Changes occur to the mandible with dental loss and senescence. However, the influence that these changes have on sex and ancestry estimations remains unclear. The purpose of this study was to investigate the influence of dental loss and senescence on changes in mandibular morphology. The outcome has implications for both forensic anthropology and restorative dentistry. The study sample consisted of 717 mandibles consisting of both male and female South Africans of African (SAA) and European ancestry (SAE). To minimise the effects of variation in dentition amongst sex-ancestry groups, the sample included individuals with a spectrum of tooth loss patterns, namely efficient and inefficient occlusions as well as no occlusions. Dentition was considered efficient when the remaining teeth in occlusion were evenly distributed between the sides. Linear measurements as well as geometric morphometric shape analyses were performed. Shape analyses of the complete mandible were performed on models from digitised landmarks by using a MicroScribe G2. Detailed shape analyses of the ramus and chin area as well as measurements of the cortical thickness at specific sites were executed on images generated by cone beam computed tomography (CBCT). A comprehensive assessment of changes in shape, size and cortical thickness of the mandible with age and dental loss were made. Shape and size differences of the mandible were evaluated for discriminant abilities between sex and ancestry groups. Although most dimensions decreased with tooth loss, the greatest impact was noted in the loss of alveolar bone. The mandibular angle increased minimally in size when a few teeth were lost, but recovered to some extent with further tooth loss. The cortical thicknesses at the mental foramen lingually as well as in the midline in females, were relatively spared with tooth loss. Male individuals of SAA were often the most resilient to tooth loss. In general external linear dimensions were maintained with age despite tooth loss. Conversely, measurements of cortical bone thickness decreased slightly, but could have been influenced by dental loss. The shape of the chin and gonial area was more affected by aging in SAE. The sex and ancestry discriminant ability of the linear dimensions when considered collectively approximated 90%, in general improving further when tooth loss was taken into account. All linear measurements were smaller in females and in general tooth loss accentuated sex differences. SAA exhibited greater dimensions, apart from maximum ramus height, bigonial breadth and cortical thickness at the gonion. The mental tubercles were more prominent than the pogonion in SAE (square chin) and vice versa in individuals of SAA (pointed chin). The gonial area in individuals of African ancestry was broad and more convex and the gonial eversion more prominent with a more upright ramus. Discriminant qualities of the gonial shape for sex in individuals of African ancestry reached 90% within dentition groups. Ramus flexure and chin shape were not found to be useful in sex estimation. In conclusion, this research elucidated the effects of tooth loss and senescence on the morphology of the mandible for the forensic anthropological setting. / Thesis (PhD)--University of Pretoria, 2015. / tm2015 / Anatomy / PhD / Unrestricted

Este estudo teve como objetivo avaliar e comparar desgaste dentário e perda dentária de pacientes eutróficos, obesos mórbidos pré cirúrgico, operados com até 24 meses e operados com mais de 36 meses de cirurgia bariátrica. O estudo foi do tipo observacional transversal e analítico com pareamento de sexo e idade. A amostra foi composta por 240 pacientes, (GC) - pacientes eutróficos (N=60), (GO) - pacientes obesos mórbidos (N=60), (G24) - pacientes operados com menos de 24 meses (N=60) e (G36) - pacientes operados com mais de 36 meses (N=60). As variáveis que foram analisadas: sexo, raça, escolaridade, classe econômica, hipertensão, diabetes, triglicerídeos, colesterol, tabagismo, etilismo, idade, IMC, % de perda de peso, perda dentária, desgaste dentário e relação cintura-quadril. Foi aplicada a análise estatística descritiva para obter as frequências absolutas e relativas. Para verificar a associação entre obesidade e os desfechos bucais (desgaste dentário e perda dentária) foi usado o modelo de regressão linear multivariada, Odds ratio (OR) e o intervalo de confiança (IC) de 95%. Não houve diferenças estatisticamente significativas entre os grupos considerando etnia (p=0,135), escolaridade (p=0,108), triglicerídeos (p=0,078), tabagismo (p=0,568) etilismo (p=0,712), dentes perdidos (p=0,686) e o desgaste dentário tanto por sextantes, quanto total (p=0,448). Porém houve desgaste maior entre os sextantes II e V. O GO apresentou menor classe econômica (p=0,012), maior proporção de hipertensão (p<0,001), diabetes (p<0,001), colesterol (p=0,001), IMC (p<0,001) e relação cintura-quadril (p<0,001), % de perda de peso foi maior no G24 comparado ao G36 (p<0,001). Pode-se concluir que indivíduos submetidos à cirurgia Bypass Gástrico em Y de Roux, independente do período de cirurgia, apresentaram mais desgaste dentário nas superfícies incisais/oclusais, sendo que os dentes anteriores foram os mais afetados. O desgaste dentário esteve associado à idade e ao número de dentes perdidos. / The aim of this study was to evaluate and compare dental wear and tooth loss of eutrophic, preoperative, morbidly obese patients operated on for up to 24 months and operated with more than 36 months of bariatric surgery. The study was crosssectional and analytical with gender and age matching. The sample consisted of 240 patients (GC) - Eutrophic patients (N = 60), (GO) - morbidly obese patients (N = 60), (G24) - patients operated on less than 24 months (G36) - patients operated on for more than 36 months (N = 60). The variables that were analyzed were sex, race, schooling, economic class, hypertension, diabetes, triglycerides, cholesterol, smoking, alcoholism, age, BMI, weight loss, dental loss, dental wear and waist-to-hip ratio. The descriptive statistical analysis was applied to obtain the absolute and relative frequencies. The multivariate linear regression model, odds ratio (OR) and 95% confidence interval (CI) were used to verify the association between obesity and oral outcomes (dental wear and tooth loss). There were no statistically significant differences between groups (p=0,135), schooling (p=0.108), triglycerides (p=0.078), smoking (p=0.568) and dental wear by both sextants and total (p=0.448). However, there was greater wear among the II and V sextants. The GO presented lower economic class (p=0.012), higher proportion of hypertension (p<0.001), diabetes (p<0.001), cholesterol (p=0.001), BMI (p<0.001) and waist-hip ratio (p<0.001), % weight loss was higher in G24 compared to G36 (p<0.001). It can be concluded that individuals submitted to the Roux-en-Y obesity surgery, regardless of the surgery period, presented more tooth wear on the incisal / occlusal surfaces, and the anterior teeth were the most affected. Dental wear was more related to age and tooth loss.

BACKGROUND: There is a dearth of studies on the association between diabetes mellitus (DM) and the risk of developing oral health complications in nonsmokers. Recent studies have presented a strong link between smoking and increased risk of periodontal disease in patients with T2DM. This study attempts to look at the risk of developing caries and poor oral health in nonsmokers who also have DM. Male and female subjects from the cross-sectional National Health and Nutrition Examination Survey (NHANES) 2017-2018 study who were 21+ years at the time of entering the study were included. The exposures are DM and smoking, and the outcome is oral health. HYPOTHESIS: DM-IFG will increase the risk of developing dental caries and tooth loss, thus lowering the quality of oral health in smokers compared to nonsmokers. METHODS: DM was defined as either the self-report of a doctor’s diagnosis of DM or a fasting glucose level of 126mg/dL or higher, or both. IFG was defined as a level of fasting glucose between 100mg/dL and 126mg/dL, as well as being informed by a medical doctor about having borderline DM. Subjects with IFG or DM were further combined into a DM-IFG group. Each subject’s status was classified on the basis of both DM-IFG status and smoking status, yielding four exposure groups: (1) no DM-IFG/non-smokers, (2) no DM-IFG/smokers, (3) DM-IFG/non-smokers, and (4) DM-IFG/smokers. Oral health outcomes were defined as a percent of missing teeth (due to dental health issues), percent of teeth with dental caries, and percent of teeth either missing or with caries. The primary statistical analysis for association between DM-IFG and smoking exposures and oral health outcomes was multivariable logistic regression. Adjusted models controlled for covariates such age, gender, Body Mass Index (BMI), education level, minutes of sedentary activity, race, HR, and percent of calories from fat intake. RESULTS: Overall, the prevalence of having 25% or more of teeth with dental caries was similar in those with and without DM-IFG (50.9% vs. 49.9%, respectively) and, surprisingly, was with higher among non-smokers than smokers (51.9% vs. 42.1%, respectively. Those with DM-IFG had a prevalence of missing teeth due to dental causes (≥ 15% missing) of 43.2% compared with a prevalence of 28.6% among those without DM-IFG. Since the majority of missing teeth were likely to be due to caries as well, the final outcome for these analyses consists of participants with either missing teeth or carious remaining teeth. Here, we found that 55.8% of those with DM-IFG had 40% of more of teeth missing vs. 44.8% of those without DM-IFG (p<0.0001). Similarly, 52.1% of smokers vs. 48.8% of non-smokers had more missing or carious teeth (p=0.1587). In the multivariable models, adjusting for age, race, HR, and percent of calories from fat, these analyses showed that DM-IFG alone (among non-smokers) was associated with a 1.42-fold increased risk of missing teeth while smoking along was associated with a 2.86-fold increased risk. The combined effects of the two factors were even stronger. Those who smoked cigarettes and who had DM-IFG (compared with those who did not smoke and had no DM-IFG) had a 3.88-fold increased risk of have 15% or more of their teeth missing due to dental health issues. Lastly, I examined these same effects on the risk of having either missing teeth or dental caries. In these analyses, smokers without DM-IFG had a 67% higher risk (95% CI: 1.27-2.19) of have 40% or more of their teeth missing or with caries while non-smokers with DM-IFG had no excess risk. Finally, those with DM-IFG who also smoked cigarettes had a 52% increased risk (95% CI: 1.08-2.14) of have 40% or more of their teeth missing or with caries compared with non-smokers who did not have DM-IFG. CONCLUSION: These results suggest that smoking was a more important risk factor for having missing teeth or dental caries than was DM or IFG.

Background: The aim of this cross-sectional study was to investigate potential associations between periodontal inflamed surface area (PISA) and tooth loss with disease-related parameters in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Patients who attended the Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany, were included. The oral examination comprised the detection of the number of remaining teeth and periodontal condition based on staging and grading matrix. Based on periodontal pockets with positive bleeding on probing, the periodontal inflamed surface area (PISA) was determined. Disease related parameters were extracted from the patients’ records. Results: In total, 101 (RA) and 32 participants (AS) were included. Patients with RA had 22.85 ± 4.26 and AS patients 24.34 ± 5.47 remaining teeth (p < 0.01). Periodontitis stage III and IV was present in 91% (RA) and 81.2% (AS) of patients (p = 0.04). Associations between PISA and disease-related parameters were not found in both groups (p > 0.05). In RA, a higher age (p < 0.01), C-reactive protein (p = 0.02), disease activity (p < 0.01) and prednisolone intake (p < 0.01) were associated with fewer remaining teeth. In AS, a higher age (p = 0.02) and increased Bath Ankylosing Spondylitis Metrology Index (p = 0.02) were associated with a lower number of remaining teeth. Conclusions: Tooth loss is associated with disease activity, especially in RA individuals. Dental care to prevent tooth loss might be recommendable to positively influence oral health condition and disease activity in RA and SA patients.

Syfte Syftet med denna studie var att undersöka hur tandförlust påverkar den orala hälsorelaterade livskvalitén genom ett OHIP-14 fråge-formulär samt ytterligare konstruerade frågor, bland patienter som besöker Kantipur Dental College and Hospital (KDCH) i Katmandu, Nepal. Material och metod Data erhölls från ett frågeformulär baserat på OHIP-14, kompletterande frågor och klinisk undersökning. Studien var av beskrivande karaktär och undersökte konsekutiva patienter (n=249) som besökte KDCH. Data från ifyllda formulär analyserades genom SPSS för att undersöka sambandet mellan tandförlust och påverkan på livskvalitén. Resultat Medelåldern var 47.6 år med en könsfördelning på 48 % (n=119) män och 52 % (n=130) kvinnor. Det genomsnittliga antalet saknade tänder var 5, och den genomsnittliga totala OHIP-poängen var 21.57 (SD 12.55). De mest påverkade dimensionerna för OHIP-14 var "Fysisk smärta" (77 %) och "Psykologiskt obehag" (82.5 %). 96.8 % av den undersökta befolkningen upplevde någon form av påverkan på deras orala hälsorelaterad livskvalitet. Slutsats Resultaten i denna studie visar att en stor majoritet av patienterna som besöker KDCH upplever någon form av påverkan på sin oral-hälsorelaterade livskvalitet relaterad till tandförlust. De saknade tändernas position hade ingen signifikant effekt på den orala hälsorelaterade livskvaliteten medan en större inverkan på livskvalitén kunde observeras vid ökande antal saknade tänder. De OHIP-poäng, utifrån de kriterier som använts i denna studie, visade sig vara högre i jämförelse med andra internationella fynd. / Aim The aim of this study was to investigate how tooth loss affects the oral health related quality of life through an OHIP-14 questionnaire and additional questions among patients visiting the Kantipur Dental College and Hospital (KDCH) in Kathmandu, Nepal. Materials and method Data was obtained from a questionnaire based on the OHIP-14 form, additional questions and a clinical examination. The study was of a descriptive nature and investigated consecutive patients (n=249) visiting the KDCH. Data from completed forms were analysed with SPSS to investigate how tooth loss affects the oral health related quality of life (OHRQoL) Results Mean age was 47.6 years with a gender ratio of 48 % (n=119) male and 52 % (n=130) female. The mean number of missing teeth was 5, and the mean total OHIP-score was 21.57 (SD 12.55). The most frequently impacted dimensions for the OHIP-14 were “Physical pain” (77 %) and “Psychological discomfort” (82.5 %). 96.8 % of the investigated population experiencing some form of impact on their OHRQoL. Conclusion A large majority of the patients visiting the KDCH experienced an impact on their OHRQoL related to missing teeth. The number of missing teeth had an impact on OHRQoL, but the position of missing teeth had not. The OHIP score with the criteria used in this study was found to be higher in comparison to other international findings.

Att förlora tänder kan ha en stor inverkan på en människas liv. Syftet med denna studie var dels att undersöka hur människor, som söker tandvård på en volontärklinik i Zimbabwe, upplever att förlora sina tänder. Studien berör även vilken effekt detta har på deras liv. Semistrukturerade intervjuer utfördes på volontärkliniken med 19 deltagande patienter. Ett ytterligare syfte var att undersöka hur oralt folkhälsoarbete kan bedrivas i en del av Zimbabwe med lågt socio-ekonomiskt status. Studien omfattar observationer vid skolor på landsbygden, stadsskolor och från volontärklinik. Enligt denna studie är inte antalet tänder korrelerat till tuggförmåga eller sociala och psykologiska livskvaliteter. Det fanns en betydelsefull spridning mellan individer gällande upplevelser och attityder. Det är av stor vikt att utöka offentliga hälsoprogram inom dessa områden för att etablera en långsiktigt positiv effekt på patienters munhälsa. Det största problemet i framtiden är att få information och instruktioner att leda till en permanent förändring av hälsorelaterade vanor. / Tooth loss may have a big impact on a person’s life. The aims of this study were twofold: examine how people, when seeking dental care at a volunteer clinic in Zimbabwe, experienced losing teeth and the subsequent effects of this on their lives. For this purpose, semi-structured interviews were conducted at a clinic in Zimbabwe with 19 patients participating. To examine how oral public health work can be pursued in a rural part of Zimbabwe observations at rural schools, city schools and from the volunteer clinic were performed. According to this study, chewing ability, different social and psychological qualities of life was not correlated to the number of remaining teeth. There was a considerable variation between the individuals own experiences and attitudes.It is of great importance to expand the public health programs in these areas to establish a long-term positive effect on the patient’s oral health. The main problem in the future is to get the information and instructions to lead to a permanent change of patients' health care habits.

No description available.

Bakgrund: Den orala hälsan har förbättrats i Sverige de senaste åren och den oral hälsan är en del av den allmänna hälsan. Parodontit är en inflammatorisk parodontal sjukdom och sjukdomstillståndet progredierar utan behandling. Trots att den orala hälsan har förbättrats med åren, har många individer en hög risk för att utveckla sjukdomen. Parodontit har koppling till flertalet systemiska sjukdomar och demens. Alzheimers sjukdom [AS] är den vanligaste typen av demens. Även fast AS är en vanlig demenssjukdom, är patologin kring sjukdomen inte fullständigt klarlagd.  Syfte: Att undersöka samband mellan parodontit och utvecklingen av Alzheimers sjukdom. Metod: Arbetet är en litteraturstudie som är byggd på vetenskapliga artiklar från databaserna PubMed och CINAHL. Inkluderings- och exkluderingskriterier har använts för att få fram artiklar som svarar mot syftet. Relevansmall och kvalitetsgranskningsmall för exponeringsstudier från SBU har använts för att få fram artiklar av god kvalitet. Resultat: Litteraturstudiens resultat är indelade i skilda rubriker för att påvisa artiklarnas varierande resultat. Resultatet presenteras genom följande teman: ”Parodontit och högre risk för AS”, ”Kognitiva test”, ”Mikrobiell nivå” samt ”Oklart samband mellan parodontit och AS”. Totalt redovisas 15 artiklar. 13 artiklar påvisar ett samband mellan sjukdomarna, medan 2 artiklar inte påvisar något samband.  Slutsats: Majoriteten av artiklarna visade att parodontit kan bidra till utveckling och progression av demenssjukdomen AS. Två artiklar påvisade inget samband. / Background: The oral health has increased in Sweden the past years and the oral health is a part of the general health. Periodontitis is an inflammatory periodontal disease. Even though the oral health has generally improved over the years, several individuals have a high risk of developing periodontal disease. Periodontitis has relationship with several systemic diseases and dementia. Alzheimer’s disease [AD] is most common type of dementia, but the pathology of the disease is not yet clarified.  Aim: To study the relationship between periodontitis and the development of Alzheimer’s disease. Method: This literature study is based on scientific articles from the databases PubMed and CINAHL. Inclusions- and exclusions criteria has been used to obtain articles related to the aim. Relevant templates and quality reviews of exposing studies from SBU has been used to obtain articles of good quality. Results: The literature study’s results are divided into different headlines with the purpose to demonstrate the different results of the articles. The results are presented in following themes: “Periodontitis and risk of AD”, “Cognitive tests”, “Microbial level” and “Unclear connection between periodontitis and AD”. A total of 15 articles is presented. 13 of these articles demonstrate a relationship between the diseases, while 2 articles did not show a connection. Conclusion: Most of the articles showed that periodontitis can contribute to the development or progression of AD. Two articles did not show a relationship.

We aimed to evaluate possible factors influencing the long-term survival of teeth after tumor therapy to the head and neck region with and without radiation. Between January 2019 and January 2020, patients who underwent for head and neck cancer and received dental treatment before and after at the Department of Prosthetic Dentistry of the Martin Luther University Halle- Wittenberg were enrolled in the study. Clinical examination with assessment of dental status and stimulated salivary flow rate (SFR) was performed and information about disease progression and therapy was retrieved from medical records. Of 118 patients (male: 70.3%; mean age: 63.2 12.4 years), 95 received radiotherapy (RT), and 47 were administered radio-chemotherapy (RCT). The teeth of irradiated patients exhibited a lower 5-year survival probability (74.2%) than those of nonirradiated patients (89.4%). The risk of loss (RL) after RT increased with nicotine use, presence of intraoral defects, reduced SFR, RCT and regarding mandibular teeth, and decreased with crowning following. Lower SFR increased the RL even without RT. Consideration of patient’s treatment history, individual risk profile, and clinical findings during the prosthetic planning phase could enable earlier, more targeted dental treatment after (e.g., timely crowning).

A periodontite agressiva (PA) é uma doença que acomete uma população mais jovem, com aspectos clínicos e radiográficos característicos. Possui 2 formas de apresentação: localizada (PAL) e generalizada (PAG) que apresentam padrões distintos. É uma doença que pode provocar perdas dentárias precocemente, levando ao comprometimento estético, funcional e social. É fundamental que se estabeleça um programa adequado de manutenção periodontal (MP) após o tratamento, para impedir ou retardar a progressão da doença. Os objetivos desse estudo foram avaliar os parâmetros clínicos periodontais: profundidade clínica de sondagem (PCS), nível clínico de inserção (NCI), sangramento à sondagem (SS), mobilidade e perda dentária, de 39 pacientes, por um período de 5 anos (realizando as avaliações no início, 1 ano, 3 anos e 5 anos após a conclusão do tratamento ativo, que consistiu de tratamento mecânico - raspagem e alisamento radicular - orientação de higiene bucal e antibioticoterapia - metronidazol e amoxicilina). As consultas de MP foram feitas trimestralmente durante os 5 anos. Como conclusão verificou-se uma melhora dos parâmetros clínicos periodontais em ambos os grupos, bem como, uma pequena quantidade de dentes extraídos por motivos periodontais (5%), mostrando a efetividade do tratamento e das consultas de MP. / Aggressive periodontitis (AP) is a disease that affects a younger people, with typical clinical and radiographic aspects. It has 2 forms of presentation: localized (LAP) and generalized (GAP) which have different patterns. It is a disease which can cause early tooth loss, induce to aesthetic, functional and social impairment. It is decisive that an appropriate periodontal maintenance (PM) program be established after treatment to prevent or delay the progression of the disease. The aim of this study was to evaluate the periodontal clinical parameters: probing of depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), mobility, tooth loss, of 39 patients, for a period of 5 years ( performing evaluation on baseline, 1 year, 3 years and 5 years after the end of the active treatment, which consisted of mechanical treatment - scaling and root planning - oral hygiene orientation and antibiotic therapy - metronidazole and amoxicillin). PM appointments were made quarterly during the 5 years. As conclusion, there was an improvement in periodontal clinical parameters in both groups, as well as, a small quantity of teeth extracted by periodontal causes (5%), showing the effectiveness of the treatment and the PM appointments.