| 1. |
- Almohandes, Ahmed, et al.
(författare)
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Accuracy of bone-level assessments following reconstructive surgical treatment of experimental peri-implantitis
- 2022
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 33:4, s. 433-440
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Tidskriftsartikel (refereegranskat)abstract
- Aims The purpose of this study was to evaluate the accuracy of bone-level assessments using either cone-beam computed tomography (CBCT), intra-oral peri-apical (PA) radiographs or histology following reconstructive treatment of experimental peri-implantitis. Materials and Methods Six Labrador dogs were used. Experimental peri-implantitis was induced 3 months after implant placement. Surgical treatment of peri-implantitis was performed and peri-implant defects were allocated to one of four treatment categories; no augmentation, bone graft materials with or without a barrier membrane. Six months later, intra-oral PA radiographs and block biopsies from all implants sites were obtained. Marginal bone levels (MBLs) were measured using PA radiographs, CBCT and histology. Results Significant correlations of MBL assessments were observed between the three methods. The measurements in PA radiographs consistently resulted in an overestimation of the bone level of about 0.3-0.4 mm. The agreement between the methods was not influenced by the use of bone substitute materials in the management of the osseous defects. Conclusions Although MBL assessments obtained from PA radiographs showed an overestimation compared to MBL assessments on corresponding CBCT images and histological sections, PA radiographs can be considered a reliable technique for peri-implant bone-level evaluations following reconstructive surgical therapy of experimental peri-implantitis.
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| 2. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances : a randomized controlled trial with 1-year follow-up
- 2021
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:3, s. 245-253
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate and compare the skeletal and dentoalveolar effects of tooth-borne (TB) and tooth-bone-borne (TBB) rapid maxillary expansion (RME).MATERIALS AND METHODS: Fifty-two consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years [standard deviation (SD) 1.3], or the TBB group, mean age 9.5 years (SD 1.2). Cone-beam computed tomography (CBCT) records and plaster models were taken before (T0), directly after (T1), and 1 year after expansion (T2). Dentoalveolar and skeletal measurements were made on the CBCT images. The dental expansion was also measured on the plaster models.RANDOMIZATION: Participants were randomly allocated in blocks of different sizes using the concealed allocation principle in a 1:1 ratio. The randomization list was also stratified by sex to ensure homogeneity between groups.BLINDING: Due to clinical limitations, only the outcomes assessors were blinded to the groups to which the patients were allocated.RESULTS: Skeletal expansion in the midpalatal suture and at the level of the nasal cavity was significantly higher in the TBB group. However, the magnitude of the expansion in the midpalatal suture was around 1 mm [95 per cent confidence interval (CI) 0.5-1.7, P = 0.001] more and perhaps not clinically significant. The magnitude of the expansion at the level of the nasal cavity was almost two times higher in the TBB group (95 per cent CI 0.7-2.6, P = 0.001). The dental expansion, alveolar bending, tipping of the molars, and stability 1 year post-expansion did not show any statistically significant differences between the groups. The actual direct cost of the treatment for the TBB group was approximately €300 higher than TB group.LIMITATIONS: Double blinding was not possible due to the clinical limitations.CONCLUSIONS: In young preadolescents with constricted maxilla and no signs of upper airway obstruction, it seems that conventional TB RME achieves the same clinical results with good stability 1 year post-expansion at lower cost.TRIAL REGISTRATION: The trial was not registered.
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| 3. |
- Bertilsson, Carolina, 1990, et al.
(författare)
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Caries prevalence and other dental pathological conditions in Vikings from Varnhem, Sweden.
- 2023
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Ingår i: PloS one. - 1932-6203. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- In a late Swedish Viking Age population dating from around 10th-12th century AD, the prevalence, distribution and location of dental caries were studied. Tooth wear, other dental pathology and anatomical variations were identified and recorded clinically and radiographically. A total of 3293 teeth were analyzed from 171 individuals with complete and partial dentitions, of which 133 were permanent and 38 deciduous/mixed dentition. The dentitions were studied clinically, using a dental probe under a strong light source, and radiographs were taken for 18 of the individuals to verify and complement the clinical caries registration. Almost half the population, 83 of 171 individuals (49%), had at least one carious lesion. All individuals with deciduous or mixed dentitions were caries-free. The number of teeth affected by caries among adults was 424 (13%) and the surface most susceptible to caries was the root surface. The tooth most commonly affected by caries was the first mandibular molar. Other findings included apical infections, which were detected clinically in 4% of the teeth, and one case of filed front teeth. The findings gave a unique understanding of life and death in this early Christian Viking community and indicated that it was common to suffer from dental caries, tooth loss, infections of dental origin and tooth pain. These Vikings also manipulated their teeth through filing, tooth picking and other occupational behaviors.
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| 4. |
- Björksved, Margitha, 1964-, et al.
(författare)
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Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes-a multicentre, randomized controlled trial
- 2021
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Ingår i: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 43:5, s. 487-497
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare treatment time, patients' perceptions during orthodontic treatment, dental fear and side effects, between open and closed surgical exposures in patients with palatally displaced canines (PDCs). Trial design: Multicentre, randomized controlled trial, with random 1:1 allocation of two parallel groups. Materials and methods: One hundred and twenty patients from three different orthodontic centres were randomized into one of the two intervention arms, open or closed surgical exposure. Both techniques had mucoperiosteal flaps raised and bone removed above the PDCs. In open exposure, tissue was removed above the canine, and glass ionomer - reaching above soft tissue - was built on the crown. The canine was then left to erupt spontaneously, prior to orthodontic alignment. At closed exposure, a chain was bonded to the canine and orthodontic traction was applied under the mucosa until eruption. Orthodontic alignment of the canines was undertaken after eruption into the oral cavity, with fixed appliances in both groups. All participants were treated according to intention to treat (ITT). Blinding: Due to the nature of this trial, only outcome assessors could be blinded to the intervention group. Results: One hundred and seventeen patients completed the trial. All PDCs were successfully aligned. Total treatment time was equal in the two techniques, mean difference -0.1 months (95% CI -3.2 to 2.9, P = 0.93). The closed group experienced more pain and discomfort during the active orthodontic traction. Dental fear, root resorption and periodontal status did not show any clinically significant differences between the groups. Generalizability: Results of this randomized controlled trial (RCT) can be generalized only to a similar population aged 9-16 years, if exclusion criteria are met. Conclusion: The closed exposure group experienced more pain and discomfort mostly during active orthodontic traction. All other studied outcomes were similar between the two exposure groups.
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| 5. |
- Johanen, Astera, et al.
(författare)
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Trabecular bone patterns as a fracture risk predictor: a systematic review
- 2021
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 79:7, s. 482-491
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods.The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach.The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69.Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.
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| 6. |
- Kowar, Jan, 1972, et al.
(författare)
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Long-term performance of implants with moderately rough anodized surface supporting single-tooth restorations: A retrospective analysis with an up to 15-year follow-up
- 2023
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 34:4, s. 367-377
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis retrospective study aimed to evaluate long-term clinical and radiologic performance of anodized surface implants supporting single implant restorations. Materials and MethodsPatients who received at least one anodized surface implant for a single-tooth restoration between 2003 and 2004 in the Branemark clinic (Goteborg, Sweden) were included in the study. The assessed outcomes included implant survival, biological and technical complications, as well as marginal bone levels (MBL) based on radiographs. Baseline data on patient demographics, implant placement, and surgery details were also collected. The cumulative survival rate (CSR) was calculated using the Kaplan-Meier survival analysis. ResultsThe study included 97 patients with 129 implants. Mean patient age at the time of implant placement was 31.7 +/- 16.4 years. All implants were placed in a two-stage approach with delayed loading. The last follow-up visit was on average 13.4 +/- 4.8 years after implant insertion. Three implants failed, yielding the implant-level 15-year CSR of 97.4%. Majority of the implants had no biological (70.5%) nor technical (81.4%) complications. The mean MBL was -1.0 +/- 0.7 mm (n = 101) at prosthetic placement and -1.8 +/- 1.0 mm (n = 80) at the last follow-up, while the mean marginal bone loss (MBL) from prosthetic placement to last follow-up was 0.6 +/- 1.1 mm (n = 65). ConclusionsModerately rough anodized implants have shown favorable long-term outcomessingle-tooth indication, with high survival and a low rate of technical complications. Furthermore, long-term studies are needed to present longitudinal data on peri-implantitis.
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| 7. |
- Lennholm, Camilla, et al.
(författare)
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Assessment of thin bony structures using cone-beam computed tomography.
- 2023
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Ingår i: The Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 1945-7103 .- 0003-3219.
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the validity and reliability of marginal bone level measurements on cone-beam computed tomography (CBCT) images of thin bony structures using various reconstruction techniques, two image resolutions, and two viewing modes.CBCT and histologic measurements of the buccal and lingual aspects of 16 anterior mandibular teeth from 6 human specimens were compared. Multiplanar (MPR) and three-dimensional (3D) reconstructions, standard and high resolutions, and gray scale and inverted gray scale viewing modes were assessed.Validity of radiologic and histologic comparisons were highest using the standard protocol, MPR, and the inverted gray scale viewing mode (mean difference = 0.02 mm) and lowest using a high-resolution protocol and 3D-rendered images (mean difference = 1.10 mm). Mean differences were significant (P < .05) at the lingual surfaces for both reconstructions, viewing modes (MPR windows), and resolutions.Varying the reconstruction technique and viewing mode does not improve the observer's ability to visualize thin bony structures in the anterior mandibular region. The use of 3D-reconstructed images should be avoided when thin cortical borders are suspected. The small difference when using a high-resolution protocol is unjustified due to the higher radiation dose required. Previous studies have focused on technical parameters; the present study explores the next link in the imaging chain.
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| 8. |
- Lindfors, Ninita, et al.
(författare)
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Is cone-beam computed tomography (CBCT) an alternative to plain radiography in assessments of dental disease? A study of method agreement in a medically compromised patient population
- 2024
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Ingår i: CLINICAL ORAL INVESTIGATIONS. - : Springer. - 1432-6981 .- 1436-3771. ; 28:2
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesPoor oral health and dental infections can jeopardize medical treatment and be life-threatening. Due to this, patients with head and neck malignancies, generalized tumor spread, organ transplant, or severe infection are referred for a clinical oral and radiographic examination. The aim of this study was to compare the diagnostic agreement of three radiographic modalities: intraoral radiographs (IO), panoramic radiographs (PX), and cone beam computed tomography (CBCT) for diagnosis of dental diseases.Materials and methodsThree hundred patients were examined with IO, PX, and CBCT. Periapical lesions, marginal bone level, and caries lesions were diagnosed separately by four oral radiologists. All observers also assessed six teeth in 30 randomly selected patients at two different occasions. Kappa values and percent agreement were calculated.ResultsThe highest Kappa value and percent agreement were for diagnosing periapical lesions (0.76, 97.7%), and for the assessment of marginal bone level, it varied between 0.58 and 0.60 (87.8-89.3%). In CBCT, only 44.4% of all teeth were assessable for caries (Kappa 0.68, 93.4%). The intra-observer agreement, for all modalities and diagnoses, showed Kappa values between 0.5 and 0.93 and inter-observer agreement varied from 0.51 to 0.87.ConclusionsCBCT was an alternative to IO in diagnosing periapical lesions. Both modalities found the same healthy teeth in 93.8%. All modalities were performed equally regarding marginal bone level. In caries diagnosis, artifacts were the major cause of fallout for CBCT.Clinical relevanceIntraoral radiography is the first-hand choice for diagnosing dental disease. For some rare cases where intraoral imaging is not possible, a dedicated panoramic image and/or CBCT examination is an alternative.
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| 9. |
- Sebring, Dan, 1986, et al.
(författare)
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A1Meighted Composite of Endodontic Inflammatory Disease is Linked to a First Myocardial Infarction
- 2023
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Ingår i: Oral Health & Preventive Dentistry. - 1602-1622 .- 1757-9996. ; 21:1, s. 375-382
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore a weighted composite of endodontic inflammatory disease (ED) as a risk factor for suffering a first myocardial infarction (MI).Materials and Methods: Seven tooth-specific conditions related to EID were assessed radiographically in 797 patients suffering a first MI and 796 controls. A weighted composite of EID was calculated as the sum of all teeth, excluding third molars. Using maximum likelihood estimation, each condition was assigned a specific weight. Wth multivariable condi-tional regression, EIDvariables, periodontal disease, and missing teeth were assessed as predictors of a first MLResults: Periodontal disease (OR 1.38; 95% CI 1.13-1.69, p =0.0016) and missing teeth (OR 1.03; 95% CI 1.002-1.05, p =0.034) were related to the risk of a first MI, while none of the ED-related conditions individually were. However, when assessed as an aggregate, a weighted composite of ED (OR 1.97; 95% CI 1.23-3.17, p =0.0050) and periodontal disease (OR 1.34; 95% CI 1.09-1.63, p =0.0046) was associated with the risk of ML Missing teeth did not remain a statistically sig-nificant predictor of MI in the final model.Condusions: A weighted composite of ED was associated with the risk of MI and strengthens the evidence for a direst connection between oral inflammatory diseases and cardiovascular disorders.
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| 10. |
- Sebring, Dan, 1986, et al.
(författare)
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Calibration improves observer reliability in detecting periapical pathology on panoramic radiographs
- 2021
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 79:7, s. 554-561
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine whether calibration improves observer reliability when assessing DMFT-score, root-filled teeth and periapical lesions on panoramic radiographs. Material and methods A sample of 100 panoramic radiographs was selected from a cohort of myocardial infarction patients (n = 797) and matched controls (n = 796). The following variables were assessed: DMFT-score, remaining teeth, root-filled teeth and periapical lesions. Two specialists, an endodontist and a radiologist, served as reference examiners and undertook two separate assessments. Disagreement cases were jointly assessed and the final results were used as the reference standard. Three observers undertook three separate assessments, the first without prior training, the second after calibration against the reference standard and the third with the sample concealed in the complete material. Statistical analysis was made with Wilcoxon Signed rank test and Sign test. Agreement was calculated as Intraclass Correlation Coefficient (ICC) (95% CI) and Weighted Kappa (kappa) (95% CI). Results Periapical lesions disclosed high inter-observer variability for the reference examiners and diverged significantly between the observers and the reference standard. For the reference examiners, inter-observer agreement was kappa = 0.53. The observers, in their first assessments had kappa values ranging from 0.22 to 0.60 in relation to the reference standard. Following calibration, the kappa values increased, ranging from 0.59 to 0.80. For the third assessment, the kappa values ranged from 0.54 to 0.75. DMFT-score, remaining teeth and root-filled teeth disclosed high reliability throughout all assessments (ICC = 0.88-0.98 and kappa = 0.98-0.99). Conclusions DMFT-score, remaining teeth and root-filled teeth can be reliably assessed on panoramic radiographs. Calibration against a reference standard improves observer reliability in the detection of periapical lesions.
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| 11. |
- Sebring, Dan, 1986, et al.
(författare)
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Endodontic inflammatory disease: A risk indicator for a first myocardial infarction
- 2022
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 55:1, s. 6-17
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Tidskriftsartikel (refereegranskat)abstract
- Aim To study the association between endodontic inflammatory disease and a first myocardial infarction (MI). Methodology The study comprised 805 patients with recent experience of a first MI, each gender, age and geographically matched with a control. Panoramic radiographs were available for 797 patients and 796 controls. Endodontic inflammatory disease was assessed radiographically. The sum of decayed, missing and filled teeth (DMFT) was calculated, and the number of root filled teeth and teeth with periapical lesions were recorded. The associated risk of a first MI was expressed as odds ratios (OR) with 95% confidence intervals (CI), unadjusted and adjusted for confounders (family history of cardiovascular disease, smoking habits, marital status, education and diabetes). Results Patients who had suffered a first MI had higher DMFT (mean 22.5 vs. 21.9, p = .013) and more missing teeth (mean 7.5 vs. 6.3; p < .0001) than the healthy controls. The number of missing teeth was associated with an increased risk of a first MI (adjusted OR 1.04; CI 1.02-1.06). Conversely, decay-free, filled teeth were associated with decreased risk (adjusted OR 0.98; CI 0.96-1.00). Analysis based on age disclosed the following variables to be associated with an increased risk of a first MI: number of decayed teeth (adjusted OR 1.18; CI 1.02-1.37, in patients <60 years), any primary periapical lesion (adjusted OR 1.57; CI 1.08-2.29, in patients <65 years) and the proportion of root filled teeth (adjusted OR 1.18; CI 1.03-1.36, in patients >= 65 years). Conclusions More missing teeth was independently associated with an increased risk of a first MI. In addition, endodontic inflammatory disease may contribute as an independent risk factor to cardiovascular disease since untreated caries, periapical lesions and root fillings, depending on age, were significantly associated with a first MI.
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| 12. |
- Sebring, Dan, 1986, et al.
(författare)
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Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study
- 2024
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Ingår i: Journal of Endodontics. - 0099-2399.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Prospective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study. Methods: Eight-hundred five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 and 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately 8 years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and nonfatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the log-rank test and Cox proportional hazards regression adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis. Results: In total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root-filled tooth increased the risk of a future event. After adjustment, the number of remaining teeth and non–root-filled teeth decreased the risk of future events, whereas a higher Decayed, Missing and Filled Teeth score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. A higher Decayed, Missing and Filled Teeth score and decayed teeth increased the risk of all-cause mortality. Conclusions: Tooth loss is a strong indicator of an increased risk for future cardiovascular events. Root-filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.
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| 13. |
- Sebring, Dan, 1986, et al.
(författare)
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Primary apical periodontitis correlates to elevated levels of interleukin-8 in a Swedish population: A report from the PAROKRANK study
- 2024
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Ingår i: International Endodontic Journal. - 0143-2885 .- 1365-2591. ; 57:1, s. 12-22
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore associations between root filled teeth, primary and secondary apical periodontitis, and levels of inflammatory markers in blood from patients with a first myocardial infarction and matched controls.MethodologyBetween May 2010 and February 2014, 805 patients with a first myocardial infarction and 805 controls, matched for sex, age, and postal code area, were recruited to the multicentre case-control study PAROKRANK (periodontitis and its relation to coronary artery disease). All participants underwent a physical and oral examination, as well as blood sampling. Using panoramic radiography, root filled teeth, primary apical periodontitis, and secondary apical periodontitis were assessed by three independent observers. Blood samples were analysed with enzyme-linked immunosorbent assay method for the following inflammatory markers: interleukin-1 beta (IL-1 beta), IL-2, IL-6, IL-8, IL-12p70, tumour necrosis factor-alpha, and high-sensitivity C-reactive protein (hsCRP). Additionally, white blood cell count and plasma-fibrinogen were analysed. Associations between endodontic variables and the levels of inflammatory markers were statistically analysed with Mann-Whitney U-test and Spearman correlation, adjusted for confounding effects of baseline factors (sex, age, myocardial infarction, current smoking, diabetes, family history of cardiovascular disease, education, marital status, and periodontal disease).ResultsMean age of the cohort was 62 years, and 81% were males. Root fillings were present in 8.4% of the 39 978 examined teeth and were associated with higher levels of hsCRP, fibrinogen, and leukocyte count, but lower levels of IL-2 and IL-12p70. After adjusting for confounders, root filled teeth remained associated with higher levels of fibrinogen, but lower levels of IL-1 beta, IL-2, IL-6, and IL-12p70. Primary apical periodontitis was found in 1.2% of non-root filled teeth and associated with higher levels of IL-8 (correlation 0.06, p = .025). Secondary apical periodontitis was found in 29.6% of root filled teeth but did not relate to the levels of any of the inflammatory markers.ConclusionsThis study supports the notion that inflammation at the periapex is more than a local process and that systemic influences cannot be disregarded. Whether the observed alterations in plasma levels of inflammatory markers have any dismal effects on systemic health is presently unknown but, considering the present results, in demand of further investigation.
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