Syftet med litteraturstudien var att undersöka tandtrådens effekt på plack och gingivit. Metoden som användes var en kvantitativ allmän litteraturstudie där sökningen av vetenskapliga artiklar gjordes i den medicinska databasen PubMed. Litteraturstudiens resultat sammanställdes utifrån elva vetenskapliga artiklar. Tandtrådens effekt på plack och gingivit utvärderades, i form av reduktion av: plackmängd och blödning hos såväl barn, ungdomar som vuxna individer. Tio av artiklarna visade att tandtråd hade en effekt på ovanstående parametrar medan den kvarstående artikeln inte kunde visa några sådana effekter. Slutsatsen är att användning av tandtråd i samband med tandborstning har en effekt med avseende på reduktion av plackmängd och gingivit. Ytterligare forskning krävs för en noggrann utvärdering av tandtrådens effekt.

Syfte:Syftet med studien var att undersöka munhygien- och kostvanor hos gymnasieelever i årskurs 3. Material och metod: Studien var en kvantitativ tvärsnittsstudie. Datainsamlingen genomfördes i form av enkätundersökning med 123 deltagare i åldrarna 18-22 år. Enkäten bestod av 20 frågor med fasta svarsalternativ som berörde elevernas bakgrund, munhygien- och kostvanor. Resultat: Studiens resultat visade att majoriteten av deltagarna borstade tänderna två gånger om dagen med tandborste och fluortandkräm och 28 % använde något approximalt hjälpmedel. Mer än hälften av deltagarna åt lunch och middag varje dag, däremot var det endast hälften av deltagarna som åt frukost varje dag. Deltagarna hade ett lågt intag av sötsaker. Slutsats: Studien visade att deltagarna hade relativt goda munhygienvanor, däremot var användningen av approximala hjälpmedel och fluorpreparat bristfälliga. Vidare visade resultatet att deltagarna hade bristfälliga kostvanor då endast hälften av deltagarna åt frukost varje dag.

Introduction:

Pulp necrosis in immature permanent teeth stops root development and may lead to higher risk of cervical fractures and a challenging treatment. Regenerative endodontic treatment (RET) aims to continue tooth development and implies the use of calcium silicate-based cements, such as Mineral trioxide aggregate (MTA) and Biodentine to seal the root canal. However, its effect on stem cells has been poorly explored. 

Aims: Examine the effect of two different calcium silicate-based cements on the viability and the odonto-/osteogenic potential of Stem Cells from Apical Papilla (SCAP).

Material and method: 

Isolated SCAPs from three healthy donors (donor I, II and III) were used and exposed for different concentration extracts of ProRoot® MTA and BiodentineTM for 21 days. Cell viability was studied using the neutral red cytotoxicity test. Osteogenic differentiation was analyzed by the alkaline phosphatase test (ALP).

Results: 

No difference in SCAPs viability was detected by the type of cements used, Biodentine or ProRoot MTA. However, material concentration could be associated with cells cytotoxicity.  Osteogenic differentiation was not based on the type of cement used but the environment conditions (aerobic/anaerobic) and the genetical background.

Conclusions:

The type of cement used in RET, Biodentine or MTA, showed similar effect on SCAPs viability and differentiation potential in vitro. Further studies should be performed to analyze their effect -in -vivo.

Purpose 

This study aimed to evaluate the mechanical properties of the different layers of multi-layered zirconia materials produced with different strategies for gaining translucency.

Materials and methods 

Sixty zirconia specimens were prepared in a bar shape from two different partially sintered multi-layered zirconia blanks (KATANA™ Multi-layered Zirconia HTML, Kuraray Noritake Dental, EU) and (IPS e.max® ZirCAD Prime, Ivoclar, USA). The specimens were distributed into two groups based on the material used (n=30) and further subdivided into three subgroups according to the different layers of zirconia blanks: translucent, transition, and dentin (n=10). All specimens were subjected to a static three-point flexural strength test. A one-way ANOVA and a T-test were performed to determine the significant differences among the groups. 

Results 

The different layers of ZirCAD Prime showed significant differences in flexural strength (p=0.001). In contrast, the different layers of KATANA™ HTML showed no significant differences (p=0.437). A T-test was conducted to compare the results from different layers within the same material. The results of the One-Way ANOVA test for the different groups of KATANA™ HTML demonstrated no difference between the groups (p=0.437). 

Conclusion 

Different compositions of different multi-layered zirconia materials result in various mechanical properties. Brand-specific differences are an essential consideration for dentists and dental technicians when using multi-layered zirconia. It is crucial to consider various factors such as type of restoration, positioning of the restoration in the disc (nesting), and restoration to be used anteriorly or posteriorly, and the desired esthetical requirements as the translucency are gained in different ways.   

Purpose

 To evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants.

Materials and methods

A search was undertaken in three electronic databases, complemented by manual search of some journals. Implant failure was the outcome evaluated, with the estimate of relative effect expressed in risk ratio (RR). Heterogeneity among studies was evaluated by I²statistic. Inverse variance method was used for random- or fixed-effects models. Quality assessment of the studies was performed, and a funnel plot was drawn. A meta-regression was performed in order to verify how the RR was associated with the follow-up time.

Results

The reviews included 353 publications. Altogether, there were 25,490 short implants and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher risk of failure than long implants (RR 2.437, p<0.001). The meta-regression observed that the follow-up time did not have any effect of the RR of failure between short and long implants. A sensitivity analysis plotting together only the studies with follow-up up until 7 years, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up.

Conclusion

Short implants showed (< 10 mm) a 2.5 times higher risk of failure than long implants (≥ 10 mm). Implant failure is multifactorial and the implant length is only one of the many factors contributing to the loss of implant. A good treatment plan and the patient’s general health should be taken into account when planning for an implant treatment.

Keywords: dental implant, failure, implant length, systematic review, meta-analysis

The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (>= 10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, p < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient's general health should be taken into account when planning for an implant treatment.

Patients with tobacco habits visit the dental care regularly, therefore it is well placed to carry out tobacco cessation for those who smoke or use snuff. The purpose of this study was to highlight methods available for tobacco cessation and results of these methods. The authors searched in the database PubMed and was limited to articles published during the last ten years and performed in the dental care. The framework was limited to eight studies which were performed in the dental care. The results showed that there are several different combination methods for tobacco cessation. In three articles, the 5A method was used in combination with nicotine replacement therapy. In other articles five different combination methods with different follow-up times were used. In one of those with

combined approach two methods are described. In addition a method was used for snuff cessation. The result showed differences in frequency of success to tobacco stop. The best result was shown after twelve months tobacco cessation and a follow up in two of the combination methods and the method for snuff cessation (36%, 25% and 30%). The lowest success rate was 7% after twelve months follow up with one of the 5A methods. The conclusion of the study is that there are few published studies regarding tobacco cessation in the dental care, which are based on evaluation of methods performed among patients. Follow up, counselling and support have essential effects on the result.

The aim of this present record-based retrospective study was to investigate the influence of the crown-implant ratio (CIR) and implant inclination in relation to the occlusal plane on the marginal bone loss (MBL) around dental implants supporting single crowns in the posterior region of the jaws. All the cases of implant-supported single crowns in the premolar and molar regions were initially considered for inclusion. Only implants not lost, with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up, were considered for the analysis of MBL. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. After the exclusion of 49 cases, a total of 316 implant-supported single crowns in 234 patients were included. The results from the statistical models suggested that implant inclination and anatomical- and clinical CIR (the main related factors investigated in the study) were not statistically significantly related to MBL over time. Age (older people), tooth region (premolar), and bruxism (bruxers) had a statistically significant influence on MBL over time.

BACKGROUND: It is not clear to what extent chewing is improved by unilateral oral rehabilitation with implant-supported fixed partial prostheses (ISFPPs).

AIM: This study aimed to investigate whether patients treated with unilateral ISFPPs in the maxilla use their prostheses during mastication to the same extent as they used their contralateral natural teeth. A further aim was to investigate whether there is a correlation between preferred chewing side and laterality.

MATERIAL AND METHODS: Chewing side preference was assessed in 15 participants treated with unilateral ISFPPs in the maxilla. The first, second, third, fifth, and tenth chewing cycles were assessed, and the test was repeated ten times. All participants also answered a questionnaire about their chewing side preference.

RESULTS: Most of the participants presented bilateral chewing, but two (13%) chewed only on the ISFPP. There was no statistically significant association between the objectively assessed chewing side and dental status (natural teeth or ISFPPs) during any of the recorded chewing cycles (p >.1). There were statistically significant correlations between both the subjectively reported usually preferred chewing side and the subjective chewing side preference during the test, and the objectively assessed chewing side for the first three chewing cycles (p <.01). No correlation was found between handedness and the objectively assessed chewing side.

CONCLUSION: In the present study, most participants chewed bilaterally, and chewing was performed both on the ISFPP and on the natural teeth. No correlation was found between the preferred chewing side, objectively or subjectively determined, and laterality.

Introduction: Removable partial dentures (PRD) are among the treatment options available for partially edentulous patients. The usage of RPD and patient satisfaction with the prosthesis relates to Oral health related quality of life (OHRQoL).

Aim: The aim of this study was to evaluate the use of RPDs, satisfaction with the prostheses as well as OHRQoL in patients provided with a RPD in general practice. A further aim was to identify possible factors related to RPD usage, patient satisfaction and OHRQoL.

Material and method: A cross-sectional survey study, utilizing a questionnaire regarding patient satisfaction with different aspects of the participants RPD, the Swedish version of OHIP-14 questionnaire and the usage of the prosthesis.

Results: A majority of respondents, (83.6%) reported that they used their prosthesis daily or often. The overall satisfaction rate among respondents was 83.0% with 39.3% stating that they were highly satisfied with the prosthesis and the mean OHIP- 14 score was 8.5, SD 10.2. The chewing ability was reported to be improved by 58.9% but impairment in chewing was reported by 26.8%. Pain from supporting teeth and soft tissue, sociodemographic factors and dissatisfaction with pre-treatment information and personal treatment were associated with not using the RPD.

Conclusions: In the present study, treatment with RPD was in most patients associated with improvement in chewing and appearance. Insufficient pretreatment information, perception of treatment and pain from supporting tissue was associated with reduced use of and satisfaction with the RPD.

Objective To investigate in 10 orthodontic journals how many randomized controlled trials (RCTs) considered the Hawthorne effect, and if considered, to determine whether it was related to the patients or the therapists involved in the trial and, finally, to discuss the Hawthorne effect in an educational way. Materials and methods A search was performed on the Medline database, via PubMed, for publication type ‘randomized controlled trial’ published for each journal between 1 August 2007 and 31 July 2017. The American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, Australian Orthodontic Journal, Dental Press Journal of Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, Journal of Orofacial Orthopedics, Korean Journal of Orthodontics, Orthodontics and Craniofacial Research and Progress in Orthodontics were assessed. Two independent reviewers extracted the data and identified whether the Hawthorne effect was considered or discussed in the articles and whether the Hawthorne effect was related to the behaviour of the patients, the therapists, or both. Results The initial search generated 502 possible trials. After applying the inclusion and exclusion criteria, 290 RCTs were included and assessed. The Hawthorne effect was considered or discussed in 10 of 290 RCTs (3.4%), and all were related to the patients’ and none to the therapists’ behaviour. Conclusions The Hawthorne effect reported in orthodontic RCTs was suboptimal. The researchers’ lack of knowledge about this phenomenon is evident, despite evidence that the Hawthorne effect may cause over-optimistic results or false-positive bias.

Objective: To analyse in 10 orthodontic journals how many randomized controlled trials (RCTs) performed 'single-', 'double-', 'triple-', or 'outcome assessors blinding' and to evaluate, from the number of RCTs that did not conduct blinding, how many could actually have achieved it. Material and methods: Randomized controlled trials published in 10 orthodontic journals between 1 September 2012 and 28 February 2018 were included. A search was performed in PubMed and conducted for publication type 'randomized controlled trial' for each journal. Two reviewers independently analysed each RCT and registered that blinding was performed and included which specific type. It was also evaluated whether misclassifications of blinding items occurred and whether it was possible to achieve blinding among the RCTs that did not perform blinding. Results: After applying the inclusion criteria, 203 RCTs were assessed, and 61.6 per cent of them had used blinding, with the main type being 'outcome assessors blinding' (40.4%) followed by 'single-blinding' (15.3%), 'double-blinding' (2.5%), and 'triple-blinding' (3.4%). In 38.4 per cent of the trials, no blinding was performed; however, 79.4 per cent of them could have achieved blinding. Fifteen RCTs (7.3%) misclassified the blinding in relation to single-, double-, or triple-blinding. Journals followed the CONSORT (AJODO, EJO, JO, OCR) published together significantly more RCTs that performed blinding than journals not following the CONSORT. Conclusions: Blinding of outcome assessors was the most frequent type, as orthodontic trials are often of intervention design and thereby difficult to mask for patients and trial staff. The misclassifications of blinding items may indicate suboptimal knowledge among researchers and peer-reviewers regarding the definitions for diverse blinding types.

Objective: To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II) the influence of different orthodontic bracket systems on halitosis. Material and methods: Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched prior to March 15, 2018. The review was systematically conducted and reported according to the Cochrane Handbook and the PRISMA statement. Only Randomised Clinical Trials (RCTs) were considered. Selected full-text papers were independently assessed by four investigators and any disagreements were resolved by consensus. The Cochrane Handbook was used to grade the risk of bias and the quality of evidence was rated according to GRADE. Results: Out of 363 identified studies, three RCTs on halitosis and fixed orthodontic appliances met the inclusion criteria. The risk of bias in the three studies was rated as high and the quality of evidence was rated as very low. Conclusions/clinical implications: There is a lack of scientific evidence that subjects with fixed orthodontic appliances develop halitosis during treatment. Additional well-conducted RCTs with extended periods of assessment are needed as well as consensus concerning cut-off values for the diagnosis of halitosis.

AIMS: To identify if lower incisor movements after orthodontic treatment are due to the relapse of the orthodontic treatment or due to natural growth. SUBJECTS AND METHODS: The subjects consisted of 92 patients who have had orthodontic treatment, divided into three groups, group 1: 38 individuals had no retainer in the lower jaw. Group 2: 24 individuals had a retainer 0.028 inch, a spring hard wire bonded to the mandibular canines only. Group 3: 30 individuals had a 0.0195-inch Twist-Flex wire, bonded to all mandibular incisors and canines. Study models before orthodontic treatment (T0), immediately after orthodontic treatment (T1), 6 years after orthodontic treatment (T2), and 12 years after orthodontic treatment (T3) were used for the measurements. The wires in groups 2 and 3 were removed after mean 2.6 years (SD 1.49). Little Irregularity Index (LII), inter-canine distance, available mandibular anterior space, and number of crowded incisors were registered. A Tooth Displacement Index (TDI) was developed to measure the tooth displacement directions at T0 and T3. RESULTS: The LII showed equal values before treatment (T0) and at the follow-up registrations (T2 and T3). But about 25 per cent of the tooth displacements at T2 and T3 did not exist before treatment, at T0. This indicates usual growth changes and not relapse of the orthodontic treatment. CONCLUSION: As about 25 per cent of the displaced incisors can be considered as an effect of natural growth, not a relapse of the orthodontic treatment, it is valuable to use a displacement index in combination with other variables for investigations of stability after orthodontic treatment. Importance of the present study is that it is possible to differ between relapse and usual growth changes.

The primary function of adipose tissue is to store energy in the form of triacylglycerol, which is hydrolyzed to fatty acids to supply other tissues with energy. While insulin promotes the storage of triacylglycerol, catecholamines stimulate its hydrolysis. The development of type II diabetes is strongly associated with obesity, indicating a role of triacylglycerol metabolism in the pathogenesis of diabetes. Caveolae are plasma membrane invaginations found in most cells but are highly abundant in adipocytes. Insulin receptors are localized in caveolae and their function depends on intact caveolae structures. In the present thesis work, mass spectrometry-based methodology allowed identification of a number of new proteins and their posttranslational modifications in caveolae of human adipocytes. Variable N-terminal acetylation and phosphorylation of caveolin-1α and caveolin-1β were identified, which might regulate the function of caveolae. The transcription regulator protein PTRF was identified as the major caveolae associated protein. Specific proteolytic modifications of PTRF at the cytosolic surface of caveolae and phosphorylation on nine serine and one threonine residues were identified. Moreover, insulin induced translocation of PTRF from the plasma membrane to the nucleus. PTRF was previously shown to regulate the activity of both RNA polymerase I and polymerase II, thus a role of PTRF in mediating the anabolic action of insulin on protein synthesis and gene transcription is proposed.

PTRF was also involved in an extranuclear function in the hormonal regulation of triacylglycerol metabolism in caveolae. PTRF was colocalized with the triacylglycerol regulator proteins perilipin and hormone-sensitive lipase (HSL) in the triacylglycerol-synthesizing caveolae subclass. We showed that, while perilipin was translocated to the plasma membrane, both PTRF and HSL were translocated from the plasma membrane to the cytosol as a complex in response to insulin. The perilipin recruited to the plasma membrane was highly threonine phosphorylated. By mass spectrometry, three phosphorylated threonine residues were identified and were located in an acidic domain in the lipid droplet targeting domain of perilipin. The insulin-induced recruitment of perilipin to the plasma membrane might, therefore be phosphorylation-dependent. Isoproterenol, which stimulates hydrolysis of triacylglycerol, induced a complete depletion of perilipin B from the plasma membrane, suggesting a function of perilipin B to protect newly synthesized triacylglycerol in caveolae from being hydrolyzed by HSL. The location of PTRF and HSL was not affected by isoproterenol, indicating that insulin is acting against a default presence of PTRF and HSL in caveolae.

Taken together, this thesis expands our knowledge about caveolae and provided valuable information about their involvement in novel roles, particularly in the hormonal regulation of triacylglycerol metabolism.

Abstract Objectives: To evaluate the space-maintaining capacity of a titanium mesh or a bioresorbable mesh after periosteal expansion and to assess bone formation under a titanium mesh or a bioresorbable mesh on the lateral border of the mandible by qualitative and quantitative histological analysis. Material and methods: In 13 rabbits, a self-inflatable soft tissue expander was placed intraorally, bilaterally under the mandibular periosteum via an extra oral approach. After 2 weeks, the expanders were removed and a particulated onlay bone graft was placed and covered by a titanium mesh or a bioresorbable mesh. After 3 months, the animals were sacrificed and specimens were collected for histology. Results: The osmotic soft tissue expander created a subperiosteal pocket and a ridge of new bone had formed at the edges of the expanded periosteum in all sites. After the healing period of 3 months, soft tissue dehiscence was recorded in two of the sites with bioresorbable meshes. The mean bone fill was 65% under the titanium mesh and 85% under the bioresorbable mesh (P<0.05). There was no significant difference between the titanium mesh and the bioresorbable mesh regarding the height of the meshes, mesh area and mineralized bone area. Scanning electron microscopy shows that new bone is growing in direct contact with the resorbable mesh and the titanium mesh. Conclusion: This study confirms that an osmotic soft tissue expander creates a surplus of periosteum and soft tissue and that new bone can be generated under a titanium mesh or bioresorbable mesh.

About 30 % of individuals in the Swedish population will at some stage during life have treatment with orthodontic appliances. In more severe cases, when orthodontic treatment is not considered sufficient enough to correct the malocclusion, the orthodontic treatment is combined with orthognathic surgery. For these cases, a satisfying jaw relation is achieved by surgically moving the maxilla and/or the mandible into a pre-planned position.Patients due to be treated with orthognathic surgery often suffer from an impaired masticatory function, symptoms from the masti- catory muscles or temporomandibular joints (temporomandibular disorders), headaches as well as dissatisfaction with their facial aesthetics.Since orthognathic treatment is expensive, in many cases arduous to the patient and not without complications, it is important to assess the treatment outcome and if this is satisfying for the patients. Previous studies that have examined the outcome after ortho- gnathic treatment have had diverging study designs and have come to different conclusions with regard to both temporomandibular disorders and masticatory function.The overall aim of this thesis was to assess and compare the frequencies of temporomandibular disorders and the masticatory function in patients with dentofacial deformities before and after orthognathic treatment.The thesis is based on the following studies:paper i is a systematic literature review aiming to, in an evidence- based approach, answer the question whether orthognathic treatment affects the prevalence of signs and symptoms of temporomandibular disorders. The review encompasses the period from January 1966 to April 2006 and was further extended to May 2013 in the frame story of this thesis.Conclusions in Paper I and the complementary survey• There is insufficient scientific evidence for a decrease of sub diagnoses of temporomandibular disorders after orthognathic treatment.• There is limited scientific evidence for a reduction of masticatory muscle pain on palpation after orthognathic treatment.• There is insufficient scientific evidence for an effect on temporomandibular joint pain on palpation and temporomandibularjoint sounds from orthognathic surgery.• Further controlled, well-designed studies assessing temporomandibular disorders before and after orthognathic treatment are needed to consolidate strong evidence considering treatment outcomes.papers II and III are studies comparing frequencies of temporomandibular disorders in patients with dentofacial deformities with a control group. The patients were referred for a combined orthodontic and orthognathic treatment to correct their malocclusion. The control group comprised individuals with normal occlusion or minor malocclusion traits not in need of orthodontic treatment. In Paper III, temporomandibular disorders were longitudinally analysed by assessing and comparing frequencies before and after orthognathic treatment. All individuals in the studies were diagnosed according to the research diagnostic criteria for temporomandibular disorders.Conclusions in Papers II and III• Patients due to be treated with orthognathic surgery had more signs and symptoms of temporomandibular disorders and a higher frequency of diagnosed temporomandibular disorders compared with the age- and gender matched control group.• Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, had a positive treatment outcome in respect of myofascial pain and arthralgia.• After treatment the frequency of temporomandibular disorders in the treatment group was low and at an equivalent level of that in the control group.paper iV evaluates the self-estimated masticatory ability and the masticatory performance before and after orthognathic treatment in the same individuals as in Paper II and III.Conclusions in Paper IV• Masticatory ability and performance increased after orthognathic treatment.• The number of occlusal contacts and severity of overall symptoms of TMD influenced both the masticatory ability and performance.• Open bite had a negative effect on masticatory performance.Key conclusions and clinical implications:Patients with dentofacial deformities diagnosed with temporomandibular disorders do in most cases benefit from orthognathic treatment. In addition, masticatory ability and performance, which is impaired in patients with dentofacial deformities, improve after treatment. Thus, patients with dentofacial deformities that are to be treated with orthodontics in combination with orthognathic surgery can be recommended the treatment in order to relieve symptoms of TMD and impaired mastication.

Objective: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. Materials and Methods: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Results: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. Conclusions: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.

OBJECTIVE: To answer the question whether orthognathic surgery does affect the prevalence of signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: A literature survey in the PubMed and Cochrane Library electronic databases was performed and covered the period from January 1966 to April 2006. The inclusion criteria were controlled, prospective or retrospective studies comparing TMDs before and after orthognathic surgery in patients with malocclusion. There were no language restrictions, and three reviewers selected and extracted the data independently. The quality of the retrieved articles was evaluated by four reviewers. RESULTS: The search strategy resulted in 467 articles, of which 3 met the inclusion criteria. Because of few studies with unambiguous results and heterogeneity in study design, the scientific evidence was insufficient to evaluate the effects that orthognathic surgery had on TMD. Moreover, the studies had problems with inadequate selection description, confounding factors, and lack of method error analysis. CONCLUSION: To obtain reliable scientific evidence, additional well-controlled and well-designed studies are needed to determine how and if orthognathic surgery alters signs and symptoms of TMD.

Objective: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. Materials and Methods: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Results: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. Conclusions: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.

OBJECTIVE: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. MATERIALS AND METHODS: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. CONCLUSIONS: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.

OBJECTIVES: The aim of this study was to investigate the self-estimated masticatory ability and masticatory performance in patients with dentofacial deformities before and after orthognathic treatment; in comparison to an age- and gender-matched control group. SUBJECTS AND METHODS: The masticatory ability and masticatory performance were evaluated in 121 consecutive patients (treatment group), referred for orthognathic treatment. Eighteen months after treatment, 98 patients (81%) completed a follow-up examination. Masticatory ability was assessed on a visual analog scale, while the masticatory performance was evaluated by a masticatory test using round silicon tablets. Signs and symptoms of temporomandibular disorders (TMD) were registered by a clinical examination and a questionnaire. The control group comprised 56 age- and gender-matched subjects who were examined at baseline. RESULTS: At the baseline examination, the treatment group had a significantly lower masticatory ability and performance compared with the control group. After treatment, the masticatory ability significantly improved in the treatment group and reached the same level as in the control group. The masticatory performance index increased significantly but was still lower than in the control group. Both the masticatory ability and masticatory performance were affected by the number of occlusal contacts during maximal biting pressure and by the self-estimated overall symptoms of TMD. CONCLUSIONS: Patients with dentofacial deformities, corrected by orthognathic treatment, have a significant positive treatment outcome in respect of masticatory ability and masticatory performance. Furthermore, the occlusion and symptoms of TMD have an impact on both masticatory ability and masticatory performance.

Abstract The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain

Objectives: To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation.

Materials and methods: This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018.

Results: Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients.

Conclusions: In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods.

Clinical relevance: Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.

OBJECTIVES: To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation. MATERIALS AND METHODS: This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018. RESULTS: Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients. CONCLUSIONS: In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods. CLINICAL RELEVANCE: Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.

The aim of this epidemiological survey was to analyze the periodontal conditions of 19-year old individuals in an urban area of Sweden, with special reference to gender and socioeconomic factors. A randomized sample of 272 individuals living in Göteborg, Sweden, was clinically examined with regard to oral hygiene, gingivitis, periodontal pockets, probing attachment loss (PAL) and gingival recession. Bitewing radiographs were used for assessments of alveolar bone level (ABL) and dental calculus. A questionnaire-based interview regarding oral hygiene habits was included. Data were analyzed with regard to differences between gender and socioeconomic grouping. The subjects showed a mean plaque score of 59% and a gingivitis score of 44%. 70% of the adolescents had a plaque score of ≥50%, whereas corresponding figure for gingivitis was 37%. 27% of the subjects had at least one tooth with gingival recession. The mean prevalence of sites with probing depth of ≥6 mm was 0.5, and the prevalence of PAL ≥2 mm was 0.7. A radiographic bone level of ≥2 mm was observed at on average 0.8 teeth per subject. Females had significantly less plaque and gingivitis than males and significantly higher number of teeth with gingival recession. There were no clinically significant differences in periodontal conditions between socioeconomic groups. In conclusion, the survey revealed higher prevalence of plaque and gingivitis among male than female adolescents but no differences between socioeconomic groups.

The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.

Insufficient regeneration of missing bone and soft-tissue may presentaesthetic or functional problems in patients indicated for dentalimplant surgery. Several techniques such as bone grafts, bone substitutesand guided tissue regeneration (GTR) have been described torebuild a compromised alveolar ridge. Adequate soft-tissue coverageof grafted bone and titanium-mesh is important to avoid exposurewhich may result in loss of the bone graft.The general aim of this thesis was to evaluate use of an osmotictissue expander for expanding intra-oral soft tissue – creating a surplusof soft tissue – in preparation for onlay bone grafting.An experimental rabbit model was used in studies (I), (II) and (III).In (I) an osmotic soft-tissue expander was placed bilaterally on thelateral wall of the mandible via an extra-oral approach. After twoweeks of expansion the rabbits were killed and specimens were collectedfor histology. No inflammatory reaction and no resorbtion ofthe cortical bone occured. The periosteum was expanded and newbone formation was seen in the edges of the expander.In (II) and (III) the expander was placed under the periosteum in thesame way as in (I): bilaterally in 13 rabbits in (II) and unilaterally in11 rabbits in (III).After two weeks of expansion the expander was identified andremoved. In (II) particulated bone was placed at the recipient siteprotected by a titanium mesh in one site and a bio-resorbable meshon the other site. In (III), DBBM particles and bone particles collected from the lateralborder of the mandible separated by a collagen membrane wasplaced at the recipient site. The graft was protected by a pre-benttitanium mesh covered by a collagen membrane.After a healing period of 3 months specimens were collected forhistological and SEM examination. New bone was growing in directcontact with the titanium mesh and bio resorbable mesh. The newlyformed bone had the same calcium content as the mature bone in thebase of the mandible.In the clinical study (IV) 20 patients were consecutively recruitedand randomised into two groups.The experimental group (ten patients) had an osmotic soft tissueexpander implanted. After two weeks of expansion the expanderwas removed and a particulated bone graft protected by a titaniummesh and a collagen membrane was fixed to the recipient site. Titaniumimplants were installed after a healing period of 6 months.The patients in the reference group had a bone block grafted fromthe anterior ramus fixated to the recipient site with one or two titaniummini screws. Implants were installed after a healing period of6 months.A three dimensional optical measuring device was used to measurealterations in the soft tissue profile before each surgical procedure.The three-dimensional changes were then analysed on a PC.The results from the clinical study in patients confirmed the resultsfrom the experimental rabbit studies. The osmotic tissue expanderexpanded the soft tissue. Expander perforations of the soft tissueoccurred in two patients. The optical measurements demonstrated apositive volume gain after soft tissue expansion and bone grafting.The expanded tissue could be used to cover a bone graft. There stillwas a risk of mesh exposure, even after soft tissue expansion, whichoccurred in two patients. In both groups, implants could be installedin the grafted bone in positions that would allow the crowns to fitaesthetically into the dental arch.

OBJECTIVES: To evaluate the space-maintaining capacity of titanium mesh covered by a collagen membrane after soft tissue expansion on the lateral border of the mandible in rabbits, and to assess bone quantity and quality using autogenous particulate bone or bone-substitute (Bio-Oss(®) ), and if soft tissue ingrowth can be avoided by covering the mesh with a collagen membrane.

MATERIAL AND METHODS: In 11 rabbits, a self-inflatable soft tissue expander was placed under the lateral mandibular periosteum via an extra-oral approach. After 2 weeks, the expanders were removed and a particulated onlay bone graft and deproteinized bovine bone mineral (DBBM) (Bio-Oss(®) ) were placed in the expanded area and covered by a titanium mesh. The bone and DBBM were separated in two compartments under the mesh with a collagen membrane in between. The mesh was then covered with a collagen membrane. After 3 months, the animals were sacrificed and specimens were collected for histology.

RESULTS: The osmotic soft tissue expander created a subperiosteal pocket and a ridge of new bone formed at the edges of the expanded periosteum in all sites. After the healing period of 3 months, no soft tissue dehiscence was recorded. The mean bone fill was 58.1±18% in the bone grafted area and 56.9±13.7% in the DBBM area. There was no significant difference between the autologous bone graft and the DDBM under the titanium mesh with regard to the total bone area or the mineralized bone area. Scanning electron microscopy showed that new bone was growing in direct contact with the DBBM particles and the titanium mesh. There is a soft tissue ingrowth even after soft tissue expansion and protection of the titanium mesh with a collagen membrane.

CONCLUSION: This study confirms that an osmotic soft tissue expander creates a surplus of periosteum and soft tissue, and that new bone can subsequently be generated under a titanium mesh with the use of an autologous bone graft or DBBM.

To determine whether it is possible to vertically augment bone utilizing a block graft from compressed titanium granules mainly used previously for contained bone defects and to determine whether there exists a difference in osteoconductive properties between the white and the grey granules. In 11 rabbits, 4 titanium blocks were inserted on each rabbit's skull bone according to a randomized scheme. These blocks were made from standardized compressed titanium granules. Type A: PTG grey, small granules (Pourus Titanium Granules, Tigran, Malmo, Sweden); Type B: PTG grey, large granules; Type C: PTG white, small granules; Type D: PTG white large granules. After 12 weeks, the animals were sacrificed and specimens were collected for histology and mu CT scanning. From both the mu CT and histology, it can be said that bone formation was successfully achieved for all groups, and the granules maintained their volume. The histomorphometric BA (bone area) evaluation in the entire grafted area presented that there were no statistical differences between all groups tested. The lowest 1/4 BA in contact with the rabbit skull presented that groups A and C presented the highest mean BA, and group A presented significantly higher BA than that of group D (p = 0,049). No significant differences were noted between groups A, B and C. Within the limitation of this study, no differences were noted between small white or grey PTG blocks. The large granules presented less bone ingrowth area compared to the small granules and this trend was regardless of the different PTG types. The entire grafted area was not filled with new bone suggesting that bone migration occurred mostly from the existing cortical bone side suggesting contact osteogenesis.

To evaluate the outcome of intraoral soft tissue expansion by measuring the profile change using objective 3D metering equipment and to evaluate localized bone grafting after soft tissue expansion with regard to gain of bone and complications.

The results of a randomised trial with bisphosphonate-coated dental implants have been reported previously. Each patient received one coated and one uncoated implant in a double-blind split-mouth design study. After 6 months of osseointegration, resonance frequency analysis indicated better fixation of the coated implants. Reduced marginal bone resorption was also shown. However, it was not known whether the advantage of the bisphosphonate coating would persist over time. The radiographic results at 5 years after implant installation are reported herein. A blinded investigator measured marginal resorption on fresh radiographs obtained for 14 of the 16 patients (two had died) and compared these with the post-implantation images. Non-parametric statistics were used. All implants functioned well. The median marginal bone loss for control implants was found to be 0.70 mm, which is less than usually reported in the literature. The bisphosphonate-coated implants showed even less resorption (median 0.20 mm). The median difference within each pair of implants after 5 years of use was 0.34 mm (95% confidence interval 0.00-0.75 mm; P = 0.04). The present data suggest that bisphosphonate-coated implants enable prolonged preservation of the marginal bone.

ABSTRACT Autologous bone grafts are considered the gold standard for reconstruction of the edentulous alveolar ridges. However, this procedure is associated with unpredictable bone loss caused by physiological bone resorption. Bisphosphonates are antiresorptive drugs that act specifically on osteoclasts, thereby maintaining bone density, volume, and strength. It was hypothesized that the resorption of bone grafts treated with an ibandronate solution would be less advanced than bone grafts treated with saline. Ten patients who underwent bilateral sagittal split osteotomy were included in a randomized double-blind trial with internal controls. Each patient received a bone graft treated with a solution of ibandronate on one side and a graft treated with saline (controls) contralaterally. Radiographs for the measurement of bone volume were obtained at 2 weeks and at 6 months after surgery. The primary endpoint was the difference in the change of bone volume between the control and the ibandronate bone grafts 6 months after surgery. All of the bone grafts healed without complications. One patient was excluded because of reoperation. In eight of the nine patients, the ibandronate bone grafts showed an increase in bone volume compared with baseline, with an average gain of 126 mm3 (40% more than baseline) with a range of +27 to +218 mm3. Only one ibandronate-treated graft had a decrease in bone volume (8%). In the controls, an average bone volume loss of −146 mm3 (58% of baseline) with a range of −29 to −301 mm3 was seen. In the maxillofacial field, the reconstructions of atrophic alveolar ridges, especially in the esthetical zones, are challenging. These results show that bone grafts locally treated with ibandronate solution increases the remaining bone volume. This might lead to new possibilities for the maxillofacial surgeons in the preservation of bone graft volumes and for dental implant installations. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.

Autologous bone grafts are considered the gold standard for reconstruction of the edentulous alveolar ridges. However, this procedure is associated with unpredictable bone loss caused by physiological bone resorption. Bisphosphonates are antiresorptive drugs that act specifically on osteoclasts, thereby maintaining bone density, volume, and strength. It was hypothesized that the resorption of bone grafts treated with an ibandronate solution would be less advanced than bone grafts treated with saline. Ten patients who underwent bilateral sagittal split osteotomy were included in a randomized double-blind trial with internal controls. Each patient received a bone graft treated with a solution of ibandronate on one side and a graft treated with saline (controls) contralaterally. Radiographs for the measurement of bone volume were obtained at 2 weeks and at 6 months after surgery. The primary endpoint was the difference in the change of bone volume between the control and the ibandronate bone grafts 6 months after surgery. All of the bone grafts healed without complications. One patient was excluded because of reoperation. In eight of the nine patients, the ibandronate bone grafts showed an increase in bone volume compared with baseline, with an average gain of 126 mm(3) (40% more than baseline) with a range of +27 to +218 mm(3). Only one ibandronate-treated graft had a decrease in bone volume (8%). In the controls, an average bone volume loss of -146 mm(3) (58% of baseline) with a range of -29 to -301 mm(3) was seen. In the maxillofacial field, the reconstructions of atrophic alveolar ridges, especially in the esthetical zones, are challenging. These results show that bone grafts locally treated with ibandronate solution increases the remaining bone volume. This might lead to new possibilities for the maxillofacial surgeons in the preservation of bone graft volumes and for dental implant installations.

ABSTRACT

Introduction: Esthetics have become a huge part of dental treatment especially when treating missing teeth slots in the anterior maxilla “esthetic zone”. Today, implant treatment is the main approach to treat missing teeth in the esthetic zone. The treatment result must fulfill functional and esthetical demands from the treating dentist, but mainly from the patient. Esthetic dental evaluation can be performed by using indices like: Pink Esthetic Score (PES) and White Esthetic Score (WES). Esthetics is not a specific subject in dental education, but every dentist has their own opinion about esthetics and one can wonder if the perception of esthetics will change with increased educational level.

Aim: To assess if increased dental educational level affects esthetic evaluation.

Methods: Two intraoral photographs with two different single implant-supported crowns were used. A combination of PES/WES were selected to assess an overall esthetic outcome. Each photograph illustrated the implant supported crown and the peri-implant soft tissue in the position of the central incisor. Specialists, general dentists and dental students were involved to esthetically evaluate these clinical photographs using PES and WES. Two Microsoft forms were sent to 70 participants with these photographs and PES/WES indices to perform esthetic evaluation.

Results: In total 44 participants answered the first form while 42 answered the second. No significant difference was found when comparing how the participants scored PES/WES.

Conclusion: The result from our study found no difference between different educational levels when evaluating the esthetics for implants in the esthetic zone.

AIMS: This study was designed to evaluate the effect of gap width and graft placement on bone healing around implants placed into simulated extraction sockets in the mandibles of four beagle dogs. MATERIALS AND METHODS: Four Ti-Unite implants (13 mm x 3.3 mm) were placed on each side of the mandible. Three implants were surrounded by a 1.35 mm circumferential and a 5 mm deep gap around the coronal portion of the implants. A fourth implant was inserted conventionally into both sides of the mandibles as a positive control. The gaps were filled with either Bio-Oss, autogenous bone or with a blood clot alone. The study design was balanced for animal, side and modality. Ground sections were prepared from biopsies taken at 3 months, and computer-aided histometric measurements of bone/implant contact and area of bone within threads were made for the coronal 5 mm. Data were analysed using analysis of variance. RESULTS: The mean bone/implant contact was 9.8 mm for the control and ranged from 9.3 to 11.3 mm for the three test modalities. The corresponding values for area within threads were 1 mm(2) and 1-1.2 mm(2). Modality had a significant effect on both bone/implant contact (F=16.9; P<0.0001) and area within threads (F=16.7; P<0.0001). CONCLUSION: The results of this study suggest that both autogenous bone graft and Bio-Oss played an important role in the amount of hard tissue fill and osseointegration occurring within marginal bone defects around implants.

Background: Osteoclasts are the cells responsible for bone resorption and they are formed by the fusion of cells from the monocyte/macrophage lineage. The formation of osteoclasts is dependent on various signaling pathways, including those under the control of chemokines and their receptors. In vitro, the expression of C-C chemokine receptor 3 (CCR3) is upregulated during osteoclastogenesis and the lack of Ccr3 gene (Ccr3-/-) leads to an increased size and activity of osteoclasts. The increased size and activity of the Ccr3-/- osteoclasts correlated with an upregulation of the transcripts from the C-C chemokine receptor 2 (Ccr2) and C-C chemokine receptor 5 (Ccr5) genes. 

Aim: The aim of this study is to see if the upregulation of Ccr2 and Ccr5 contributes to the phenotypes of Ccr3-/- osteoclasts. 

Methods: In this study, we used antagonists of CCR2 and CCR5 (RS 504393 and Maraviroc) to investigate the effect of the respective receptor on osteoclastogenesis in Ccr3+/+ and Ccr3-/- cells.  For this experiment we obatianed Bone marrow macrophages (BMMs) from Ccr3+/+ and Ccr3-/- mice for osteoclastformation. tartrate-resistant acid phosphatase (Trap) staining was thereafter added to the cultures to be able to analyze the results visually and statistically.  

Results: At the concentration of 5μM (RS 504393 ) and 7.5 μM (Maraviroc ) the osteoclastogenesis was inhibited. Lower concentrations than 5μM of RS 504393 and 7.5 μM of Maraviroc, the size of the osteoclasts formed in cultures were significantly bigger than those formed in the controls. Further, this effect was largely independent of the genotype of the cells. In addition, the inhibition of CCR2 with RS 504393 suggest that the number of Ccr3+/+ and Ccr3-/-osteoclasts increased compared to the control groups. 

Conclusion: The observation that the inhibition of CCR2 or CCCR5 appears to promote osteoclastogenesis implies that the increased expression of Ccr2 and Ccr5 may not underly the phenotypes of Ccr3-/- osteoclasts. This as the osteoclasts became larger overall when antagonists of each receptor were added. 

Background: Panoramic radiography provides an overview of the teeth, jawbone and surrounding bony/calcified structures. The examination is, however, challenging to perform without errors. Poor-quality panoramic radiographs can result in misinterpretations, repeated or supplementary examinations, increasing the radiation dose.  

Aim: To assess the overall quality of a sample of panoramic radiographs performed in Västerbotten county council and to investigate whether the patients’ gender and/or age influence image quality.

Methods: A total of 274 digital panoramic radiographs were assessed by two observers for the presence of errors, following an assessment protocol. The general image quality was classified and the causes of imaging errors were evaluated.  

Results: The most common error was turned patient head, and the least frequent was the presence of external artifacts. Only five radiographs were without error (1.8%), 31.4% were adequate, 51.5% poor but diagnosable, and 15.3% undiagnosable. No major differences in image quality were found between gender (P=0.138) or between adults and children (p=0.607). Younger children had a significantly higher incidence of image errors compared to older children (P=0.021). The most common cause of undiagnosable radiographs among adults was incorrect tongue position and among children, movement during exposure.  

Conclusion: Image quality in panoramic radiographs performed in Västerbotten county council can improve, since more than every seventh radiograph was considered undiagnosable and less than 2% were deemed excellent. It is more challenging to perform panoramic examinations on smaller children. By reducing the number of image errors, retakes and additional radiation dose to the patient can be avoided.  

Biobased composites were manufactured by using a compression moulding technique. Novel thermoset resins from soybean oil were used as matrix while flax fibres were used as reinforcement. The airlaid fibres were stacked randomly while woven fabrics were stacked crosswisely (90°) and impregnation was done manually. The fibre/ resin ratio was 60% to 40%.

OBJECTIVE: There is a need to develop easy-to-use tools to screen periodontal condition in daily practice. This study aimed to evaluate the FDI World Dental Federation "Chairside Guide" (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening.

METHODS: Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis.

RESULTS: Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001).

CONCLUSION: The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice.

Objective: There is a need to develop easy-to-use tools to screen periodontal condition in daily practice. This study aimed to evaluate the FDI World Dental Federation “Chairside Guide” (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening. Methods: Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis. Results: Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001). Conclusion: The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice. © 2020 The Authors

Aim: To evaluate the effect of different mouth rinses 12 h after rinsing on genuine intra-oral halitosis. Materials and Methods: Twenty-four adults with halitosis were included in a double-blind, crossover, randomized clinical trial. Halitosis was evaluated 12 h after rinsing with placebo and five mouth rinse products containing zinc acetate and chlorhexidine diacetate; zinc lactate, chlorhexidine and cetylpyridinium chloride; zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol; zinc chloride and essential oil; and chlorine dioxide using the organoleptic method and a gas chromatograph. Test periods were separated by 1 week. Results: Hydrogen sulphide (H2S), methyl mercaptan (MM) and the organoleptic scores (OLS) were significantly reduced 12 h following rinsing with all substances compared to placebo (P < 0.05). H2S was more effectively reduced after rinsing with zinc acetate and chlorhexidine diacetate and zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol compared to rinsing with zinc chloride and essential oil (P < 0.05), and significantly lower values of MM were obtained after rinsing with zinc acetate and chlorhexidine diacetate compared to zinc lactate, chlorhexidine and cetylpyridinium chloride (P < 0.05). The percentage effectively treated individuals (H2S (<112 ppb), MM (<26 ppb) and OLS score <2) varied from 58% percentage (zinc acetate and chlorhexidine diacetate) to 26% (zinc chloride and essential oil). Conclusion: All treatments resulted in reduction in halitosis 12 h after rinsing compared to placebo. H2S and MM were most effectively reduced by zinc acetate and chlorhexidine diacetate.

Objectives. To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping. Materials and methods. Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography. Results. Twenty-one subjects with a mean age of 45.7 years (SD: +/- 13.3, range: 21-66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H2S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H2S and MM were found in the active rinse sequence with or without tongue scraping. Conclusion. The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.

Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.

Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.

This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue. Material and methods: A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization. Results: No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone. Conclusions: VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied. Clinical relevance: Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

Objectives: The study aim was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) and acceptance or nonacceptance of such disorders in adult patients attending all public dental health services in the County of Sormland, Sweden, during a 3-year period, 2011-2013.

Methods: Two questions were asked about TMD and the voluntary mouth-opening capacity was measured. The results were registered in a score 0-3. The registration was completed with a question about each patient's acceptance or nonacceptance of their condition.

Results: More than 73,000 registrations of the TMD condition were performed in general dental clinics from 2011 to 2013. The mean prevalence of a TMD score of 1-3 was 5% and was consistent over these years. Seventy percent of these patients were women. The peak prevalence of TMD was registered in patients aged 30-45years (38%), and the frequency declined in older age groups. Reduced voluntary mouth-opening capacity (<= 35 mm) was found in less than 2% of the participants. About one-fifth of the patients with a TMD-score of 1-3 did not accept their condition and wanted professional care. The frequency of nonacceptance of the condition increased with the severity of symptom score: 15%, 27%, and 49% for scores 1, 2, and 3, respectively.

Conclusions: This study shows that the prevalence of self-reported TMD in adult patients was consistent from 2011 to 2013 and should be considered as a public health issue in Sweden. Patients with more severe TMD pain symptoms wanted care more frequent. The annual clinical calibrations should be continued to achieve an acceptable level of registration.