Sammanfattning Syfte: Syftet med studien var att undersöka om böjhållfastheten pålitiumdisilikatbaserad glaskeram som har framställts genom pressteknik påverkasav en energidryck (NOCCO) och apelsinjuice motsvarande 13-års förbrukning. Material och metod: Totalt tillverkades 30 provkroppar genom att pressas i IPSe.max Press®. Provkropparna delades in i tre grupper, varav två grupper utsattesför sura drycker (EMA & EMN) och en grupp som kontrollgrupp (EMK). Antaletprovkroppar var 10 i varje grupp med måtten 12 mm i diameter och 1,7 mm itjocklek. Alla grupper bevarades i varsin behållare fylld med respektive dryck.EMA förvarades i 8°C apelsinjuice, EMN förvarades i 8°C NOCCO focus 4legend soda och EMK förvarades i 37°C destillerat vatten. Efter 14 dygn utsattesprovkropparna för biaxialt böjhållfasthetstest och efteråt analyserades resultatetmed One-way ANOVA, Tukey’s test med en signifikansnivå på α= 0,05. Resultat: Resultatet visade att det fanns en signifikant skillnad mellan grupperna.Testet påvisade att EMK hade lägst medelvärde (215 MPa) och EMA hade högstmedelvärde (432 MPa). Gruppen EMK hade en signifikans i jämförelse medsamtliga grupper medan EMN och EMA inte uppvisade signifikant skillnadgentemot varandra. Slutsats: Följande slutsatser i föreliggande invitro studie kan dras; sura dryckerhar ingen påverkan på böjhållfastheten hos litiumdisilikatbaserade glaskeramerframställt genom pressteknik. / Abstract Aim: The aim of the study is to investigate whether the strength of lithiumdisilicate-based glass ceramics that have been produced by pressing technologyare affected by an energy drink (NOCCO) and orange juice after treatmentcorresponding to 13 years of consumption. Material and method: A total of 30 specimens by IPS e.max Press® weremanufactured, then divided into two groups exposed to acidic beverages (EMA &EMN) and one group was assigned as a control group (EMK) with 10 specimensin each group, measuring 12 mm in diameter and 1.7 mm in thickness. EMA waspreserved with 8 °C orange juice, EMN was preserved with 8 °C NOCCO focus 4legend soda and EMK was preserved in 37 °C distilled water. After 14 days, thespecimens were subjected to biaxial flexural strength and subsequently analyzedwith One-way ANOVA, Tukey's test with a significance level of α = 0.05. Result: The results showed that EMK had the lowest mean (215 MPa) and EMAhad the highest mean (432 MPa). It turned out that EMK had a significance incomparison with all groups, while EMN and EMA have no significant differencefrom each other. Conclusion: The following conclusions are drawn from this in vitro study; acidicbeverages have no effect on the flexural strength of lithium disilicate-based glassceramics produced by pressing technology.

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 objective of this study was to evaluate the faculty perception of case-based learning weekly seminars held in Kuwait University-Faculty of Dentistry. Case-based learning (CBL) has been described in the dental literature as an important method for distilling the basic knowledge learned in texts and lectures and applying it to a patient's circumstances. To enhance the integration between disciplines and minimize isolated learning, the Faculty of Dentistry-Kuwait University created comprehensive dental care 3 (CDC) seminars. Those weekly seminars include real cases presented by fifth, sixth, and seventh-year clinical year students, facilitated by a case-based teaching and learning approach. Literature suggests that a shift to a more problem-based learning curriculum can represent a substantial challenge for many faculty members who may be unfamiliar with the process. This research investigated the experiences and perceptions about CBL of faculty in one dental school. Subjects were invited to volunteer to answer a questionnaire. The survey included 25 "forced choice" questions and three open-ended optional questions. Most participants believed that faculty members do not understand the difference between problem-based learning and case-based learning. In addition, results showed that casebased learning was found to be beneficial not only for students, but also for faculty. Although the majority of the participants agreed that case-based learning was not a useful method for preparing students for written assessments, the majority agreed that case-based learning improves the integration between theory and clinical application. It was noted that case-based learning can be time consuming for both faculty and students. In general, faculty members agreed that case-based learning improves clinical skills, treatment planning skills for comprehensive dental patients, and clinical problem-solving as students progress from their fifth to seventh years.

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.

Periodontitis is a chronic inflammatory condition affecting periodontal tissues, leading to gingival separation and destruction of the periodontal ligament and alveolar bone. Dysbiosis of the oral microbiome leads to microbial accumulation in the form of plaque. This subverts the immune system leading to local destruction and exacerbated inflammation. Daily activities such as tooth-brushing and eating can lead to bacteremia. In the context of periodontitis, dissemination of bacteria and inflammatory mediators increases the burden of systemic inflammation, complexifying noncommunicable diseases when comorbid. Periodontal therapy is relatively safe, minimally invasive, and known to reduce systemic levels of inflammatory markers. We can consider periodontal disease as a manageable risk factor and associate periodontal therapy with a wide range of health benefits. Associations between periodontitis and noncommunicable diseases have been established despite their high prevalence and shared similarities. While we can infer a biological relationship in many cases, more research is needed to establish effective interventions.

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.

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