSION: The metabolic capacity to form acid from dietary sugars differed significantly between the various probiotic strains.
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24.
  • Holmen, A., et al. (författare)
  • Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping
  • 2018
  • Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To describe, with aid of geo-mapping, the effects of a risk-based capitation model linked to caries-preventive guidelines on the polarization of caries in preschool children living in the Halland region of Sweden. Methods: The new capitation model was implemented in 2013 in which more money was allocated to Public Dental Clinics surrounded by administrative parishes inhabited by children with increased caries risk, while a reduced capitation was allocated to those clinics with a low burden of high risk children. Regional geo-maps of caries risk based on caries prevalence, level of education and the families purchasing power were produced for 3-6-year-old children in 2010 (n = 10,583) and 2016 (n = 7574). Newly migrated children to the region (n = 344 in 2010 and n = 522 in 2016) were analyzed separately. A regional caries polarization index was calculated as the ratio between the maximum and minimum estimates of caries frequency on parish-level, based on a Bayesian hierarchical mapping model. Results: Overall, the total caries prevalence (dmfs > 0) remained unchanged from 2010 (10.6%) to 2016 (10.5%). However, the polarization index decreased from 7.0 in 2010 to 5.6 in 2016. Newly arrived children born outside Sweden had around four times higher caries prevalence than their Swedish-born peers. Conclusions: A risk-based capitation model could reduce the socio-economic inequalities in dental caries among preschool children living in Sweden. Although updated evidence-based caries-preventive guidelines were released, the total prevalence of caries on dentin surface level was unaffected 4 years after the implementation.
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25.
  • Hänsel Petersson, G, et al. (författare)
  • Comparing caries risk factors and caries risk profiles in children and elderly.
  • 2004
  • Ingår i: Swedish dental journal. ; 28:3, s. 119-128
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of this study were to compare the caries risk profiles of children and elderly, the actual annual caries increment and the impact of some selected caries related factors. Another aim was to find out if there were gender differences among the participants. The risk profiles were created by a computerised risk assessment program, the Cariogram, which evaluates data and presents the weighted and summarized result as one figure, illustrating the ‘percent chance of avoiding caries’ in the future. Methods: The Cariogram was earlier evaluated in two longitudinal studies for its capacity to assess caries risk. One study comprised about 400 children, 10-11 years of age and the other study included about 150 elderly (age 55, 65 and 75). At baseline, information on past caries experience, diet, oral hygiene and use of fluoride was obtained. Saliva analyses included mutans streptococci and lactobacilli, buffering capacity and secretion rate. The caries risk was assessed and the participants were divided into five groups according to the calculated Cariogram risk profiles. After two and five years, respectively, caries was re-evaluated and the incidence was compared with the predictions. Results: The Cariogram risk predictions were statistically in agreement with the actual caries increment. Fifty percent of the children, but only two percent of the elderly appeared in the lowest caries risk group. Of the elderly, 26.4% belonged to the highest caries risk group versus 3.1% of the children. The median value ‘chance of avoiding caries’ was 44% for the elderly and 80% for the children. The main Cariogram sectors contributing to the observed higher caries risk among elderly was the bacterial components in combination with higher susceptibility. Individual factors contributing significantly to the higher risk profiles for the adults compared to the children were higher plaque scores, higher counts of mutans streptococci and lower buffering capacity. Conclusion: comparing the risk profiles of the children and the elderly showed that the elderly were at a higher risk developing caries lesions. Overall one may say that the risk for caries, as assessed by the Cariogram, was twice as high for the elderly.
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26.
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27.
  • Keller, MK, et al. (författare)
  • Probiotic supplements (Lactobacillus reuteri DSM 17938 and ATCC PTA 5289) do not affect regrowth of mutans streptococci after full-mouth disinfection with chlorhexidine : a randomized controlled multicenter trial
  • 2012
  • Ingår i: Caries Research. - : S. Karger. - 0008-6568 .- 1421-976X. ; 46:2, s. 140-146
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate the effectiveness of tablets containing two probiotic Lactobacillus reuteri strains in inhibiting regrowth of salivary mutans streptococci (MS) after full-mouth disinfection (FMD) with chlorhexidine. The null hypothesis was that the levels of MS would not differ in comparison with a placebo protocol. The study population was comprised of 62 young adults (mean age 23 years) with moderate or high counts of salivary MS who volunteered after informed consent. The study was a double-blinded randomized controlled trial with two parallel groups. After a 3-day chlorhexidine regimen, the subjects were randomly assigned to a test group (n = 32) with probiotic lozenges (2/day) or a placebo group (n = 30). The intervention period was 6 weeks, and stimulated whole saliva was collected at baseline and after 1, 6, and 12 weeks. The samples were processed for MS by a chair-side test and DNA-DNA hybridization as an estimate of 19 bacterial strains associated with oral health and disease. There was no significant difference between the groups at inclusion, and FMD reduced the salivary MS levels significantly in both groups. The MS suppression lasted less than 6 weeks and there were no statistical differences in salivary MS regrowth between the test and control groups at any of the follow-ups. Likewise, there were no major differences in the regrowth patterns of the checkerboard panel between the two groups. We conclude that daily oral administration of L. reuteri did not seem to affect or delay the regrowth of salivary MS after FMD with chlorhexidine. Copyright (c) 2012 S. Karger AG, Basel
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28.
  • Lundgren, T, et al. (författare)
  • Saliva composition in children and young adults with Papillon-Lefèvre syndrome
  • 1996
  • Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 23:12, s. 1068-72
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to evaluate the salivary secretion rate and composition in a group of 16 children and young adults (6-27 years) with Papillon-Lefèvre Syndrome (PLS), and to compare the findings with a group (n = 16) of healthy controls. Unstimulated and stimulated whole saliva was collected at least 2 h after meals and the secretion rate determined. The stimulated saliva was assessed for buffer capacity, total protein, peroxidase and hexosamine, while the unstimulated samples were evaluated for total protein, lysozyme, thiocyanate, lactoferrin and salivary IgA. Both the unstimulated (p < 0.01) and stimulated (p < 0.05) saliva secretion rates were significantly lower among the PLS patients compared with the controls. Furthermore salivary buffer capacity was significantly (p < 0.01) lower in the PLS patients. The total protein content in saliva was comparatively high in the study group, while the concentrations of immunoglobulins and non-immunoglobulins were within normal ranges. When calculating the output of the assessed antimicrobial factors, the mean peroxidase level in stimulated whole saliva was found to be significantly (p < 0.01) lower in the PLS patients than in the healthy controls. In conclusion, the present study indicates an impaired water secretion and a somewhat altered saliva gland function in children and young adults with PLS.
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29.
  • Lundgren, T, et al. (författare)
  • Systemic retinoid medication and periodontal health in patients with Papillon-Lefèvre syndrome
  • 1996
  • Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 23:3 Pt 1, s. 176-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Periodontal health in relation to systemic retinoid medication was evaluated retrospectively in patients with Papillon-Lefèvre Syndrome (PLS). The material consisted of 18 children/young adults ranging from 8 to 28 years of age, all with a confirmed diagnosis of PLS. 9 participants, comprising a medication group, had been on long-term (range 1.5-9 years) retinoid medication for their cutaneous lesions. The remaining 9 served as controls. Regardless of whether or not retinoid medication was received, every patient experienced an early and devastating periodontitis, with atypical edematous and erythematous gingiva, suppuration from deep gingival pockets and premature loss of teeth. No correlation could be found between the severity of skin involvement and the severity of periodontal involvement. An improvement with age could be seen for the cutaneous lesions but not for the periodontal condition. Systemic medication with retinoids had a favorable therapeutic effect on cutaneous lesions, and no severe complication/side effect could be seen after several years of continuous use. However, from the results of this study it can be concluded that, at least in a situation with poor compliance of daily oral home-care, no positive effect on the periodontal health in patients with PLS could be seen by the retinoid medication.
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30.
  • Morténius, Helena, 1966, et al. (författare)
  • Creating research and development awareness among dental care professionals by use of strategic communication: A 12-year intervention study
  • 2017
  • Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 17:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite the availability of contemporary research advances, only a limited fraction is implemented into dental practice. One possible way to facilitate this process is to stimulate the research and development (R&D) awareness and interest with aid of strategic communication. Methods: The aim of the study was to analyse the role of a strategic communication in R&D awareness and interest among dental care professionals (DCP) over a 12-year period. A second aim was to compare the findings with those from primary care professionals (PCP). The project had a prospective design and the intervention was conducted through established oral, written and digital channels. The outcome was captured by two validated questionnaires submitted after 7 and 12 years, respectively. An additional Questionnaire file shows the details [see Additional file 1]. The material consisted of 599 health care professionals (205 DCP; 394 PCP) that responded to the first questionnaire and 526 individuals (195 DCP; 331 PCP) who responded to the second. All were employed by the primary care organization of Region Halland located in southwest of Sweden. The majority were women (≥ 85%) and the mean age at the first questionnaire was 49 years (SD 8.5). Longitudinal analyses were applied to those individuals that responded to both surveys after 7 and 12 years (n = 248). Comparisons between DCP's and PCP's were processed with Chi-square and Fischer's exact tests. Results: Strategic communication contributed to increase the R&D awareness and interest among the dental personnel. The created interest was reported stronger among the DCP when compared with PCP at both surveys (p < 0.05). The longitudinal findings confirmed a long-term interest among the DCP's. Direct and indirect communication facilitated R&D interest in both groups. The most powerful channels were the written "Research bulletin" and peer inspiration. Conclusion: Strategic communication can be employed as a scientific tool that may contribute to the creation of a long-term R&D awareness and interest among dental care professionals. © 2017 The Author(s).
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31.
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32.
  • Norman, M., et al. (författare)
  • Urinary fluoride excretion in preschool children after intake of fluoridated milk and use of fluoride-containing toothpaste
  • 2017
  • Ingår i: Community Dental Health. - Suffolk : FDI World Dental Press Ltd.. - 0265-539X. ; 34:1, s. 27-31
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To assess the urinary fluoride excretion in preschool children after drinking fluoridated milk with 0.185 mg F and 0.375 mg F and to study the impact of use of fluoride toothpaste.Basic research design: Double-blind cross-over study.Participants: Nine healthy children, 2.5-4.5 years of age.Intervention: In a randomized order, participants drank 1.5 dl milk once daily for 7 days with no fluoride added (control), 0.185 mg fluoride added and 0.375 mg fluoride added. The experiment was performed twice with (Part I) and without (Part II) parental tooth brushing with 1,000 ppm fluoride toothpaste. The fluoride content in the piped drinking water was 0.5 mg F/L.Main outcome measure: Urinary fluoride excretion.Results: The 24-hour urinary fl uoride excretion/kg body weight varied from 0.014 mg F for the placebo intervention and non-fluoride toothpaste to 0.027 mg F for the 0.375 mg intervention with use of 1,000 ppm fluoride toothpaste. The difference compared with the placebo intervention was not statistically significant for any of the interventions when fluoride toothpaste was used (p⟩0.05) while it was statistically significantly different when non-fluoride toothpaste was used (p⟨0.05).Conclusions: All sources of fluoride must be considered when designing community programs. With 0.5 mg F/L in the drinking water and daily use of fluoride toothpaste, most children had a fluoride intake optimal for dental health. In this setting, additional intake of fluoride milk was within safe limits up to 0.185 mg/day while conclusions about the safety of 0.375 mg/day were uncertain.
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33.
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34.
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35.
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36.
  • Roos, Stefan, et al. (författare)
  • Effect of Lactobacillus reuteri on cell viability and PGE2 production in human gingival fibroblasts
  • 2017
  • Ingår i: Probiotics and Antimicrobial Proteins. - : Springer Science and Business Media LLC. - 1867-1306 .- 1867-1314. ; 9, s. 278-283
  • Tidskriftsartikel (refereegranskat)abstract
    • Emerging evidence suggests that probiotic therapy can play a role in the prevention and management of oral inflammatory diseases through immunomodulation and downregulation of the inflammatory cascade. The aim of this in vitro study was to investigate the viability of human gingival fibroblasts (HGF) and its production of prostaglandin E-2 (PGE(2)), when exposed to supernatants of twomixed Lactobacillus reuteri strains (ATCC PTA 5289 and DSM 17938). The experiments were conducted in the presence and absence of the proinflammatory cytokine IL-1 beta. L. reuteri strains were grown and the bacterial supernatant was collected. The cell-free supernatant was diluted to concentrations equivalent to the ones produced by 0.5 to 5.0 x 10(7) CFU/mL bacteria. Cell viability was assessed with the MTT colorimetric assay and the amount of PGE(2) in the cell culture medium was determined using the monoclonal enzyme immune assay kits. Our findings showed that none of the L. reuteri supernatants were cytotoxic or affected the viability ofHGF. The most concentrated bacterial supernatant stimulated the production of PGE(2) by the gingival cells in a significant way in the presence of IL-1 beta (p < 0.05), suggesting that bacterial products secreted from L. reuteri might play a role in the resolution of inflammation in HGF. Thus, our findings justify further investigations on the influence of probiotic bacteria on gingival inflammatory reactions.
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37.
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38.
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39.
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40.
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41.
  • Stecksén-Blicks, C, et al. (författare)
  • Effect of Long-Term Consumption of Milk Supplemented with Probiotic Lactobacilli and Fluoride on Dental Caries and General Health in Preschool Children : A Cluster-Randomized Study.
  • 2009
  • Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 43:5, s. 374-381
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to evaluate the effect of milk supplemented with probiotic bacteria and fluoride on caries development and general health in preschool children. Children 1-5 years of age (n = 248) attending 14 day care centres with 27 units in northern Sweden entered the study. The centres were randomly assigned to two parallel groups: children in the intervention group were served 150 ml milk supplemented with Lactobacillus rhamnosus LB21 (10(7) CFU/ml) and 2.5 mg fluoride per litre for lunch while the control group received standard milk. The double-blind intervention lasted for 21 months (weekdays) and data were collected through clinical examinations and questionnaires. The primary outcome was caries increment and secondary outcomes were measures of general health. The dropout rate was 25%. The mean baseline caries experience was 0.5 dmfs in the intervention units and 0.6 in the control units and after 21 months 0.9 and 2.2 (p < 0.05). The number of days with sick leave was similar in both groups but the children of the intervention units displayed 60% fewer days with antibiotic therapy (mean 1.9 vs. 4.7 days) and 50% less days with otitis media (0.5 vs. 1.0) (p > 0.05). In children who had participated during the whole 21-month intervention, fewer days with otitis media were reported (0.4 vs. 1.3 days, p < 0.05). No serious side effects were reported. It is concluded that daily consumption of milk containing probiotic bacteria and fluoride reduced caries in preschool children with a prevented fraction of 75%. Additional beneficial health effects were evident.
  •  
42.
  • Sundell, Anna Lena, et al. (författare)
  • Salivary microbial profiles in 5-year old children with oral clefts : a comparative study
  • 2018
  • Ingår i: European Archives of Paediatric Dentistry. - : Springer. - 1818-6300 .- 1996-9805. ; 19:1, s. 57-60
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To compare the salivary microbial profile in children with oral clefts to matched non-cleft controls in a cross-sectional study.Methods: The cleft group consisted of 80 children aged 5 years and 144 age-matched non-cleft children were recruited as a control group. Stimulated whole saliva samples were collected and analysed with checkerboard DNA–DNA hybridisation using 12 pre-determined bacterial probes. Background data on caries, oral hygiene, dietary habits and fluoride exposure were collected from clinical examinations and questionnaires.Results: Children in the cleft group had a significantly higher prevalence of dental caries but only minor differences in the salivary microbial profile were found. In general, the cleft-children displayed a lower prevalence of common commensal species (e.g. Streptococcus, Fusobacterium) when compared with the non-cleft controls. The differences were statistically significant (p < 0.05) but the clinical significance was unclear.Conclusions: The profile of the salivary microflora in 5-year-old children with and without oral clefts was basically similar and displayed only marginal differences with respect to commensal bacteria. 
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43.
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44.
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45.
  • Twetman, S, et al. (författare)
  • Comparison of the efficacy of three different chlorhexidine preparations in decreasing the levels of mutans streptococci in saliva and interdental plaque
  • 1998
  • Ingår i: Caries research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 32:2, s. 113-118
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to evaluate and compare the effects of three different chlorhexidine (CHX)-containing preparations on mutans streptococci (MS) levels in interdental plaque and whole saliva. Ninety-three healthy schoolchildren (8–10 years old) with high scores of salivary MS were selected by a screening procedure and randomised into three equally sized groups. MS were enumerated at all mesial interdental sites of the first permanent molars with aid of a modified chairside technique. The patients were then treated three times within 2 weeks with either a 1% CHX/thymol-containing varnish (group A) or a 1% CHX gel (group B), or they were subjected to daily supervised toothbrushing with a 0.4% CHX dentifrice for 1 month (group C). Follow-up samples of saliva and plaque from the interdental sites were collected 1 and 3 months after termination of treatment. A statistically significant reduction of MS levels in saliva and interdental plaque was found in all groups after 1 month. The CHX-containing dentifrice (group C) was the most effective method in reducing MS levels in saliva, and a significantly stronger (p < 0.05) suppression was found after 1 and 3 months when compared with the gel and the varnish forms. The gel (group B) tended to be slightly more effective than the varnish (group A). In the interdental plaque, the reduction of MS was less marked than in the saliva, and the three groups exhibited MS reductions of similar magnitude (20%) and duration, persisting up to 3 months. However, a high proportion (approximately 50%) of all interdental sites were relatively unaffected by the treatments. In conclusion, our results suggest that the interdental MS colonisation was difficult to combat, irrespective of CHX preparation and method, while the salivary levels were more easily affected. Daily tooth-brushing with a CHX-containing dentifrice was more effective in reducing MS in saliva compared with the gel or varnish applications.
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