| 1. |
- Albertsson, Josefin, et al.
(author)
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The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-A re-evaluation of a long-term clinical study
- 2021
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 37:4, s. 537-545
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Journal article (peer-reviewed)abstract
- Background/Aim: The survival of an avulsed tooth highly depends on the emergency management. The aim of this study was to evaluate the risk of ankylosis for avulsed human teeth stored in saliva preceded by various dry storage conditions prior to replantation. Material and methods: Data include 74 patients (54 male and 20 female) with 89 avulsed and replanted teeth (16 immature teeth, 73 mature teeth). Patient ages ranged from 6 to 36 years (median: 13.0 years). All teeth were stored in saliva before replantation. Treatment and follow-up were performed according to a standardized procedure. Follow-up periods ranged from 7 months to 20 years (mean 5.3 years). The risk of ankylosis over time was estimated by the Aalen-Johansen method in relation to the length of dry storage and the stage of root development. The effect of risk factors (root development and length of dry time) on the risk of ankylosis was analysed by Cox regression analysis. Results: For mature teeth, dry storage for 5 min or less before saliva storage resulted in a 47.4% (95% confidence interval (CI): 32.8-60.7) ankylosis rate. When dry storage was >5 min and <20 min, the risk of ankylosis was 76.8% (95% CI: 45.7-91.5). When dry storage exceeded 20 min prior to saliva storage, ankylosis increased to 89.3% (95% CI: 68.0-96.7). Ankylosis also increased with increasing saliva storage time. Specifically, one additional minute of wet time increased the ankylosis hazard rate (HR) by approximately 1% (CI = [0%, 2%], p = .052). Teeth with mature root development were significantly more frequently affected by ankylosis than teeth with immature root development (HR: 2.4 (95% CI: 1.0-5.5), p = .04). Conclusion: Temporary storage in saliva should be encouraged if an avulsed permanent tooth cannot be immediately replanted or a suitable storage medium such as milk or saline is not immediately available at the place of the accident.
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| 2. |
- Andersson, Lars, et al.
(author)
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Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology.
- 2021
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 37:1, s. 4-16
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Journal article (peer-reviewed)abstract
- The life and professional contributions to dental traumatology of Dr. Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.
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| 3. |
- Andersson, Lars, et al.
(author)
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Reprint of: Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology
- 2021
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In: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 47:6, s. 852-861
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Journal article (other academic/artistic)abstract
- The life and professional contributions to dental traumatology of Dr Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.
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| 4. |
- Gul, Abdulaziz, et al.
(author)
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Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation : A long-term clinical study
- 2024
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 40:2, s. 137-143
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIM: There are few long-term clinical follow-up studies on human teeth replanted immediately or after storage in a suitable storage medium prior to replantation. This study aimed to assess the risk of ankylosis in avulsed human teeth replanted immediately or after storage in physiological media for a short time.MATERIAL: Data from 116 patients with 145 replanted avulsed permanent teeth were selected from a comprehensive dental trauma database in Copenhagen University Hospital. The following teeth were selected: Group 1 comprised 36 teeth replanted immediately (dry time <6 min; wet time <6 min). Group 2 comprised 61 teeth replanted after physiologic storage media (saliva and saline) (dry time <6 min; wet time >5 min; wet time ranged from 7 to 170 min, and mean wet time was 59 min). Group 3 (control) included 48 teeth replanted after dry storage (dry time > 60 min).METHOD: Clinical and radiographic registrations were carried out according to a standardized protocol; follow-up ranged from 7 months to 23 years. Ankylosis was diagnosed by percussion test and radiographs and related to the conditions prior to replantation and stage of root development.RESULTS: The overall risk of ankylosis was 17.2% [95% CI: 4.61; 29.79] for immediately replanted teeth, 55.3% [95% CI: 42.54; 68.00] for teeth stored in physiologic media before replantation, and 85.7% [95% CI: 75.70; 95.73] for teeth stored dry more than 1 h. Mature teeth showed a significantly higher risk of ankylosis than immature teeth.CONCLUSION: This clinical long-term study has verified earlier experimental studies showing that immediate reimplantation has the lowest risk of ankylosis. Physiologic storage media are good alternatives that also reduce the risk of ankylosis compared to dry storage, where ankylosis is more likely although not always seen. Mature teeth are significantly more likely to develop ankylosis.
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| 5. |
- Kenny, Kate P, et al.
(author)
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What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set.
- 2018
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 34:1, s. 4-11
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Journal article (peer-reviewed)abstract
- Background/Aims: There are numerous treatment options following traumatic dental injury (TDI). Systematic reviews of different treatments are challenging owing to the diversity of outcomes reported between clinical studies. This issue could be addressed through the development and implementation of a agreed and standardized collection of outcomes known as a core outcome set (COS). The aim of this study was to develop a COS for TDI in children and adults. The secondary aim was to establish what, how, when and by whom these outcomes should be measured. Materials and Method: The project was registered with Core Outcomes Measures in Effectiveness Trials (COMET). A web‐based survey was developed to capture the opinions of dentists globally as to which outcomes should be recorded. A list of outcomes was entered into a Delphi Survey and scored by an Expert Working Group (EWG). The scoring was repeated, followed by conference calls to discuss, refine and finalize the COS. The EWG split into small groups of subject‐specific experts to determine how, when and by whom each outcome would be measured. Results: The questionnaire was completed by 1476 dentists. The EWG identified 13 core outcomes to be recorded for all TDI's. An additional 10 injury‐specific outcomes were identified. A table has been produced for each outcome detailing what, when, and how each outcome should be recorded. Conclusions: A robust consensus process was used to develop an international COS for TDI in children and adults. This includes both generic and injury‐specific outcomes across all identified domains.
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| 6. |
- Kevci, Mir, et al.
(author)
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The risk of healing complications in primary teeth with root fractures : A retrospective cohort study
- 2023
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 39:5, s. 455-461
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Journal article (peer-reviewed)abstract
- Background/aim: Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition.Materials and methods: A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR).Statistics: The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%.Results: A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3].Conclusions: There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.
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| 7. |
- Lauridsen, Eva, et al.
(author)
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Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage : A re-evaluation of a long-term clinical study
- 2020
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In: Dental Traumatology. - : John Wiley & Sons. - 1600-4469 .- 1600-9657. ; 36:2, s. 108-116
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIMS: Ankylosis and subsequent tooth loss is a serious complication following tooth avulsion and replantation. The aim of the study was to evaluate the risk of ankylosis of human teeth replanted after various periods of dry storage prior to replantation. The material originates from a previously reported clinical study of 400 replanted teeth. METHODS: Initial treatment, clinical and radiological examination and follow-up were conducted according to a standardized protocol. PDL was not removed. Follow-up periods ranged from 0.2 to 20 years (mean 5.1 years). The risk of ankylosis was analysed using the Cox regression model including stage of root development, length of dry time and age > 20 years. RESULTS: The risk of ankylosis significantly increased with increasing length of dry time (hazard ratio: 1.22, P = .002) and was significantly higher for teeth with mature root development than for teeth with immature root development (hazard ratio: 2.1 P < .0001). The estimated risks of ankylosis after 900 days for teeth with immature root development were: dry time < 20 minutes: 33.9% (95% confidence interval (CI): 25.4-42.7), dry time 20-40 minutes: 49.6% (95% CI: 37.5-64.8), dry time 40-60 minutes: 54.4% (95% CI: 37.1-71.3) and dry time > 60 minutes: 60.0% (95% CI: 45.0-75.8). The risks for teeth with mature root development were: dry time < 20 minutes: 59.4% (95% CI: 51.6-66.5), dry time 20-40 minutes: 78.3% (95% CI: 69.5-86.2), dry time 40-60 minutes: 81.9% (95% CI: 67.2-92.4) and dry time > 60 minutes: 86.4% (95% CI: 79.7; 92.9). CONCLUSION: The risk of ankylosis rose with increasing length of dry time. However, some teeth may heal without ankylosis even after 60 minutes of dry time. Immature teeth have a lower risk of developing ankylosis. Replantation should therefore always be considered for avulsed teeth.
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| 8. |
- Lauridsen, Eva, et al.
(author)
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The Dental Trauma Guide : An evidence-based treatment guide
- 2023
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In: Endodontology. - : Wolters Kluwer. - 0970-7212 .- 2543-0831. ; 35:2, s. 79-84
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Research review (peer-reviewed)abstract
- Dental trauma is complex, as it includes a wide range of different injury types with each type requiring specific considerations. It constitutes the fifth-most prevalent disease, and nearly 900 million individuals from 7 to 65 years of age are affected. The Dental Trauma Guide (DTG) project was initiated by Dr. Jens Andreasen in 2008 with the intention that all dentists around the world should be able to get access to the best available evidence regarding diagnosis, treatment, and prognosis for a patient with dental trauma within a few minutes. The DTG has been a global success, and today, 40,000 colleagues visit the DTG website every year. The website displays the treatment guidelines developed by the International Association of Dental Traumatology as well as visualized with film animations to make it easy and appealing for the users. The dentist can connect to the DTG Copenhagen database to compare his/her case with similar cases from the database, providing guidance to emergency treatment. Furthermore, DTG provides prognosis estimates for each individual injury type, as well as prognosis estimates for teeth with combinations of fracture and luxation injuries. Today, the DTG is a nonprofit organization with the aim of improving the level of care for dental trauma patients worldwide. Therefore, the DTG team has decided to offer free access for students at all dental schools in India.
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| 9. |
- Montagnese, Sara, et al.
(author)
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A pilot study of golexanolone, a new GABA-A receptor-modulating steroid antagonist, in patients with covert hepatic encephalopathy
- 2021
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In: Journal of Hepatology. - : Elsevier. - 0168-8278 .- 1600-0641. ; 75:1, s. 98-107
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Journal article (peer-reviewed)abstract
- Background & Aims: Golexanolone is a novel small molecule GABA-A receptor-modulating steroid antagonist under development for the treatment of cognitive and vigilance disorders caused by allosteric over-activation of GABA-A receptors by neurosteroids. It restored spatial learning and motor coordination in animal models of hepatic encephalopathy (HE) and mitigated the effects of intravenous allopregnanolone in healthy adults in a dose-dependent fashion. Herein, we report data on the safety, pharmacokinetics (PK) and efficacy of golexanolone in adult patients with cirrhosis.Methods: Following single/multiple ascending dose studies, adults with Child-Pugh A/B cirrhosis and abnormal continuous reaction time (CRT) on screening were randomized to 3 weeks’ dosing with golexanolone (10, 40 or 80 mg BID) or placebo. CRT, psychometric hepatic encephalopathy score (PHES), animal naming test (ANT), Epworth sleepiness scale (ESS) and electroencephalogram (mean dominant frequency [MDF]; delta+theta/alpha+beta ratio [DT/AB]) were obtained at baseline, 10, and 21 days.Results: Golexanolone exhibited satisfactory safety and PK. Baseline characteristics were similar between the 12 and 33 patients randomized to placebo or golexanolone, respectively. By prespecified analyses, golexanolone was associated with directionally favourable changes vs. placebo in ESS (p = 0.047), MDF (p = 0.142) and DT/AB (p = 0.021). All patients also showed directionally favourable changes in CRT, PHES and ANT, but with no statistical difference between golexanolone and placebo. Post hoc analyses taking into account the variability and improvement in CRT, PHES and ANT observed between screening and baseline suggested an efficacy signal by cognitive measures as well.Conclusion: Golexanolone was well tolerated and associated with improvement in cognitive performance. These results implicate GABA-A receptor-modulating neurosteroids in the pathogenesis of HE and support the therapeutic potential of golexanolone.Lay summary: Many patients with cirrhosis experience subtle but disabling cognitive problems, including sleepiness and poor attention span, that impair their ability to be gainfully employed or carry out activities of daily living. This pilot study tested the hypothesis that these problems with cognition, for which there is no approved treatment, might be improved by an experimental drug, golexanolone, designed to normalize the function of receptors which inhibit brain function. The results of this study suggest that golexanolone is well tolerated and may improve cognition, as reflected by measures of sleepiness, attention span and brain wave activity, paving the way for future larger studies of this promising experimental drug.Clinical trial registration number: EudraCT 2016-003651-30.
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| 10. |
- Moss, Brian D., et al.
(author)
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Climate change and the future of freshwater biodiversity in Europe : a primer for policy-makers
- 2009
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In: Freshwater Reviews. - : Freshwater Biological Association. - 1755-084X. ; 2:2, s. 103-130
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Journal article (peer-reviewed)abstract
- Earth's climate is changing, and by the end of the 21st century in Europe, average temperatures are likely to have risen by at least 2 °C, and more likely 4 °C with associated effects on patterns of precipitation and the frequency of extreme weather events. Attention among policy-makers is divided about how to minimise the change, how to mitigate its effects, how to maintain the natural resources on which societies depend and how to adapt human societies to the changes. Natural systems are still seen, through a long tradition of conservation management that is largely species-based, as amenable to adaptive management, and biodiversity, mostly perceived as the richness of plant and vertebrate communities, often forms a focus for planning. We argue that prediction of particular species changes will be possible only in a minority of cases but that prediction of trends in general structure and operation of four generic freshwater ecosystems (erosive rivers, depositional floodplain rivers, shallow lakes and deep lakes) in three broad zones of Europe (Mediterranean, Central and Arctic-Boreal) is practicable. Maintenance and rehabilitation of ecological structures and operations will inevitably and incidentally embrace restoration of appropriate levels of species biodiversity. Using expert judgement, based on an extensive literature, we have outlined, primarily for lay policy makers, the pristine features of these systems, their states under current human impacts, how these states are likely to alter with a warming of 2 °C to 4 °C and what might be done to mitigate this. We have avoided technical terms in the interests of communication, and although we have included full referencing as in academic papers, we have eliminated degrees of detail that could confuse broad policy-making
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