Background: Wisdom tooth surgery is one of the most common dentoalveolar surgical procedure carried out by dentists to remove impacted wisdom teeth. Complications may occur during or after all different types of surgical procedures. At the dentistry program at Umeå University, the students in the 8th term perform operative extraction of a mandibular wisdom tooth under the guidance of an oral surgeon. Although this has been a part of the dental students clinical training for some time, there is no evaluation of the rate of complications that might occur after surgery performed by students. Aim: The aim of this study is to determine if a difference in frequencies and type of complications is present when the operative procedure is carried out by dental students or by oral surgeons. Methods: A retrospective study including data of 74 cases that underwent wisdom tooth surgery done by oral surgeons or dental students at Umeå University Hospital in Sweden. All cases were matched based on age, gender, and degree of difficulty of the surgery and then radiologically evaluated by the authors. Thereafter complications were recorded and divided into subgroups of intraoperative or postoperative complications. Results: The complication rate in total was 31% and there was no significant difference regarding complications between dental students and oral surgeons. Conclusion: As no higher degree of complication rate is present when students perform surgery, the authors of this study advocates continued operative extractions of mandibular wisdom teeth for dental students at the dentistry program at Umeå University.

The aims of the two studies were to survey and describe views of xerostomia among health care professionals and to explore, among afflicted adults; the main concerns associated with xerostomia and attempted remedies. Two empirical studies with qualitative design were conducted. In Paper I, 16 participants were interviewed representing health care professionals with various exposures to patients with xerostomia. The data were subjected to qualitative content analysis. In Paper II, qualitative, conversational style interviews were conducted with 15 participants with subjective complaints of dry mouth. The grounded theory method was applied for data analysis. In the findings (Paper I), the latent content was formulated into a theme: Xerostomia is a well-known problem yet, there is inadequate management of patients with xerostomia. The findings identified three major categories expressing the manifest content: awareness of xerostomia, indifferent attitude, and insufficient support. Health care professionals recognised xerostomia as a common and escalating problem, particularly among elderly. Yet, the problem received little attention. In Paper II, a model was generated to elucidate the main concerns of xerostomia among afflicted individuals and how they handle various aspects of their condition. The core category was labelled: an aggravating misery, meaning that xerostomia has a devastating and debilitating impact on multiple domains of well-being. The model involves three different categories/remedial strategies, namely professional consultation, search for affirmation, and social withdrawal. All three categories express what the participants do to resolve their problems with xerostomia. In general, the participants perceived xerostomia as a burden and as a condition they were constantly reminded of. The participants also expressed a feeling of resignation due to lack of confirmation and support. The findings underscore that xerostomia is not a trivial condition for those afflicted. Oral impairment as well as physical and psychosocial consequences of xerostomia had negative impact on the participants´ qualitative of life. Health care professionals felt that xerostomia was an underestimated problem and that clinical symptoms and subsequent treatment were often ignored. The findings revealed that xerostomia is not only a predicament of the oral cavity but affects the individual as a whole. This is of particular concern among elderly as the occurrence of xerostomia increases with advancing age due to chronic diseases and adverse medications. In summary, it is essential to adopt a holistic view, and to provide additional education and improved interdisciplinary collaboration to manage and care for individuals suffering from xerostomia.

Despite a remarkable reduction in prevalence of dental caries in the developed countries, childhood tooth decay is still a public health problem, and it is well known that children from disadvantaged communities and from minority ethnic groups continue to experience a high level of disease. Even in Sweden there are groups of children in need of early intervention to prevent oral diseases, and especially socially deprived city communities require special attention. Here, preventive strategies adapted to children and families with a multicultural background are needed. The aim of this study was to evaluate a comprehensive oral health programme, based on a High-risk group strategy, and directed towards young children living in a low socio-economic, multicultural area in the city of Malmö, Sweden. The specific aims were to investigate the effect on the prevalence of dental caries after one and three years of intervention, and the impact of parent education and training on various factors related to caries development. 804 2-year-old children were enrolled in the programme and constituted the Intervention group. These children were recalled every 3rd month between ages 2 and 3 years and semi-annually between ages 3 and 5 years for individualized oral health information. Except for the yearly dental examinations the information took place at an outreach facility located in the local shopping area, not in direct connection with the local Public Dental Service clinic. The parent information focused on tooth-brushing and dietary habits, and fluoride tablets were provided free of charge. Clinical examinations were carried out at baseline (2 years of age) and at age 3 and 5 years. On the same occasions the guardians were interviewed with the aid of a structured questionnaire. The results after one year of intervention (3 years of age) were compared with a non-intervention Reference group from the same district consisting of 217 children of the same age. A final comparison between the groups was made at the age of 5, after three years of intervention. The programme significantly reduced the caries increment during the 3 year period of study. The main impact of the programme was noted during the first year of study, the number of caries-free children at the age of 3 (initial and cavitated lesions included) being 37% in the Intervention group as compared with 15% in the Reference group (p<0.001). At the age of 5, the corresponding figures were CV 14% and 6% (p<0.001). At this age, 45% of the children in the Intervention group had cavitated or filled lesions compared with 67% in the Reference group (p<0.001). The self-reported compliance with taking fluoride tables was high in the Intervention group and the difference between the groups was considerable. No difference in the reported use of fluoride toothpaste was found, the use being close to 100% in both groups. A significant positive effect on the dietary habits, recorded as frequent small-eating and sweet drinks at night, was seen after one year of intervention, but no significant difference between the two groups was found after 3 years. The programme had a positive effect on the parents’ brushing habits, but no effect on the oral hygiene level. In conclusion, the study showed that the oral health programme, using conventional caries-preventive measures, significantly improved the oral health situation in this multicultural, low socioeconomic city area of Malmö. The main caries preventive impact was noted during the first year of study, which was haracterized by a more intense preventive intervention. A high compliance with the programme might be explained by the use of an outreach facility for oral health information, located in the centre of the local community.

ABSTRACT Background: An adequate basic hygiene routine has a significant factor in healthcare but also in dental care. This is critical during endodontic treatments that should be carried out under aseptic conditions to provide successful results. In order to prevent and optimize an adequate working environment and cleaning procedures in dentistry, the surfaces on the workplace during dental treatments need to be measured and evaluated. Aim: The aim of this study was to identify which surfaces were most and least contaminated during dental treatments. Methods: This was done in both the student clinic and the specialist clinic for endodontics by swabbing separately on eight selected test surfaces and then using Clean-Trace™ Hygiene Management System that measured the level of contamination. Results: The operation lamp handle was the most contaminated surface before the patient entered the treatment room, while the glove box was the least contaminated. In general, the specialist clinic had more approved values than the student clinic. Conclusion: The surfaces were contaminated and required improvement. This study has mainly a clinical relevance where healthcare professionals should prioritize aseptic practices and follow disinfection guidelines for clinical surfaces.

ABSTRACT  Background Different dental adhesive systems are used in modern restorative dentistry. Older adhesive systems such as etch and rinse systems of generation 4 have been extensively tested and proven reliable, newer adhesive systems such as self-etch systems of generation 7 and 8 have been developed with the aim of improving bonding performance, durability and to be less technique sensitive.  Aim This study aimed to compare the shear bond strength of universal adhesive systems from generation 7 (Futurabond DC) and Generation 8 (Scotchbond Universal, Optibond Universal) with an etch-and-rinse system from generation 4 (Optibond FL). Methods Four groups consisting of six specimens were prepared. The dentine specimens were then treated with four adhesive systems 1. Optibond FL, 2. Optibond Universal, 3. Futurabond DC and 4. Scotchbond Universal. Composite pillars were placed on the specimens and a shear bond strength test was performed. The results were analyzed with SPSS using One-way Kruskal-Wallis test (p<0.05). Results The OptiBond FL adhesive system exhibited the highest bond strength values, while the lowest values were observed in the Futurabond DC group. The results indicated significant differences in bond strength when comparing OptiBond FL to Futurabond DC and Scotchbond Universal (p<0.05). However, no significant difference was found between OptiBond FL and OptiBond Universal (p>0.05). Conclusions The three component etch-and-rinse system showed the highest median value of the systems tested. OptiBond FL and OptiBond Universal showed similar bond strength values, with the latter requiring fewer steps in clinical practice. More studies are needed for long-term durability and reliability.

Purpose The aim of the present retrospective study was to compare the marginal bone loss (MBL)around dental implants in a group of smokers in relation to a matched group of non-smokers. Materials and methods The present dental record-based retrospective study included patients selected fromindividuals treated with dental implants during the period 1980-2018 at one specialist clinicin Malmö. Reproducible periapical radiographs were used to measure MBL after calibrationbased on the inter-thread distance of the implants. MBL was calculated by comparing bone-to-implant contact levels to the radiographic baseline examination. Results After matching of the patients, the study group included 677 implants installed in 204patients, 340 implants in 104 smokers, and 337 implants in 100 non-smokers. The resultssuggested that smoking degree (greater MBL for higher degrees of smoking), bruxism(greater MBL for bruxers), jaw (greater MBL in maxilla), prosthesis fixation (greater MBLfor screw-retained prosthesis), and implant diameter (greater MBL for 3.75mm – 4.10mm)had a statistically significant influence on MBL over time. There appears to be a positivecorrelation between the degree of smoking and the degree of MBL, meaning, the higher thedegree of smoking, the greater the MBL. However, this correlation is more clearly observeduntil a certain limit. The difference is not apparent for different degrees of smoking when thisis high, namely above 10 cigarettes per day. Conclusion Smoking negatively affects the MBL around implants. Other factors that are suggested tonegatively affect MBL are bruxism, implant location (in the maxilla), and screw-retainedimplant-supported prostheses. / Syfte Syftet med denna retrospektiva studie var att jämföra den marginella benförlusten (MBL)kring tandimplantat hos en grupp rökare i förhållande till en matchad grupp icke-rökare.Material och metodDen aktuella tandjournalbaserade retrospektiva studien omfattade patienter utvalda frånindivider som behandlats med tandimplantat under perioden 1980–2018 vid enspecialistkliniken i Malmö. Periapikala röntgenbilder användes för att mäta MBL efterkalibrering baserat på implantatens mellantrådsavstånd. MBL beräknades genom att jämföraben-till-implantatkontaktnivåer med den radiografiska baslinjeundersökningen. Resultat Efter matchning av patienterna inkluderade studiegruppen 677 implantat installerade hos 204patienter, 340 implantat hos 104 rökare och 337 implantat hos 100 icke-rökare. Resultaten antydde att rökningsgrad (högre MBL för högre rökningsgrad), bruxism (högre MBL förbruxers), käke (högre MBL i överkäken), protesfixering (högre MBL för skruvad protes), ochimplantatdiameter (högre MBL för 3,75mm – 4,10mm) hade en statistiskt signifikantinverkan på MBL över tid. Det verkar ha ett positivt samband mellan graden av rökning ochgraden av MBL, vilket innebär att ju högre rökningsgrad desto högre MBL. Dennakorrelation observeras dock tydligare fram till en viss gräns. Skillnaden är inte uppenbar förolika grader av rökning när denna är hög, nämligen över 10 cigaretter per dag. Slutsats Rökning påverkar MBL runt implantat negativt. Andra faktorer som föreslås påverka MBLnegativt är bruxism, implantatplacering (i överkäken) och skruvade implantatstödda proteser.

ABSTRACT Filifactor alocis is a gram-positive rod-shaped bacterium, and several studies have demonstrated that the species is associated with periodontal disease. It has several proteins and properties that makes it a potential partner in crime in a disease process. Here we studied a small collection of 10 isolates of F. alocis, sampled for routine analysis at Oral Microbiology. One of the main questions of this exam project was to investigate if there was any genotypic and/or phenotypic differences between those isolates with potential association with virulence. To examine that we used a selection of laboratory methods, including PCR, SDS-PAGE, Silver-staining, extraction of membrane vesicles, Western immunoblotting and cytotoxicity assays on human macrophages. Our results show that there were both genotypic and phenotypic differences among the 10 strains. For example, they could be divided in two genotypes, based on carriage of gene (here denoted rtx) encoding a protein with similarity to Leukotoxin.  There were also differences in their protein content. Of the two tested F. alocis strains, frozen whole cell extracts from them both showed a similar dose-dependent cytotoxic effect on macrophages.  It also showed that the cytotoxicity did not depend on the rtx gene product since this study was conducted on two F. alocis strains, one with the rtx gene and the other without. In conclusion, our study could come in use in characterizing different F. alocis strains and their virulence factors in order to find future ways to reduce its virulence.

Background   Decision-making within the dental field is an essential factor that influences every aspect of the profession. It is of absolute importance for patients to receive the most suitable treatment for their individual situation. Aim The aim of this study was to examine whether dentists in the county of Västerbotten, Sweden, made suitable therapy choices when faced with teeth with diseases in the dental pulp or in the periradicular tissues. Methods  This was executed by analyzing data from patient journals and deciding whether the chosen treatment was the optimal one or if considered questionable. When faced with questionable treatment choices, the aim was to determine if there was a common denominator between these cases.  Factors taken in consideration when analyzing the journals were the patient’s sex and age, the tooth treated, the total number of teeth including wisdom teeth, x-ray images, cause of the treatment, sex of the dentist responsible and a description of case. In total, 360 patients were analyzed, and 51 were excluded. Result  The result showed that 95% of the analyzed patient cases had a suitable treatment. Conclusion The conclusion was that dentists in Västerbotten make good treatment choices and that it is not possible to draw any conclusions regarding the questionable treatments.

No description available.

Introduktion: Karies är en vanlig sjukdom som drabbar stor del av befolkningen. För att karies ska uppstå behövs tand, bakterier och frekvent intag av fermenterbara kolhydrater. En skyddande faktor mot karies är fluor vilket hämmar demineralisering samt gynnar remineralisering. Det har visats att fluorlack kan förebygga karies men även hämma kariesprogression på viss befintlig karies. Syfte: Att beskriva olika fluorlackers progressionshämmande effekt på karies. Frågeställning: Vilket fluorlack fungerar bäst i progressionshämmande syfte? Metod: En litteraturstudie Resultat: Resultatet visade progressionshämmande effekt av fluorlacker på emalj-, dentin- och rotkaries. Skillnaden mellan flera lackers effekt var på grund av olika lackningsintervall, utvärderingstid och liknande resultat svår att skilja åt. Konklusion: Alla fluorlacker, förutom Prevident (5 % NaF), involverade i denna studie sågs ha progressionshämmande effekt på karies.  Detta tyder på att fluorlackning är bättre än ingen fluorlackning oavsett fluorlack. Duraphat (5 % NaF) sågs i vissa studier ha något bättre effekt än andra fluorlacker.