Aim: To evaluate different parameters potentially affecting the efficacy of air-polishing devices in disinfecting implant surfaces in a non-surgical treatment approach of peri-implantitis lesions. Material and method: Altogether, 56 turned and 56 moderately rough implants were coated with a simulated biofilm. The implants were mounted in customized resin models simulating peri-implant 30° bone-defects, 3- and 5-mm deep; soft tissues were simulated with ballistic gelatin. Each implant was cleaned for 30 or 90 seconds in total (6 sites pr. implant; 5 or 15 seconds pr. site) with one of two different air-polishing devices (W&H and EMS). Implants were photographed in three different angulations and the amount of residual biofilm on the implant surface was measured digitally. Beta-regression models were used to assess the outcome. Results: Implant surface, treatment time and air-polishing device significantly affected the amount of residual biofilm. Turned implant surface, longer treatment time, and using the EMS device resulted in significantly less residual biofilm. In the most apical part of the defect, both air-polishing devices performed similarly, however, this was also the area with most biofilm left compared to more coronal aspects. Defect depth had no significant effect.  Conclusion: Superior biofilm removal is achieved at implants with turned surface, and when applying longer treatment time. At the deepest aspect of the defect, implant decontamination is compromised. / Syfte: Syftet med denna laborativa studie är att utvärdera olika parametrar som potentiellt kan påverka effekten av air-polishing maskiner vid icke-kirurgisk rengöring av implantat för behandling av peri-implantit. Material och metod: Sammanlagt, 56 turned (maskin bearbetade) och 56 moderately rough (måttlig ytråhet) implantat var belagda med en biofilmimitation. Implantaten var placerade i en specialgjord resin-modell som simulerar en 30° bendefektmodell med 3- respektive 5 mm defektdjup; mjukvävnaden simulerades med ballistiskt gelatin. Varje implantat rengjordes i totalt 30 eller 90 sekunder (6 sidor per implantat; 5 eller 15 sekunder per sida) med en av två air-polishing maskiner (W&H och EMS). Implantaten fotograferades sedan ur tre olika vinklar för att digitalt bedöma kvarstående biofilm. Implantatyta, tillverkare, defektdjup och behandlingstid analyserades som prediktionsvariabler för kvarstående biofilm (%). Beta-regressionsanalys användes för att bedöma resultatet. Resultat: Implantat-yta, tillverkare och behandlingstid påverkade mängden kvarvarande biofilmsimulation signifikant. Maskinbearbetade implantatytor, en längre behandlingstid, användande av EMS maskinen, resulterade alla i signifikant mindre kvarvarande biofilm. De två tillverkarna presterade endast lika i de mest apikala delarna av defekten, men detta var också det område med mest kvarvarande biofilm jämfört med mer koronala aspekter. Defekt djup hade ingen signifikant effekt på resultatet. Slutsats: Man kan förvänta sig bättre borttagning av biofilm när man behandlar maskinbearbetade implantatytor samt när man använder en längre behandlingstid.Vid den djupaste aspekten av defekten, äventyras dekontaminering av implantat

Cangrelor is a relatively new antiplatelet drug that has been approved for use as an adjunct therapy to percutaneous coronary intervention (PCI) to decrease peri-procedural myocardial infarction (MI), coronary revascularization, and stent thrombosis. Cangrelor is an adenosine triphosphate analogue with a pharmacokinetic mechanism based on a reversible, dose-dependent inhibition adenosine diphosphate (ADP)-induced platelet aggregation. This drug has lately been in the spotlight as a possible bridge therapy for anti-platelet medication prior to cardiac and non-cardiac surgeries. Platelet function is usually restored within sixty minutes of cessation of therapy, thereby decreasing the risk of bleeding while providing adequate pre-procedural coverage to reduce ischemic events. This manuscript reviews the literature on cangrelor and summarizes its role as a peri-procedural bridge.

This study investigates the prevalence of peri-operative anxiety and the effective management of intra-operative anxiety during awake surgery. Plastic and vascular surgical patients were selected for the study as many procedures performed within these specialities are performed under local or regional anaesthesia. The study consists of two distinct stages. The first stage was a postal survey of patients (n=213) who had undergone awake plastic, renal access or carotid surgery up to two weeks previously, in order to determine retrospectively the prevalence of peri-operative anxiety. The second stage of the study was a randomised controlled trial of interventions for the effective management of intra-operative anxiety in patients (n=128) having undergone the same surgical procedures described in stage one. The interventions tested in stage two were handholding and an anxiety management package involving a relaxation technique and a procedural information leaflet, against a ¿usual care¿ control. The findings from stage one of the study suggest that peri-operative anxiety prevalence is low, although unacceptable levels of anxiety are seen to elevate during the intra-operative phase. The RCT in stage two demonstrated that intra-operative anxiety was no more effectively managed by the interventions tested than by usual care alone. The validity and reliability of retrospective anxiety measurement was investigated by comparing anxiety scores from stage one with contemporaneous and post-hoc anxiety scores from stage two and found to be an accurate measure of anxiety experienced at the time of the event.

<p dir="ltr">In the US, dogs are considered members of the family by many people. Dogs may be obtained from multiple sources, but many in the US originate from commercial breeding kennels (CBKs). Prioritizing adult dogs’ welfare while they are housed in these kennels is essential for their well-being not only while residing there, but throughout the rest of their lives in new environments for those who are rehomed after their breeding careers end. However, the research conducted in this population is scarce. Therefore, evaluating dogs’ overall welfare states and factors that may affect them in this population is crucial.</p><p dir="ltr">Maternal factors are one of many that may affect puppies’ welfare states. This topic has never been directly explored in US CBKs and has been understudied in all domestic dogs. Therefore, this dissertation sought to explore associations between maternal factors and puppy welfare indicators, and related topics.</p><p dir="ltr">Chapter 2 aimed to explore changes in indicators of dams’ welfare states (<i>n</i>= 74), such as behavioral responses to a mild stressor and stress-related physiology, throughout the peri-parturient period in 8 CBKs. The changes observed were most likely due to natural biological changes associated with the peri-parturient period, and no worrisome indicators of welfare were detected. Additionally, Chapter 3 sought to investigate the relationship between dams’ levels of fear and stress (<i>n</i>= 90), as indicated by behavior and stress-related physiology, and metrics indicative of their puppies’ welfare states (<i>n</i>= 390), such as behavior, stress-related physiology, and physical health, in 12 CBKs. Findings suggest some associations between dams’ fear and stress and their puppies’ behavioral responses to isolation, physiology, and physical health. To further explore these associations, Chapter 4 examined the relationships between dams’ (<i>n</i>= 79) and puppies’ (<i>n</i>= 291) behavioral responses to novel social and non-social stimuli in 11 CBKs. No significant associations between dams’ and puppies’ responses were discovered, and possible reasons such as kennel management practices, puppies’ mobility and hazard avoidance, and differences between dams’ and puppies’ early life experiences were discussed. Finally, as the type and level of maternal care dams provide may be indicative of their welfare and may also be related to puppy welfare, Chapter 5 aimed to characterize maternal behaviors in a CBK (<i>n</i>= 12) and working dog population focused on detection work (<i>n</i>= 8). This study uncovered common maternal behaviors in each population, such as nursing and licking puppies. It also revealed that the behaviors observed were consistent with those reported for other dog populations, and found that factors such as day, time of day, litter size, and whelping type may influence their expression.</p><p dir="ltr">Overall, results from these studies suggest that there were no worrisome changes in dams’ welfare states throughout the peri-parturient period. Additionally, dams’ levels of fear and stress may affect potential indicators of their puppies’ welfare states, such as stress-related physiology, behavioral responses to stressors, and physical health. Findings highlight the importance of closely monitoring dams throughout the peri-parturient period for consistent displays of fear and stress, and abnormal behaviors. Doing so may not only affect dams’ welfare but that of their puppies as well. Further, the characterization and exploration of factors that may affect maternal care in various populations provides the basis for future work to explore maternal care as a mechanism behind the significant associations between dam and puppy welfare. The results also provide a foundation for breeders and caretakers to monitor maternal care, and make breeding selection and management interventions as needed to best support dam and puppy welfare. Altogether, findings from this research may have salient implications for dam’s welfare states throughout the peri-parturient period, and puppies’ welfare states while housed with their dams and into adulthood.</p>

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Syfte. Syftet med denna systematiska litteraturöversikt var att undersöka det vetenskapliga underlaget avseende långsiktig stabilitet hos olika typer av benersättningsmaterial i kombination med implantatinstallation.Material och metod. En elektronisk sökning gjordes med hjälp av PubMed och Web of Science. Block med sökord konstruerades och skrevs in i sökmotorerna för att hitta studier med implantatbehandling i kombination med benaugmentation, med en radiologisk uppföljning efter minst 2 år. Funna artiklar granskades i förhållande till förutbestämda inklusions- och exklusionskriterier. Data från inkluderade studier registrerades. Risken för bias i de inkluderade studierna bedömdes enligt modifierade protokoll.Resultat. Den elektroniska sökningen resulterade i 1183 studier, varav 14 studier med antingen autogent, allogent, xenogent eller alloplastiskt benersättningsmaterial inkluderades i denna litteraturöversikt. Resultatet från studierna visade en stor skillnad i både tekniker och material.Slutsats. Den generella slutsatsen i denna studie är att den marginella benförlusten vid dentala implantat som placerats i augmenterat ben inte överstiger 1 mm inom två år. En mer exakt slutsats om den marginella bennivåns stabilitet kunde inte dras på grund av de stora skillnaderna mellan de inkluderade studierna. Det finns ett behov av fler högkvalitativa studier med långtidsuppföljning som undersöker och jämför den marginella bennivåns stabilitet för olika benersättningsmaterial. / Aim. The purpose of this systematic review was to investigate the literature available regarding long-term stability of different bone augmentation materials in combination with dental implant treatment.Material and methods. An electronic search was done using PubMed and Web of Science. Blocks with keywords were constructed and inserted into the search engines to find studies involving implant treatment in combination with bone augmentation, with a radiographic follow-up of at least 2 years. Found articles were reviewed in relation to predetermined inclusion- and exclusion criteria. Data from included studies was extracted. Included studies were assessed of risk of bias according to modified protocols. Results. The electronic search yielded 1183 studies. 14 studies using either autogenous, allogeneic, xenogeneic or alloplastic augmentation materials was included in this review. The results from the data extraction process showed a wide variation in both materials and techniques used.Conclusion. The general conclusion drawn from this study is that marginal bone loss around dental implants placed in augmented bone does not exceed 1 mm within two years post-operatively. A more precise conclusion regarding marginal bone level stability could not be drawn due to the heterogeneity of the included studies. There is a need for additional high-quality studies with long-term follow-up, investigating and comparing marginal bone level stability for different bone augmentation materials.

Tandimplantat utsätts för både tekniska och biologiska komplikationer; de senare innefattar mukosit och periimplantit. Ett stort antal periimplantitbehandlingar har utvärderats, ofta i samband med bensubstitut. Det finns dock ingen konsensus idag om effektiv periimplantitbehandling.Syfte: Syftet med studien är att utvärdera och jämföra om skillnader i behandlingsresultat föreligger när periimplantit behandlas kirurgiskt med bensubstitut eller utan bensubstitut.Material och Metoder: Trettiofyra patienter (22 kvinnor, 12 män) behandlades varav 12 patienter med bensubstitut och 22 patienter utan bensubstitut.Av totalt 198 implantat har 193 utvärderats: Avseende bennivån (100 implantat) Avseende fickdjup (PPD) och blödning vid sondering (BOP) (160 implantat).Resultat: Kirurgisk behandling i form av mekanisk depuration och användning av bensubstitut har bidragit till vinst av bennivån med en statistisk signifikans (p ≤ 0,05). Dessutom kan en statistiskt signifikant förbättring (p ≤ 0,05) av PPD noteras bland patienter som behandlades med bensubstitut jämfört med patienter som behandlats utan bensubstitut.Konklusion: Av de patientfallen i studien är slutsatsen att användning av bensubstitut vid kirurgisk periimplantitbehandling resulterar i betydligt större vinst i bennivå och PPD reducering i jämförelse med endast kirurgisk behandling. Nyckelord: Bensubstitut, Periimplantit, Kirurgisk behandling. / Dental implants are subjected to both technical and biological complications; the latter ones comprise peri-implant mucositis and peri-implantitis. Numerous peri-implantitis treatments have been evaluated, often involving implantation of a bone graft. However, as of today, no consensus exists regarding effective peri-implantitis treatment.Aim: The aim of the study is to retrospectively evaluate if there are differences in treatment results after surgical peri-implantitis treatment with or without a bone graft.Material and Methods: Thirty-four patients (22 female, 12 male) were treated whereas 12 patients were treated with bone graft and 22 patients were treated without bone graft. Out of a total of 198 implants, 193 were evaluated regarding peri-implant bone level (100 implants) and probing pocket depth(PPD) and bleeding on probing (BOP) (160 implants).Results: Surgical treatment including mechanical debridement and implantation of a bone graft contributed to statistical significant (p ≤ 0,05) bone level gain in comparison to the non-grafted group. Additionally, statistically significant (p ≤ 0,05) improvement in PPD could be noted among patients treated with bone graft compared to patients treated without a bone graft.Conclusion: Of the present case series, it can be concluded that implantation of a bone graft during surgical peri-implantitis treatment, results in significant larger bone level gain and PPD reduction comparing to only surgical treatment.Keywords: Bone graft, Peri-implantitis, Surgical treatment.

Introduktion/Bakgrund: Andelen och antalet äldre personer ökar i hela världen. Dagens äldre personer åldras med flera naturliga tänder och tandimplantat än någonsin. Tandimplantat ersätter tänder som ofta förlorats på grund av orala sjukdomar. Riskfaktorerna för orala sjukdomar kan dock kvarstå och till exempel leda till periimplantit. Periimplantitbehandling är avgörande för implantatöverlevnad. För att ytterligare förstå vad som påverkar huruvida äldre personer genomgår perimplantitbehandling genomfördes följande litteraturgenomgång. Syfte var att utforska och kartlägga vilka faktorer som påverkar huruvida äldre personer genomgår periimplantitbehandling eller ej.  Metod: En litteraturstudie utfördes genom att systematiskt söka, identifiera, granska och sammanställa vetenskaplig litteratur gällande ämnet. Systematiska sökningar genomfördes i databaserna PubMed och Cinahl.Totalt identifierades 258 artiklar varav slutligen 9 artiklar inkluderas i resultatet. Urvalsprocessen understöddes av kvalitetsgranskning av artiklarna med hjälp av granskningsmallar. Resultat: Studiens resultat visar att kunskap var en viktig faktor förl att behandla periimplantit- såväl hos tandvårdspersonal som patienter. Andra faktorer som påverkade var tillgång till tandvård, patientens hälsotillstånd och ekonomiska situation. Slutsats: Periimplantit är ett komplext tillstånd och många faktorer påverkar hälsan. Ingen av de identifierade studierna har beskrivit mer samhälleliga faktorer som kan tänkas påverka om periimplantitbehandling genomförs eller ej. Studien visar att fortsatt forskning beträffande periimplantit behövs, till exempel interventioner gällande kunskap och kommunikation samt interventioner på övergripande, mer samhällelig nivå som kan tänkas påverka om periimplantitbehandling utförs eller ej. / Introduction/Background: The proportion and number of elderly people is increasing worldwide. Today´s elderly people are aging with more natural teeth and dental implants than ever before. Dental implants replace teeth that are often lost due to oral diseases. However, the risk factors for oral disease may persist and lead to peri-implantitis. Peri-implantitis treatments is essential for implant survival. To further understand whether older people undergo peri-implantitis treatment or not, this paper was written. Aim: The purpose of the study was to to explore and map factors that affect whether older people with  undergo peri-implantitis treatment or not.  Method: A literature study was carried out by systematically searching, identifying, reviewing and compiling scientific literature on the subject. Systematic searches were carried out in the PubMed and Cinahl databases. A total of 258 articles were identified and 9 articles are included in the results. These were quality reviewed using review templates. Results: The results of the study shows knowledge was an important factor in treatening peri-implantitis- both in staff and patients. Other influencing factors were access to dental care, the patient´s state of health and financial situation. Conclusion: The study shows that peri-implantitis is an area where further research is needed, especially in terms of communication, knowledge and regarding social factors that can affect whether peri-implantitis treatment is performed or not. Especially studies concerning  factors are lacking.

The study investigates the role of religious education in the promotion of girls’ educational rights in peri-urban schools in Chingola district, Zambia. Fifteen schools were involved in the study and are all in the outskirts of Chingola town. Data was collected through oral interviews, questionnaires and observations. Questionnaires were given to 260 girls ranging from grade 5 to 9. Five questionnaires were distributed to each class. Besides the school girls, six instructresses were interviewed on cultural beliefs and practices that hinder girls’ progress in education. In addition, 15 teachers were also interviewed specifically to identify topics in Religious Education and their relevance in the promotion of self-confidence and self-esteem among girls as well as various teaching methods which promote learner-centredness. The Religious Education curriculum at primary, secondary and college levels of education was evaluated to assess its relevance to the promotion of girls’ education. Furthermore, contributions by some Non-Governmental Organisations and Religious Education towards gender equity in education and the Zambian government policy on gender were highlighted. The findings of the study were in four categories namely: cultural beliefs and practices that hinder girls’ progress in education, other problems affecting girl-child education besides cultural norms, freedom to enable girls to make their own constructive decisions, and topics in Religious Education which have the potential to promote self-confidence and self-esteem among the girls. The cultural beliefs and practices highlighted were the initiation ceremonies, early pregnancies and early marriages. The other problems hindering girls’ progress and advancement which came out vividly were long distances from home to school, poverty, boys jeering at girls when they got wrong answers and household chores. Further findings identified topics in Religious Education and their relevance towards the promotion of girls’ educational rights despite the influence of cultural beliefs and practices in the peri-urban schools. Some of the topics were ‘Advantages of having a friend’ taught in grade 1, ‘Growing in responsibility’ taught in grade 2, ‘Bravery and courage’ taught in grade 4, ‘Happiness’ taught in grade 5, ‘Development and co-operation’ taught in grade 6, ‘Marriage and family life’ taught in grade 7, ‘How people make choices’ taught in grade 8, ‘The talents people have’ taught in grade 8, ‘How people develop’ and ‘How religion helps people’ taught in grade 8, ‘Freedom and community’ as well as ‘Ambitions and hopes’ taught in grade 9. In conclusion, the research study has revealed that Religious Education as a subject has the potential to promote the girls’ educational rights and advancement in the peri-urban schools. Other subjects taught like Mathematics, Science and Technology are experimental subjects. They were rigid and cannot be bent while Religious Education leaves room for freedom in making concrete decisions. It deals also with emotions, values, and feelings. Mathematics imposes the facts without query. / Religious Studies / M.A. (Religious studies)