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  • 1.
    Bergendal, B
    et al.
    National Oral Disability Centre, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Norderyd, J
    National Oral Disability Centre, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Bågesund, M
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Holst, A
    Department of Paediatric Dentistry, Kalmar.
    Signs and symptoms from ectodermal organs in young Swedish individuals with oligodontia2006In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 16, no 5, p. 320-326Article in journal (Refereed)
    Abstract [en]

    Objectives. The aim was to assess signs and symptoms from other ectodermal organs in addition to teeth in young individuals with oligodontia and to establish the prevalence of oligodontia Sample and methods. Children born 1981-94 reported by dental teams in the Public Dental Service to have oligodontia were asked to participate in a clinical study. The examinations comprised a structured interview on symptoms from ectodermal organs, and testing of salivary secretion Results. One hundred and sixty-two individuals met the inclusion criteria, and 123 individuals (75.9%) participated in the clinical study. Half of the individuals had one to four signs or symptoms from ectodermal organs beside oligodontia. The most common sign was low salivary secretion. Twelve individuals (9.6%) with isolated oligodontia reported impaired function of the sweat glands, hair, or nails. The prevalence of oligodontia was 0.090% Conclusions. An early identification of individuals with oligodontia can be made in a majority of cases by checking that all permanent incisors have erupted at the age of 8 years. The validity in asking individuals about normal and abnormal function of ectodermal organs was found to be low. This indicates that there is a strong need to establish routine clinical criteria for dysplasia of ectodermal organs

  • 2.
    Bågesund, Mats
    et al.
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Richter, Sven
    Huddinge University Hospital.
    Ringden, Olle
    Huddinge University Hospital.
    Dahllöf, Göran
    Karolinska Institute.
    Longitudinal scintigraphic study of parotid and submandibular gland function after total body irradiation in children and adolescents2007In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 17, no 1, p. 34-40Article in journal (Refereed)
    Abstract [en]

    Objective. Total body irradiation (TBI) and cyclophosphamide (CY) during allogeneic stem cell transplantation (ASCT) cause salivary gland dysfunction in children. The aim of this investigation was to study the scintigraphic functional changes over time of the parotid and submandibular glands in children and young adults one year after treatment with CY and TBI at ASCT Methods. Salivary gland scintigraphy (SGS) was performed before ASCT, and 3-6 months and 12 months after ASCT. The three male patients who fulfilled the scintigraphic study had a mean age (+/- SD) of 17.3 +/- 9.8 years at ASCT Results. The parotid secretion capacity (SPar) was 83.5 +/- 3.2% before ASCT and 48.5 +/- 25.8% during the next 3-6 months (P less than 0.05). The SPar did not increase (48.1 +/- 12.4%) during the rest of the first year after ASCT. The submandibular emptying capacity (SSub) was 91.3 +/- 12.9% before ASCT and 35.4 +/- 2.3% after 3-6 months (P less than 0.05). The SSub was 87.9 +/- 17.9% one year after ASCT Conclusions. The parotid glands were more sensitive to irradiation since they did not recover lost capacity to secrete saliva, while the submandibular glands recovered the secretion capacity at the one year follow-up

  • 3.
    Bågesund, Mats
    et al.
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Tabrizi, Parisa
    Östergötlands Läns Landsting, Public Dental Service.
    Lidocaine 20% patch vs lidocaine 5% gel for topical anaesthesia of oral mucosa2008In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 18, no 6, p. 452-460Article in journal (Refereed)
    Abstract [en]

    Background. Topical anaesthetics are important to provide pain control at dental injection Aim. The aim was to evaluate the effectiveness of the intraoral topical anaesthetics lidocaine 20% patch (DentiPatch (TM)) and lidocaine 5% gel Design. The randomized unblinded cross-over study included 31 patients (ten boys, 21 girls) aged 13.5 +/- 2.5 years. Application of lidocaine patch or gel was randomly used at first and second visit in the upper premolar region. Heart rate was measured before and at each needle insertion after 2.5, 5, and 15 min and at injection after 15 min Discomfort and pain were expressed in visual analogue scales (VAS) Paired t-test and Mann-Whitney U-test were used for statistic analyses Results. Heart rate at buccal injection decreased more when the patch was used (P = 0.0149). Heart rate was lower at the second visit (P = 0.0287). Patients expressed less discomfort when the patch was used on both buccal (P = 0.0150) and palatal (P = 0.0391) site. Boys had lower heart rate and VAS pain scale ratings than girls Conclusions. Good pain control can reduce the patients anxiety level - expressed in heart rate - at the second appointment. The patch and gel seem to provide similar pain reduction at needle stick and injection of local anaesthetics

  • 4.
    Carlsson, Gunnar E.
    et al.
    University of Gothenburg, Sweden.
    Ekbäck, Gunnar
    Örebro University, Sweden; Örebro County Council, Sweden.
    Johansson, Anders
    University of Bergen, Norway.
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Health Care.
    Unell, Lennart
    Örebro University, Sweden; Örebro County Council, Sweden.
    Is there a trend of decreasing prevalence of TMD-related symptoms with ageing among the elderly?2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 714-720Article in journal (Refereed)
    Abstract [en]

    Objective. Older adults have not been studied as much as younger ones regarding prevalence of TMD-related symptoms. The aim was to assess the prevalence of TMD-related symptoms in two population samples, 70 and 80 years old. Materials and methods. Identical questionnaires were in 2012 sent to all subjects born in 1932 and 1942 living in two Swedish counties. The response rate was 70.1%, resulting in samples of 5697 70-and 2922 80-year-old subjects. The questionnaire comprised 53 questions. Answers to questions on problems regarding TMD-related symptoms and awareness of bruxism were analysed. Results. Twelve per cent of the women and 7% of the men in the 70-year-old group reported some, rather great or severe problems regarding TMD pain. In the 80-year-olds the prevalence was 8% and 7%, respectively. Subjects who had problems with TMJ sounds reported difficulty to open the jaw wide 6-times and TMJ pain 10-13-times more frequently than subjects without such problems. Changes of taste and awareness of bruxism were the only variables significantly associated with TMD symptoms in both age groups. Number of teeth was not significantly associated with any of the TMD-related symptoms. Conclusions. Most of the elderly subjects had no severe problems with TMD-related symptoms, but 12% of the 70-year-old women reported some, rather great or severe problems. The marked gender difference at age 70 had disappeared in the 80-year-old group. The prevalence was lower among the 80-compared with the 70-year-old subjects of both sexes. The results support the comorbidity between TMD-related symptoms and general health problems.

  • 5.
    Ekback, Gunnar
    et al.
    Orebro County Council.
    Naslund, Ingmar
    Orebro University Hospital.
    Montgomery, Scott M
    Orebro University Hospital.
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Self-perceived oral health and obesity among 65 years old in two Swedish counties2010In: SWEDISH DENTAL JOURNAL, ISSN 0347-9994, Vol. 34, no 4, p. 207-216Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the association between oral health and obesity. The study was conducted in the spring of 2007 as a postal survey of all inhabitants born in 1942 and living in the two Swedish counties of Orebro and Ostergotland. This questionnaire survey has been conducted every five years since 1992 but has been updated continually with additional questions and for the sweep used here, height and weight data were collected. A total of 8,313 individuals received the questionnaire and 6,078 of those responded (73,1%). The outcome variable oral health was measured using one global question and four detailed questions representing different aspects of oral health. The independent variable Body Mass Index (BMI) was calculated using self-reported height and weight. A difference in oral health between various BMI groups was found. The difference was both statistically significant and of clinical importance, particularly among the group with severe obesity who reported poorer self-perceived chewing capacity, lower satisfaction with dental appearance, increased mouth dryness and fewer teeth and lower overall satisfaction with oral health. In view of the increased risk of poor oral health demonstrated in this study for those with severe obesity, it may be of value to increase cooperation between dental care and primary health care for these patients.

  • 6.
    Ekback, Gunnar
    et al.
    Orebro County Council.
    Nodrehaug-Astrom, Anne
    University Bergen.
    Klock, Kristin
    University Bergen.
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Unell, Lennart
    Malmö University.
    Satisfaction with teeth and life-course predictors: a prospective study of a Swedish 1942 birth cohort2010In: EUROPEAN JOURNAL OF ORAL SCIENCES, ISSN 0909-8836, Vol. 118, no 1, p. 66-74Article in journal (Refereed)
    Abstract [en]

    This study aimed to assess the stability or change in satisfaction with teeth among Swedish adults between the ages of 50 and 65 yr, and to identify the impact of socio-demographics and of clinical and subjective oral health indicators on participants satisfaction with teeth during that period. Self-administered standardized questionnaires were used as part of a longitudinal study. In 1992, 1997, 2002, and 2007 all residents (born in 1942) of two Swedish counties were invited to participate in the study. A total of 63% women and 66% men reported being satisfied with their teeth between 50 and 65 yr of age. The corresponding figures, with respect to dissatisfaction, were 7% and 6% respectively. Generalized estimated equation models revealed a decline in the odds of being satisfied with advancing age, which was particularly important in subjects with lower education, tooth loss, and smokers. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age. Promotion of a healthy adult lifestyle and improved access to quality oral healthcare might increase the likelihood of people being satisfied with their teeth throughout the third age-period in both genders.

  • 7.
    Ekback, Gunnar
    et al.
    Regional Örebro County, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Health Care. Malmö University, Sweden.
    Stahlnacke, Katri
    Regional Örebro County, Sweden.
    Satisfaction with dental care and life-course predictors: A 20-year prospective study of a Swedish 1942 birth cohort?2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 3, p. 194-201Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to assess the impact of care experience, health factors and socioeconomic factors on satisfaction with dental care across time and to assess the stability or change in levels of self-reported satisfaction with dental care in individuals as they progress from middle age to early old age.Materials and methods: The present work is based on five separate data collections from a cohort study with 3585 individuals responding in all years of the survey. Data collection was conducted in 1992 when the subjects were 50 years of age and again 5, 10, 15 and 20 years later. Absolute stability in satisfaction with dental care was assessed by calculating the proportion of individuals who maintained their position in the same category from one survey period to another. Changes across time were tested using Cochrans Q test. Satisfaction with dental care across the 20-year survey period was modeled using the generalized estimating equation (GEE).Results and conclusion: The result showed that 85% of women and 83% of men remained satisfied with dental care. Binomial GEE revealed no statistical significant change in satisfaction with dental care between 1992-2012. In sum, this study has shown that this age group, born in 1942, was stably satisfied with dental care between age 50 and age 70, despite all changes during this time period. Females are more satisfied than men and the most important factors are the experience of attention during the last visit, satisfaction with dental appearance and good chewing capability.

  • 8.
    Fagrell, Tobias G
    et al.
    Sahlgrenska University Hospital.
    Dietz, Wolfram
    University of Jena.
    Jälevik, Birgitta
    Östergötlands Läns Landsting, Public Dental Health Care, Centre for Orthodontics and Paediatric Dentistry.
    Noren, Jorgen G
    University of Gothenburg.
    Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars2010In: ACTA ODONTOLOGICA SCANDINAVICA, ISSN 0001-6357, Vol. 68, no 4, p. 215-222Article in journal (Refereed)
    Abstract [en]

    Objective. The microstructure of hypomineralized enamel in permanent teeth has been described in several studies as less distinct prism sheaths and disorganized enamel with lack of organization of the enamel crystals. The mechanical properties, hardness and modulus of elasticity of the hypomineralized enamel have lower values compared with normal. The aim of this study was to examine normal and hypomineralized enamel using scanning electron microscopy (SEM), hardness measurements and X-ray microanalysis (XRMA). Material and methods. Four extracted hypomineralized permanent first molars, sectioned and cut in half, were analyzed with SEM, XRMA and hardness measurements. Results. An inverse relation was found between the micro hardness and the Ca:C ratio in hypomineralized and normal enamel. The acid-etched hypomineralized enamel appeared on SEM to be covered with a structureless layer and the prisms appeared disorganized, with thick prism sheaths and loosely packed crystallites. Furthermore, bacteria were found deep in porous hypomineralized enamel close to the enamel-dentin junction. Conclusions. Teeth diagnosed with molar incisor hypomineralization have significantly lower hardness values in the hypomineralized enamel compared with normal enamel. The hardness values vary according to the morphological and chemical properties.

  • 9.
    Gulcan, Ferda
    et al.
    University of Bergen, Norway .
    Nasir, Elwalid
    University of Bergen, Norway .
    Ekbäck, Gunnar
    Örebro County Council and University of Örebro, Sweden .
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Health Care.
    Nordrehaug Åstrøm, Anne
    University of Bergen, Norway .
    Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden2014In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 14, no 59Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Oral health-related quality of life, OHRQoL, among elderly is an important concern for the health and welfare policy in Norway and Sweden. The aim of the study was to assess reproducibility, longitudinal validity and responsiveness of the OIDP frequency score. Whether the temporal relationship between tooth loss and OIDP varied by country of residence was also investigated.

    METHODS:

    In 2007 and 2012, all inhabitants born in 1942 in three and two counties of Norway and Sweden were invited to participate in a self-administered questionnaire survey. In Norway the response rates were 58.0% (4211/7248) and 54.5% (3733/6841) in 2007 and 2012. Corresponding figures in Sweden were 73.1% (6078/8313) and 72.2% (5697/7889), respectively.

    RESULTS:

    Reproducibility of the OIDP in terms of intra-class correlation coefficient (ICC) was 0.73 in Norway and 0.77 in Sweden. The mean change scores for OIDP were predominantly negative among those who worsened, zero in those who did not change and positive in participants who improved change scores of the reference variables; self-reported oral health and tooth loss. General Linear Models (GLM) repeated measures revealed significant interactions between OIDP and change scores of the reference variables (p < 0.05). Stratified analysis revealed that the mean OIDP frequency score worsened in participants who became dissatisfied- and improved in participants who became satisfied with oral health. Compared to participants who maintained all teeth, those who lost teeth were more likely to experience improvement and worsening of OIDP across both countries. The two-way interaction between country and tooth loss was not statistically significant.

    CONCLUSIONS:

    Changes in OIDP at the individual level were more pronounced than the percentage distribution of OIDP at each point in time would suggest. The OIDP frequency score showed promising evaluative properties in terms of acceptable longitudinal validity, responsiveness and reproducibility among older people in Norway and Sweden. This suggests that the OIDP instrument is able to detect change in the oral health status that occurred over the 5 year period investigated. Norwegian elderly were more likely to report worsening in OIDP than their Swedish counterparts. Disease prevention should be at focus when formulating the health policy for older people.

  • 10.
    Gustafsson, Annika
    et al.
    Östergötlands Läns Landsting, Public Dental Service.
    Arnrup, Kristina
    Public Dental Service, Örebro.
    Broberg, Anders G
    Göteborg University.
    Bodin, Lennart
    Örebro University.
    Berggren, Ulf
    Göteborg University.
    Psychosocial concomitants to dental fear and behaviour management problems2007In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 17, no 6, p. 449-459Article in journal (Refereed)
    Abstract [en]

    Background: Children with dental behavioural management problems (DBMP) form a heterogeneous group, where personal characteristics play significant roles. Attention to everyday life and family situation as additional background facets may help to better understand and treat these patients Aim: This study describes everyday life and family situation in child/adolescent patients referred because of DBMP, as compared to patients in ordinary dental care Design: A study group of 230 referred patients (8-19 years old; 118 girls) was compared to a reference group of 248 same-aged patients (142 girls) without DBMP. Patients and parents were interviewed according to a semistructured protocol Results: Patients referred because of DBMP more often lived in low socioeconomic status families, had parents not living together, fewer leisure-time activities, and were assessed as doing worse in social interactions compared to the reference group. Half of the study group had personal professional support, and some had experienced interventions by the social authorities. Whether these findings apply also to children/adolescents with DBMP who are not referred to specialist care remains to study Conclusions: Many children and adolescents referred because of DBMP have a burdensome life and family situation. This should be paid attention to in research and in clinical care

  • 11.
    Göranson, Emma
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care.
    Lundström, Fredrik
    Östergötlands Läns Landsting, Public Dental Health Care.
    Bågesund, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    Outcome of orthodontic care and residual treatment need in Swedish 19-year-olds2014In: Swedish Dental Journal, ISSN 0347-9994, Vol. 38, no 3, p. 133-142Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to assess the outcome of orthodontic care in Linkoping, Sweden. The dental records of 207 (107 M,100 F) 19-year-olds registered at one public dental health clinic were studied. A clinical examination was performed where malocclusions were registered, where after residual orthodontic treatment need was measured using the Index of Complexity, Outcome and Need (ICON). The 19-year-olds also filled in a questionnaire regarding residual subjective orthodontic treatment demand. Differences between genders were analysed. One hundred and ten (47 M, 63 F) individuals (53.1%) had partaken in orthodontic consultations. Orthodontic appliance treatment had been received by 86 (38 M, 48 F) individuals (41.6%). A residual orthodontic treatment need was registered in 28 (22 M, 6 F) individuals (13.5%). Residual subjective orthodontic treatment demand was expressed by 9 (3 M, 6 F) individuals (4.3%). Eight (2 M, 6 F) of those had no residual treatment need. A higher (p=0.006) rate of females (63.0%) than males (44.0%) had participated in orthodontic consultations. The proportion of males (35.5%) who had experienced orthodontic treatment was not significantly lower (p=0.069) than among the females (48.0%). However, a lower (p=0.009) proportion of treated males (55.3%; n=21 out of 38) than of treated females (81.3%; n=39 out of 48) had received their treatment by orthodontic specialists. At 19 years of age, the proportion of males with residual treatment need (20.6%) was higher (p=0.002) than among the females (6.0%). Every patient with orthodontic treatment need and -demand at 19 years of age had previously been offered orthodontic treatment. The conclusion was drawn that the orthodontic care scheme had successfully diagnosed and treated orthodontic problems in the population. However, notable differences between genders regarding treatment modalities and the amount of residual treatment need at age 19 were found.

  • 12.
    Ingemansson Hultquist, Ann
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care. Folktandvården, Västervik, Sweden.
    Lingström, Peter
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Bågesund, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    Risk factors for early colonization of mutans streptococci - a multiple logistic regression analysis in Swedish 1-year-olds2014In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 14, no 147Article in journal (Refereed)
    Abstract [en]

    Background: Mutans streptococci (MS) are closely related to the development of dental caries and are usually established in the oral cavity during early childhood. The aim of the study was to identify factors associated with the presence of MS in Swedish 1-year-olds. Methods: Parents completed a questionnaire on different caries-associated factors and an oral bacterial sample was collected from 1,050 (526 boys, 524 girls) 1-year-olds. Multiple logistic regression analyses were performed to identify risk factors for colonization with MS. Results: MS were found in 27% of the 1-year-olds with teeth. High or very high MS scores (2-3) were found in 72 (7%) of the children. MS score was correlated to the number of erupted teeth (p less than 0.001). No difference due to gender was found. Multiple logistic regression analysis showed that presence of bacteria was associated with: caries in a sibling, other beverages than water between meals, and more than 8 erupted teeth. High or very high MS scores (2-3) were associated with other beverages than water between meals, and more than 8 erupted teeth. Conclusions: Number of teeth present, diet and family aspects were factors associated with presence of MS in 1-year-olds. To develop high or very high MS scores, the number of erupted teeth and dietary habits are important.

  • 13.
    Johansson, Kristina
    et al.
    Östersund Hospital, Sweden .
    Lundström, Fredrik
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Orthodontic treatment efficiency with self-ligating and conventional edgewise twin brackets: A prospective randomized clinical trial2012In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 82, no 5, p. 929-934Article in journal (Refereed)
    Abstract [en]

    Objective: To conduct a prospective and randomized study of the efficiency of orthodontic treatment with self-ligating edgewise brackets (SL; Time2 brand, American Orthodontics) and conventional edgewise twin brackets (CE; Gemini brand, 3M). less thanbrgreater than less thanbrgreater thanMaterials and Methods: One hundred consecutive patients were randomized to treatment with either SL or CE brackets. The participants were treated by one of three specialists in orthodontics and with continuous instructions alternately by five orthodontic assistants according to our normal treatment routine (ie, modified 0.022 MBT preadjusted edgewise technique). The treatments were evaluated in terms of overall treatment time, number of visits, and treatment outcome using the Index of Complexity, Outcome and Need (ICON). The number of emergency appointments, number of archwires, overjet, relative space, and extractions at treatment start were noted. less thanbrgreater than less thanbrgreater thanResults: After dropouts, the analyzed material consisted of 44 patients treated with SL (mean age 15.3 years, mean ICON 60.7, 70.4 /0 female) and 46 patients treated with CE (mean age 15.0 years, mean ICON 56.5, 71.7/0 female). There were no statistically significant differences between the SL and CE groups in terms of mean treatment time in months (20.4 vs 18.2), mean number of visits (15.5 vs 14.1), mean ICON scores after treatment (13.2 vs 11.9), or mean ICON improvement grade (7.9 vs 9.1). less thanbrgreater than less thanbrgreater thanConclusion: Orthodontic treatment with SL brackets does not reduce treatment time or number of appointments and does not affect posttreatment ICON scores or ICON improvement grade compared with CE brackets. (Angle Orthod. 2012;82:929-934.)

  • 14.
    Jälevik, Birgitta
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care. University of Gothenburg, Sweden .
    Klingberg, Gunilla
    University of Gothenburg, Sweden; Ctr Rare Disorders, Gothenburg, Sweden; Malmö University, Sweden .
    Pain sensation and injection techniques in maxillary dento-alveolar surgery procedures in children - a comparison between conventional and computerized injection techniques (The Wand (R))2014In: Swedish Dental Journal, ISSN 0347-9994, Vol. 38, no 2, p. 67-75Article in journal (Refereed)
    Abstract [en]

    Local anesthesia, especially palatal injection, is often associated with fear and anxiety. The aim was to compare the sensation of pain when using palatal block technique with computerized injection technique (CIT), to conventional infiltration technique with traditional syringe in surgical procedures involving the palate. Patients referred for bilateral minor maxillary surgical treatments were randomized for traditional infiltration anesthesia on one side and palatal block anesthesia with CIT on the other side. AMSA and P-ASA approaches were used with CIT. The sensation of pain was scored by the VAS scale. Twenty-eight patients were included in the study, whereof 17 (61%) were girls. The median age was 14.8 yrs. (12.6 - 17.8). Bilateral exposure of palatal impacted canines was the most common treatment. The injection pain was significantly lower, (p = 0.009), when using the CIT injection compared to conventional injection. However, with time-consuming surgery, additional CIT analgesic solution had to be injected in the buccal gingiva when suturing, in one fourth of the cases. Patients sedated with nitrous oxide seemed to benefit less from CIT. Computerized injection techniques, including P-ASA and AMSA approaches, reduces the sensation of pain when carrying out less time-consuming palatal dental surgery, especially in non-sedated teenagers.

  • 15.
    Jälevik, Birgitta
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care.
    Klingberg, Gunilla
    National Orofacial Resource Centre for Rare Disorders, Göteborg, Sweden; Department of Pediatric Dentistry, the Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
    Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls - a longitudinal study2012In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 22, no 2, p. 85-91Article in journal (Refereed)
    Abstract [en]

    Background. In a previous study, 9-year-old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). less thanbrgreater than less thanbrgreater thanAim. To assess the long-term outcomes of dental treatments, dental anxiety, and patients satisfaction in adolescents with MIH. less thanbrgreater than less thanbrgreater thanDesign. Sixty-seven patients, identical with those in the baseline study, were studied at age 18-years. The participants answered the Childrens Fear Survey Schedule-Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were com-piled from the dental records concerning dental health, number of restorative treatments and BMP. less thanbrgreater than less thanbrgreater thanResults. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. less thanbrgreater than less thanbrgreater thanConclusions. Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18-years. However, their dental fear was now at the same level as the controls.

  • 16.
    Järemo, Petter
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Starkhammar, C
    Östergötlands Läns Landsting, Public Dental Service.
    Lundström, Å
    Östergötlands Läns Landsting, Public Dental Service.
    Lindahl, Tomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Richter, Arina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Inverse relationship between the severity of gingivitis and platelet reactivity in stable angina pectoris [6]2007In: Journal of Thrombosis and Haemostasis, ISSN 1538-7933, E-ISSN 1538-7836, Vol. 5, no 2, p. 422-423Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 17.
    Kallunki, Jenny
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Ericsson, Elisabeth
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Tonsillotomy versus tonsillectomy--a randomized trial regarding dentofacial morphology and post-operative growth in children with tonsillar hypertrophy2014In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 36, no 4, p. 471-478Article in journal (Refereed)
    Abstract [en]

    Objectives:The primary aim of this study was to analyse two different methods of tonsil surgery, tonsillectomy (TE) and tonsillotomy (TT), regarding post-operative dentofacial growth in children with tonsillar hypertrophy. A secondary aim was to analyse these results in relation to cephalometric standards.Material and methods:The study group consisted of 64 subjects (39 boys and 25 girls), mean age 4.8 years ± 4 months. They were randomized to a complete removal of the pharyngeal tonsil, TE, (n = 31) or a partial removal, TT, (n = 33). Pre-operative and 2 years post-operative study material were obtained and analysed. The results were compared with cephalometric standards.Results:Pre-operative, children with hypertrophic tonsils displayed an increased vertical relation (P < 0.05) compared with cephalometric standards. Post-operative, no significant difference could be detected between the two surgical procedures regarding dentofacial growth. Mandibular growth with an anterior inclination was significant (P < 0.001/TE, P < 0.01/TT) for both groups. An increased upper and lower incisor inclination was noted (P < 0.01/TE,TT). The vertical relation decreased (P < 0.001/TE, P < 0.05/TT) as well as the mandibular angle (P < 0.01/TE, P < 0.001/TT). Reduction was also significant for the sagittal intermaxillar (P < 0.001/TE,TT) relation. These post-operative results, together with a more prognatic mandible (P < 0.05/TE,TT) and chin (P < 0.001/TE, P < 0.01/TT), might indicate a more horizontal direction of mandibular growth.Conclusion:TE and TT yielded equal post-operative dentofacial growth in children treated for hypertrophic tonsils. This result should be considered when deciding upon surgical technique.

  • 18.
    Lönn, Johanna
    et al.
    Univ Orebro, Sch Hlth & Med Sci, Div Clin Med, Orebro, Sweden; PEAS Institute, Linköping and Örebro University, Sweden.
    Starkhammar Johansson, Carin
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    Nakka, Sravya
    PEAS Institute, Linköping, Sweden.
    Palm, Elenor
    Örebro University, Sweden.
    Bengtsson, Torbjörn
    Örebro University, Sweden.
    Nayeri, Fariba
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Infectious Diseases. PEAS Inst, Inst Prot Environm Affin Surveys, Linkoping, Sweden.
    Ravald, Nils
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    High Concentration but Low Activity of Hepatocyte Growth Factor in Periodontitis2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 1, p. 113-122Article in journal (Refereed)
    Abstract [en]

    Background: High levels of hepatocyte growth factor (HGF), a healing factor with regenerative and cytoprotective effects, are associated with inflammatory diseases, including periodontitis. HGF biologic activity requires binding to its receptors, the proto-oncogene c-Met and heparan sulfate proteoglycan (HSPG). This study investigates HGF expression and its relationship to subgingival microbiota in medically healthy individuals with and without periodontitis.

    Methods: Saliva, gingival crevicular fluid (GCF), and blood samples from 30 patients with severe periodontitis and 30 healthy controls were analyzed for HGF concentration using enzyme-linked immunosorbent assay and binding affinity for HSPG and c-Met using surface plasmon resonance. The regenerative effects of saliva from three patients and controls were analyzed in an in vitro model of cell injury. Subgingival plaques were analyzed for the presence of 18 bacterial species.

    Results: Patients with periodontitis showed higher HGF concentrations in saliva, GCF, and serum (P <0.001); however, the binding affinities for HSPG and c-Met were reduced in GCF and saliva (P <0.002). In contrast to the controls, saliva from patients showed no significant regenerative effect over time on gingival epithelial cells. Compared with controls, patients had a higher prevalence of periodontally related bacteria.

    Conclusions: Higher circulatory HGF levels indicate a systemic effect of periodontitis. However, the HGF biologic activity at local inflammation sites was reduced, and this effect was associated with the amount of periodontal bacteria. Loss of function of healing factors may be an important mechanism in degenerative processes in periodontally susceptible individuals.

  • 19.
    Mosskull Hjertton, Petra
    et al.
    Östergötlands Läns Landsting, Public Dental Health Care, Centre for Orthodontics and Paediatric Dentistry.
    Bagesund, Mats
    Östergötlands Läns Landsting, Public Dental Health Care, Centre for Orthodontics and Paediatric Dentistry.
    Er:YAG laser or high-speed bur for cavity preparation in adolescents2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 610-615Article in journal (Refereed)
    Abstract [en]

    Objectives. The aim was to evaluate the effect on cavity preparation time, the pulse changes and the patients subjective experience during removal of healthy tooth substance with high-speed bur and Er:YAG laser. Materials and methods. Thirty-five (13 male, 22 female) 14-18-year-olds participated. After local anaesthesia, Er:YAG laser and high-speed diamond bur were used for a 2 mm deep cavity preparation on the middle of the buccal surface on contra-lateral healthy maxillary first premolars. The cavity preparation time and the pulse were measured during the treatment. Subjective experience was evaluated using a VAS-scale and a questionnaire. Wilcoxon Signed Rank test and Chi-2-test were used for statistical analyses. Results. The mean (SD) cavity preparation time was 3.7-times longer (p andlt; 0.001) for the laser [59 (41) s] than for the high-speed bur [16 (4) s]. The mean pulse change during preparation differed (p andlt; 0.05) between the bur (+2.2%) and laser (-4.4%). The smell was worse when laser was used (p andlt; 0.01); 65.7% expressed less discomfort and 57.1% experienced a lower sound level when laser was used. Laser was preferred for future treatment in 62.9% of the adolescents. Conclusion. Laser ablation caused unpleasant smell and longer cavity preparation time, but was preferred by a majority of the adolescents.

  • 20.
    Nilsson, Ing-Marie
    et al.
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Drangsholt, Mark
    University of Washington.
    List, Thomas
    Malmö University.
    Impact of Temporomandibular Disorder Pain in Adolescents: Differences by Age and Gender2009In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 23, no 2, p. 115-122Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate the impact of temporomandibular disorder (TMD) pain by age and gender in adolescents, with assessments of this impact specifically on school absence, medication consumption, perceived need for treatment, jaw function limitation, depressive symptoms scores and somatic complaints, and graded chronic pain scale. Methods: In a population-based sample, a mailed questionnaire was sent to 350 patients with self-reported TMD pain (group 1) and 350 healthy age- and sex-matched individuals (group 2) aged 12 to 19 years 2 to 4 weeks after their annual dental examination. The groups were divided into younger (age 12 to 15) and older (age 16 to 19) groups. Descriptive statistics and 95% confidence intervals were used, and chi-square and t-tests were calculated for analyzing group differences. Odds ratios were estimated using logistic regression. Results: As expected, groups I and 2 differed significantly in most variables related to psychosocial and behavioral factors. For adolescents reporting TMD pain once a week or more, no gender or age differences in pain intensity were seen. Jaw function limitation, depressive symptoms scores, somatic complaints, graded chronic pain, and perceived need for TMD treatment were all significantly higher in girls than in boys. Older girls reported higher analgesic consumption and school absences than older boys. Conclusion: Girls reporting TMD pain had significantly greater impact on behavioral and psychosocial factors than boys. Almost one third of older girls, compared to one out of 10 older boys, reported school absences and analgesic consumption because of their TMD pain. J OROFAC PAIN 2009;23; 115-122

  • 21.
    Ordell, S
    et al.
    Östergötlands Läns Landsting, Public Dental Service.
    Soderfeldt, B
    Malmo University, Department Oral Publ Hlth, Malmo, Sweden .
    Understanding politics? Some lessons from Swedish dentistry.2009In: COMMUNITY DENTAL HEALTH, ISSN 0265-539X, Vol. 26, no 4, p. 239-243Article in journal (Refereed)
    Abstract [en]

    Background Medical and dental care are dependent on political settings or legislation and financing. The professionals in these organisations need to understand the political logic that shapes the environment of their organisation. A description of Swedish dentistry and recent legislation reports from commissions and bills to parliament from 1997 are analysed. Aim The aims are to describe changes in the environment for dentistry in Sweden from 1998, to analyse the underlying political logic, and to point to some lessons to be learned. Method The description is analysed using theories from strategic management and from decision-making. Results The objectives changed from a formal emphasis on prevention to insurance against high cost for the patient. Some ideas keep recurring in the political debates even if scientific logics contradict them. Conclusions Health care system research methods and the "garbage can" model of decision-making can be used to describe and to gain a better understanding of the politically governed environment. Some political issues keep recurring in spite of earlier rational rejections. A better understanding of the political logic that forms the environment for an organisation is needed for a successful adaptation to that environment.

  • 22.
    Ordell, Sven
    et al.
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Soderfeldt, Bjorn
    Malmö University.
    Management structures and beliefs in a professional organisation. An example from Swedish Public Dental Health Services2010In: SWEDISH DENTAL JOURNAL, ISSN 0347-9994, Vol. 34, no 3, p. 167-176Article in journal (Refereed)
    Abstract [en]

    Work as a dentist is stressful and demanding. In the Public Dental Health Service (PDHS) the heads of clinics have a great influence on the work environment. In turn the heads have to adapt to the overarching policies on management in each County, which create the environment for the clinics. The aims of this paper were to describe the management structure of the PDHS as described by their Chief Dental Officers (CDOs), and to test hypotheses that the management systems had "a logical administrative structure" A postal questionnaire was mailed to all 21 CDOs, who all responded. Context analysis and bivariate correlations were used The PDHS employed on average 60% of all dentists in a county. The numbers of clinics for general dentistry in Sweden was 698, and for specialist care 144 The heads of clinics were dentists in 92%. Four hypotheses were tested 1/ A separate political board did not lead to closer governance of the PDHS. 2/ There was more emphasis on measurable than on qualitative objectives and follow-up 3/ There was only partial correlation between a larger county and a more formalized management. 4/ There was no correlation between size of county and beliefs on advantages of scale There was a widespread belief in advantages with larger clinics both from administrative, and rather surprisingly, from clinical aspects. Two of the four hypotheses could not be corroborated which indicates that the management structures were more,formed by county specific principles. The four hypotheses on administrative behaviour were only partially corroborated. The implications for delivery of care to-sparsely populated areas need to be monitored in view of the beliefs in larger clinics. The limits for decisions by management and for professional discretion must be monitored closely considering their effects on work environment and on the quality of care the professionals are able to deliver

  • 23.
    Ordell, Sven
    et al.
    Malmö University.
    Unell, Lennart
    Malmö University.
    Söderfeldt, Björn
    Östergötlands Läns Landsting, Public Dental Service.
    An analysis of present dental professions in Sweden2006In: Swedish Dental Journal, ISSN 0347-9994, Vol. 30, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Dentistry in Sweden is predicted to have a shortage of dentists in the future and the division of labour within dentistry will be a more debated question. In order to forecast the effects of such a shortage the professional status of the involved groups must be made clearer. The objective of this paper is to analyse the emergence and present professional status of clinical dental professions in Sweden. The study was conducted on the basis of theories on professions, and their roles in organizations was analysed.The results were applied on the historical emergence, establishment and consolidation of clinical dental professions in Sweden. The results show that a large sector of salaried dentists has not diminished the professional status of the Swedish dentists. Professional ambitions such as many clinical subspecialties and a strong element of research have not been restrained by the public health ambitions in the Public Dental Health Service (PDHS). Presently, other dental professions are dental hygienists, dental technicians and dental nurses. Of these the only other licensed group, the dental hygienists, are an emerging profession.They have an uphill struggle to obtain a full professional status, mainly because their knowledge domains are neither specific nor exclusive to their group. Development of a common core curriculum on a clearly academic level would enhance their professional status. Dental technicians and nurses are lacking fundamental traits as professions. There appears to be little need for additional groups of clinical professions besides dentists and dental hygienists in Swedish dentistry. In conclusion,this analysis provided better understanding of the present status of the Swedish dental professions, to prepare for future restructuring of the dental care system. Further work will be needed to understand the impact of professional traits on the management of groups of professionals.

  • 24.
    Sjögren, Petteri
    Linköping University, Department of Department of Health and Society. Östergötlands Läns Landsting, Public Dental Service. Linköping University, Faculty of Health Sciences.
    Cost of composite and glass ionomer class II molar restorations and theoretical analyses of cost per year of function at Public Dental Services in Sweden2006In: Swedish Dental Journal, ISSN 0347-9994, Vol. 30, no 3, p. 99-107Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the cost of direct composite and glass ionomer class II molar restorations, and the theoretical cost per year of function, at Public Dental Services (PDS) in Sweden, years 2000 and 2005. Costs for patients, Social Insurance Offices (SI; Försäkringskassan), and total cost, were calculated based on fee schedules from all PDS in Sweden. Theoretical cost per year calculations were based on the median survival times (MST) of failed direct composite and glass ionomer class II molar restorations, derived from a set of clinical studies conducted in Nordic general practices. Due to lack of national statistics from SI, the number of direct restorations including more than one surface, made in adults, in general dentistry at PDS in the county of Halland were studied. From the year 2000 to year 2005, the total cost of composite class II molar restorations increased by 25 %, whereas the total cost of glass ionomer restorations more than doubled. Theoretical calculations implied a higher cost per year of function for composite restorations in year 2000, whereas in year 2005, glass ionomer restorations had a higher cost per year of function. The cost of direct composite and glass ionomer class II molar restorations increased from year 2000 to 2005, at PDS in Sweden. In the context of planning public health care funding, theoretical models for cost prediction may prove useful.

  • 25.
    Sjögren, Petteri
    et al.
    Östergötlands Läns Landsting, Public Dental Service.
    Halling, Arne
    Östergötlands Läns Landsting, Public Dental Service.
    Trends in dental and medical research and relevance of randomized controlled trials to common activities in general dentistry2000In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 58, no 6, p. 260-264Article in journal (Refereed)
    Abstract [en]

    The aim was to study publication trends in dental and medical research as well as the proportion of randomized controlled trials in dental research (RCT-Ds) of relevance to common activities in general dentistry. The study was based on Medline searches, 1969-99 (MeSH terms). Data from Public Dental Services (county of Östergötland, Sweden) were used to find the most common activities in the practice of general dentistry. In dental research the annual number of publications had decreased from 5,900 in 1969 to 4,400 in 1999, corresponding to 9,100 and 14,000, respectively, in medical research. Clinical trials in dental research had increased to 7% and RCT-Ds to 5% of all dental research during 1969-99. In medicine, clinical trials and randomized controlled trials had increased to 2% and 1%, respectively. In dental and medical research, meta-analyses (MAs) totalled 0.1-0.2% in 1994 and 1999. One out of 200 dental research publications in 1979-99 was an RCT-D of relevance to the most common activities in general dentistry. These activities contributed to more than 80% of the dental care of children and adolescents and to more than 60% of the dental care of adults in 1999.

  • 26.
    Slavnic, Snjezana
    et al.
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Marcusson, Agneta
    Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery.
    Duration of orthodontic treatment in conjunction with orthognathic surgery2010In: SWEDISH DENTAL JOURNAL, ISSN 0347-9994, Vol. 34, no 3, p. 159-166Article in journal (Refereed)
    Abstract [en]

    Patients considering undergoing combined orthodontic-orthognathic treatment for correction of malocclusion require appropriate information, particularly with respect to duration of treatment The primary aim of this study was to determine the duration of orthodontic treatment carried out in conjunction with orthognathic surgery and to analyze the influence of selected explanatory variables. A further aim was to compare the duration of orthodontic treatment in patients treated by orthodontists at Linkoping University hospital orthodontic clinic and six regional orthodontic clinics This is a retrospective study, based on data from the orthodontic records of patients who had undergone orthognathic surgery at the University Hospital Maxillofacial Unit in Linkoping, Sweden, from 2000 to 2005 The subjects comprised 207 out of 233 patients (107 women and 100 men), aged 15 8 - 56.9 years, median 24.2 years at the time of surgery 26 patients were excluded, either diagnosed with a syndrome, or because it was impossible to follow up the entire treatment. 59 subjects had undergone orthodontic treatment at the University hospital orthodontic clinic and 148 at the 6 regional orthodontic clinics. The variables recorded were gender, malocclusion, the number of appointments (scheduled and emergency) and treatment setting The median value for pre-operative orthodontic treatment time was 19.2 months (range 2.4 - 68.4); for postoperative orthodontic treatment 4 6 months (range 0 - 18 8) and for total orthodontic treatment 278 months (range 5.9 - 79 1). For the University hospital orthodontic clinic, pre-operative (16.7 months) and total orthodontic treatment times (25 months) were significantly shorter than for the regional clinics; the duration of postoperative treatment was significantly longer (4.1 months). No other explanatory variables had a significant influence on the duration of orthodontic treatment. Compared with the regional orthodontic clinics, there were significantly fewer scheduled appointments at the University hospital orthodontic clinic, but no significant difference in emergency attendance.

  • 27.
    Starkhammar Johansson, Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    Ravald, Nils
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care.
    Pagonis, Christos
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Richter, Arina
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Periodontitis in Patients With Coronary Artery Disease: An 8-Year Follow-Up2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 3, p. 417-425Article in journal (Refereed)
    Abstract [en]

    Background: This study examines whether preceding assessment of periodontal status in patients with established coronary artery disease (CAD) can predict future CAD endpoints (myocardial infarction, new revascularization procedure, or CAD-related death) during 8-year follow-up and whether the changes in periodontal status over time differ in patients with CAD compared with healthy controls. Methods: In 2003, periodontal status was examined in 161 patients with CAD who underwent percutaneous coronary intervention or coronary artery bypass graft due to significant stenosis in the coronary arteries and 162 controls without CAD. Eight years later, 126 patients with CAD (102 males and 24 females, mean age: 68 -8.9 years) and 121 controls (101 males and 20 females, mean age: 69 -9.0 years) were reexamined periodontally. A standard classification of periodontal disease in three groups (mild, moderate, and severe) was used. CAD endpoints during follow-up were obtained by review of medical records. CAD as cause of death was confirmed from the Swedish Cause of Death Register. Results: No significant differences were found among patients with CAD, with or without CAD-related endpoints at 8-year follow-up, and severity of periodontitis at baseline (P = 0.7). CAD did not influence the incidence or severity of periodontitis. Significant differences were found at the final examination in periodontitis prevalence and severity (P = 0.001), number of teeth (P = 0.006), probing depth 4 to 6 mm (P = 0.016), bleeding on probing (P = 0.001), and radiographic bone level (P = 0.042) between CAD patients and controls, all in favor of controls. Conclusions: The study results did not show a significant association during 8 years among CAD endpoints and periodontal status at baseline. The progression of periodontitis was low in both groups, although the higher proportion of individuals with severe periodontitis among patients with CAD compared with controls remained unchanged over the 8-year follow-up. Further long-term prospective studies are needed to show whether periodontitis can be considered a risk or prognostic factor for CAD, in terms of endpoints including myocardial infarction, new revascularization procedure, and CAD-related death.

  • 28.
    Ståhlnacke, Katri
    et al.
    Community Dental Office, Örebro County Council.
    Unell, L.
    Community Dental Office, Örebro County Council.
    Söderfeldt, B.
    Malmö University.
    Ekbäck, G.
    Community Dental Office, Örebro County Council.
    Ordell, Sven
    Östergötlands Läns Landsting, Public Dental Service, Centre for Orthodontics and Paediatric Dentistry.
    Self-perceived oral health among 65 and 75 years old in two Swedish counties2010In: Swedish Dental Journal, ISSN 0347-9994, Vol. 34, no 2, p. 107-119Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate self-perceived oral health in two elderly populations, ages 65 and 75 years, and its relation to background factors, socioeconomic, individual, and dental health service system factors. Another purpose was to investigate if there were any differences in these respects, between the two age groups, born in 1932 or 1942. In two counties in Sweden, Örebro and Östergötland, all persons born in 1942 have been surveyed by mail every fifth year since 1992. In the year 2007 all persons born in 1932 were also surveyed using the same questionnaire. Those born in 1932 consisted of 3735 persons and those born in 1942 6078 persons. From an outline of a general model of inequalities in oral health data were analyzed with descriptive statistics and contingency tables with ?2 analysis. Multivariable analysis was performed by using multiple regression analysis. Factors related to self-perceived oral health were age group, social network, ethnicity, education, general health, tobacco habits, oral hygiene routines, dental visit habits and cost for care. The self-perceived oral health was overall rather high, especially in view of the studied ages, although it was worse for those of age 75. Socio-economic factors, dental health service system as well as individual lifestyle factors affected self-perceived oral health. To have a satisfying dental appearance, in the aspect of how you are judged by other people, was important for these age groups.This presents a challenge for dental health planners especially since the proportion of older age groups are growing.

  • 29.
    Unell, L
    et al.
    Örebro County Council.
    Söderfeldt, B
    Malmö University.
    Halling, Arne
    Östergötlands Läns Landsting, Public Dental Service.
    Birkhed, D
    Göteborg University.
    Explanatory models for clinical and subjective indicators of periodontal disease in an adult population2000In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 27, no 1, p. 22-29Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to analyze indicators of periodontal disease using: (1) community periodontal index of treatment needs (CPITN), (2) subjectively reported change of front teeth position, and 3) subjectively reported gingival bleeding. Method: These 3 indicators were used in models with explanatory variables from 4 domains: (A) socio-economic attributes, (B) general health and health-related lifestyle, (C) dental attitudes and behaviors, and (D) dental status expressed as (number of teeth and DFT) for the clinically-determined dependent variables. In 1992, the study was carried out cross-sectionally in all 50-year olds in 2 Swedish counties using a questionnaire (n=6343) and clinical investigation of a 20% subsample (n=1040). Results: Multiple and logistic regression analysis showed that explanatory patterns varied for the clinical and subjective indicators. Use of tobacco had strong effects in all models as did high care utilization. There were few associations with socio-economic attributes. The 2 subjective indicators "changed front position" and "gingival bleeding" associated with attitudes, behaviors and subjective health. Number of teeth and DFT covaried with clinical indicators. Conclusions: The main conclusions from this study are: (1) that it is possible to find multivariate models with acceptable goodness of fit for prediction of occurrence of periodontal indicators, and (2) that the lack of relation between social attributes and the disease gives arguments for a biological provenance of periodontitis.

  • 30.
    Wahlberg, Jeanette
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Ledin, Torbjön
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Bågesund, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Public Dental Health Care, Centre for Orthodontics and Paediatric Dentistry.
    Ekman, Bertil
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Impaired Postural Balance in Turner Syndrom2013In: Hormone and Metabolic Research, ISSN 0018-5043, E-ISSN 1439-4286, Vol. 45, no 7, p. 537-540Article in journal (Refereed)
    Abstract [en]

    An impaired body balance has been found in Turner syndrome (TS) in clinical tests like Rombergs’s test and walking on a balance beam. The aim of the study was to assess postural balance in TS subjects with specific balance testing using dynamic posturography and relate to body composition. Nineteen TS subjects (20–57 years) were included. Balance was measured with dynamic posturography (Equitest) and compared with 19 sex and age-matched controls (22–59 years). Equitest, visual, vestibular, and somatosensory systems were provoked with increasing difficulty (6 tests, SO1–SO6) and body sway was measured with a dual forceplate. Body composition was measured with DXA. No difference was found between the TS subjects and the controls on fixed platform with open eyes (SO1), with closed eyes (SO2), with stable platform and visual disorientation (SO3), or on unstable platform with open eyes (SO4). In the difficult tests on unstable platform the TS subjects did worse compared with controls both in the test with eyes closed (SO5), p<0.01, and in the test with visual disorientation (SO6), p<0.05. Composite (a merge of all six recordings) was significantly lower in the TS-group, p<0.05. In the TS group high total body weight was related to worse outcome on tests SO5, SO6, and composite, while total bone mass, age, height, or waist showed no significant association with balance scores. Our findings indicate that TS could have an increased risk for falling due to impaired ability to manage complex coordination tasks.

  • 31.
    Östberg, AL
    et al.
    Public Dental Services and Skaraborg Institute, Skövde.
    Halling, Arne
    Östergötlands Läns Landsting, Public Dental Service.
    Lindblad, U
    Public Dental Services and Skaraborg Institute, Skövde.
    A gender perspective of self-perceived oral health in adolescents: associations with attitudes and behaviours2001In: Community Dental Health, ISSN 0265-539X, Vol. 18, no 2, p. 110-116Article in journal (Refereed)
    Abstract [en]

    Objective To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population. Design A census survey. Self-reported questionnaires were answered anonymously in a standardised manner in classrooms. Attitudes studied included the importance of sound teeth and feelings towards visits to the dentist. Behaviours were represented by floss usage and sweets consumption. Setting All senior and upper secondary level schools in Skaraborg County, Sweden. Subjects 17,280 students, aged 13-18 years, Outcome measures Self-perceived oral health. represented by a single-item rating: satisfaction with the appearance of the teeth: self-assessed gum bleeding and a perceived oral health (POH) index. Results Recognising sound teeth as important was a predominating attitude among the respondents (boys 94%, girls 97%) and was significantly associated with a good perceived oral health overall. Individuals who experienced visits to dentist as unpleasant (boys 36%, girls 43%) were less likely to perceive good oral health as single-item rated (OR for boys 0.55[0.49, 0.63], girls 0.40[0.34, 0.47]). Regular use of floss had a small protective effect on bleeding gums. Daily sweets consumption showed a significant and inverse association with self-perceived oral health as single-item rated (OR for boys 0.53[0.44, 0.66], girls 0.49[0.40, 0.60]). Girls, more often than boys, perceived their oral health to be good, except in the perception of the appearance of their teeth. Conclusions It is concluded that the strong associations between attitudes and self-perceived oral health should be recognised in strategies for oral health promotion and that gender differences must be considered.

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