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| 2. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Treatment of pulps in teeth affected by deep caries - A systematic review of the literature.
- 2013
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Ingår i: Singapore dental journal. - : World Scientific Pub Co Pte Lt. - 0377-5291. ; 34:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.STUDY DESIGN: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.RESULTS: No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.CONCLUSIONS: Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.
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| 4. |
- Frisk, Fredrik, 1971, et al.
(författare)
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Pulp exposures in adults--choice of treatment among Swedish dentists.
- 2013
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Ingår i: Swedish dental journal. - : Sveriges tandläkarförbund. - 0347-9994. ; 37:3, s. 153-60
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Tidskriftsartikel (refereegranskat)abstract
- This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
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| 5. |
- 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. |
- Jacobsen, Thomas, 1954, et al.
(författare)
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Application of laser technology for removal of caries: A systematic review of controlled clinical trials
- 2011
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 69:2, s. 65-74
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Forskningsöversikt (refereegranskat)abstract
- Objective. To evaluate the scientific evidence regarding laser technology for removal of carious tissue. Material and methods. A search for literature on the effect of treatment and on economic aspects of laser technology identified 23 papers. No relevant studies on economic aspects were found. Regarding the effect of treatment, 16 papers were selected for assessment according to established criteria. Results. Cavity preparation and caries excavation by erbium laser were evaluated in three studies of medium quality. The time required to remove carious tissue was evaluated in five studies assessed as being of medium quality for this outcome. In four studies the effect of laser treatment on the dental pulp was included as an outcome but, due to the short follow-up time, the quality was assessed as low. Two studies that included the longevity of the restoration as an outcome were also assessed as being of low quality because the follow-up time was inadequate. Patient response was evaluated in three studies, which were assessed as being of medium quality with respect to this outcome. Conclusions. There is limited scientific evidence that laser treatment is as effective as a rotary bur for removing carious tissue. Treatment time is prolonged. There is limited scientific evidence that adults prefer laser treatment. No conclusions can be drawn regarding biological or technical complications, children's perception of laser treatment or the cost-effectiveness of the method. © 2011 Informa Healthcare.
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- Liebe-Harkort, Carola, 1966-
(författare)
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Oral Disease and Health Patterns : Dental and Cranial Paleopathology of the Early Iron Age Population at Smörkullen in Alvastra, Sweden
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In skeletal remains of ancient populations, evidence of dental and craniofacial pathology is often well preserved in the form of lesions on the teeth or bones. Meticulous, detailed recording of these lesions provides baseline data on which a realistic assessment can be made of the probable impact of dental diseases and its sequelae on health of these earlier populations. In the present thesis, dental and cranial pathology were recorded in the remains of an Iron Age population, with special reference to the possible impact of such conditions on general health and well-being. The skeletal remains had been excavated early last century from the burial ground Smörkullen, Alvastra, Östergötland, in Eastern Central Sweden: osteological analyses showed that the material comprised the remains of 65 subadult individuals and 104 adult individuals of both sexes. The dental status of most of the adult individuals was poor. Calculus, periodontitis, moderate and severe carious lesions and periapical infections were recorded. In contrast, subadult showed less evidence of dental disease. The results indicate that the perception of health in adults was probably negatively affected by their poor oral status. The dental status of subadults, on the other hand, was unlikely to have had a negative impact on their general well-being. A sex difference was observed in the material, males tending to more ongoing disease than females. Overall, the frequencies of both dental and cranial pathologies increased with age. Caries frequency in the material was noticeable higher than in numerous other studies in Scandinavian populations. Although the high caries rates at Smörkullen may be attributable to a diet rich in carbohydrates, the result may to some extent have been influenced by observer experience. Caries rates in other populations are likely to be under-estimated in comparison with Smörkullen. However, methodological factors alone cannot not explain all the observed differences. The recording of cranial pathologies disclosed malnutrition and upper respiratory problems in all age groups in the Smörkullen material. This most certainly affected their well-being. In some cases the pathology observed was directly associated with life-threatening conditions. Analyses of combinations of pathologies suggest that a combination of linear enamel hypoplasias and cribra orbitalia, mainly observed in those who died before the age of fifteen, may have been related to a lower probability of survival.
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| 8. |
- Liebe-Harkort, Carola, 1966-, et al.
(författare)
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Quantification of Dental Caries by Osteologist and Odontologists - A Validity and Reliability Study.
- 2010
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Ingår i: International journal of osteoarchaeology. - : Wiley. - 1047-482X .- 1099-1212. ; 20:Sep, s. 525-539
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Tidskriftsartikel (refereegranskat)abstract
- As in modern populations, dental caries in early populations is linked to diet and general health. In order to record not only advanced disease states with frank cavitation of teeth but also early lesions, indicating the presence of the disease in a population, it is important that the archaeologist can correctly detect and classify lesions of varying severity. The present study compares and contrasts quantification of dental caries by osteologists and odontologists. Four osteologists and four odontologists undertook visual and radiographic inspection of 61 teeth from three different sources: medieval, 19th century and modern. Separate sets of criteria were applied to disclose observer confidence in detecting a lesion and in estimating lesion extent. For validation of visual assessments, the teeth were sectioned. Radiographic assessments were validated by a specialist in dental radiography. The results disclosed that the odontologists in general showed greater sensitivity than the osteologists, correctly identifying carious lesions, but the osteologists had higher specificity, correctly identifying healthy teeth. Thus, the osteologists tend to overlook carious lesions (under-diagnosis), while the odontologists tend to incorrectly record lesions in healthy teeth (over-diagnosis). For both osteologists and odontologists, correct assessment was poorer for radiographs than for visual inspection.
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| 9. |
- Liebe-Harkort, Carola, 1966-, et al.
(författare)
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Visual and Radiographic Assessment of Dental Caries by Osteologists: A Validity and Reliability Study.
- 2011
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Ingår i: International journal of osteoarchaeology. - : Wiley. - 1047-482X .- 1099-1212. ; 21:1, s. 55-65
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Tidskriftsartikel (refereegranskat)abstract
- In the skeletal remains of earlier populations, the presence and severity of dental caries preserves evidence about general health and diet. The quality of the data collected on dental caries is highly dependent on the diagnostic skills of the examining osteologist. A major barrier to more detailed data is reliance on visual inspection only. The present study compared quantification of carious lesions by osteologists, using both visual and radiographic inspection. Four osteologists with varying experience of caries diagnosis registered the presence and extent of dental caries on the crown and root surfaces of 61 teeth sourced from three different samples: Archaeological, Anthropological and Modern. The teeth were subsequently sectioned to provide a control or standard reference. The interobserver differences were calculated as sensitivity (observer correctness in identifying teeth with caries disease). The two observers with more experience of dental paleopathology showed higher agreement with the standard reference than the other two observers, i.e. they correctly diagnosed more carious lesions. The most pronounced interobserver difference was for radiographic inspection of root surfaces. The recordings by the two experienced observers conformed much more closely with the standard reference than those of the less experienced observers. The results confirm that experience has a major influence on practical observations in dental paleopathology. The quality of collected data on dental caries could be enhanced by improving osteologists’ knowledge of the disease process and the application of uniform, unambiguous criteria for registration of carious lesions.
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| 10. |
- Mejare, I. A., et al.
(författare)
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Diagnosis of the condition of the dental pulp: a systematic review
- 2012
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 45:7, s. 597-613
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Tidskriftsartikel (refereegranskat)abstract
- Mejare IA, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Petersson A, Portenier I, Sandberg H, Tran ae us S, Bergenholtz G. Diagnosis of the condition of the dental pulp: a systematic review. International Endodontic Journal, 45, 597613, 2012. Abstract The aim of this systematic review was to appraise the diagnostic accuracy of signs/symptoms and tests used to determine the condition of the pulp in teeth affected by deep caries, trauma or other types of injury. Radiographic methods were not included. The electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to June 2011. The complete search strategy is given in an Appendix S1 (available online as Supporting Information). In addition, hand searches were made. Two reviewers independently assessed abstracts and full-text articles. An article was read in full text if at least one of the two reviewers considered an abstract to be potentially relevant. Altogether, 155 articles were read in full text. Of these, 18 studies fulfilled pre-specified inclusion criteria. The quality of included articles was assessed using the QUADAS tool. Based on studies of high or moderate quality, the quality of evidence of each diagnostic method/test was rated in four levels according to GRADE. No study reached high quality; two were of moderate quality. The overall evidence was insufficient to assess the value of toothache or abnormal reaction to heat/cold stimulation for determining the pulp condition. The same applies to methods for establishing pulp status, including electric or thermal pulp testing, or methods for measuring pulpal blood circulation. In general, there are major shortcomings in the design, conduct and reporting of studies in this domain of dental research.
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