ABSTRACT: Background: Temporomandibular disorders (TMD) include problems that prevent the complex jaw system from working in harmony. The tool used for assessment of TMD is Diagnostic criteria for temporomandibular disorders (DC/TMD). The DC/TMD is a dual-axis system where axis I assess biological aspects, and axis II is used for psychosocial screening via a questionnaire. In today’s dental care in Sweden, axis II questionnaires are paper based despite evolution of e-services. One rationale for implementing eHealth services in TMD management is to digitalize the excessive axis II questionnaires. Aim: Our aim was to evaluate the use of an interview guide developed for the assessment of how individuals perceive the digital screening in dentistry, focusing on experiences and perceptions. Methods: In total, four volunteer, non-patient participants were included. First, all participants filled out the questionnaires in the analogue and the digital version, respectively. Secondly, and following the interview guide, all participants were individually interviewed with respect to their experiences and perceptions. All interviews were recorded, transcribed verbatim and analyzed using thematic analysis.   Results: In general, the participants expressed a satisfaction with the digital questionnaire as they appreciated it being timesaving and perceived as legitimate.  Conclusions: The findings from the present study show that our interview guide has relevant questions covering areas of interests, and the used methods were found appropriate for use in future evaluations among patients.

Background: The regenerative function of stem cells from the apical papilla (SCAPs) is affected by the presence of bacteria from infected root canals. Living microorganisms influence SCAP function but the effect of inactive bacteria and its components on SCAPs needs further investigation. Aim: To investigate the effect of residual bacterial products on the proliferation of SCAP under anaerobic conditions. Methods: Five opportunistic bacterial strains from infected dental root canals namely Fusobacterium nucleatum, Enterococcus faecalis, Actinomyces gerensceria, Slackia exigua, and Peptostreptococcaceae yuri, and two probiotic strains Lactobacillus gasseri, Lactobacillus reuteri were used in this study. SCAPs collected from three healthy young patients were exposed to UV-inactivated bacteria or bacterial DNA. Real-Time Cell Analyzer (RTCA) was used to determine real-time proliferation of SCAPs after 80 hours exposure of inactivated bacteria or their DNA. Results: UV killed Fusobacterium nucleatum and Enterococcus Faecalis DNA affects proliferation of stem cells from dental apical papilla as monitored in real-time. Inactivated probiotic species do not affect SCAPs in terms of proliferation. Conclusion:  Inactivated bacteria can affect SCAP function by modulating their proliferation. Further investigations studying SCAP modulation and differentiation are warranted to understand and improve regenerative endodontic procedures.

Introduction Dental caries is the most common chronic infectious disease and is associated with plaque, bacteria, diet and saliva. Previous caries experience predicts 1/3 of future caries development. However, there is a lack of knowledge regarding the natural history of caries development at different surfaces and their relative ability to predict caries progression.   Aim The aim of this study was to describe the caries experience and progression of caries at different tooth surfaces during 5 years in patients undergoing orthodontic multibracket treatment. Methods In the previously conducted 452-study, children were examined at 12 and 17 years of age. There were 66 patients with multibrackets at the follow-up who we analyzed. Degrees of caries, fillings and missing tooth were registered in an excel file according to the dental statuses (baseline and follow up).  Excel and SPSS were used to compare the files and create figures.  Results The most affected pair of surfaces at 12 years of age are 36/46 buccally, then occlusally and at 17 years of age 36/46 occlusally and then approximally. The progression of caries and fillings during five years mostly affects 37/47 occlusally and then 17/27 occlusally. A progression also occurred at buccal surfaces 13-23. Conclusion  The results show that occlusal and approximal surfaces at molars experience caries most frequently and the progression is highest for the second molars. There was also a progression of caries noted on 13-23 which could be associated with the multibrackets. This information may be important in future risk assessment models.

Background: Digital impressions are becoming increasingly favored among dentists and dental technicians in Sweden. The knowledge about the use of digital impression techniques is important to improve the clinical work for dentists and dental technicians. However, the conventional impression techniques are still widely used although the digital impression techniques have become more preferred nowadays. Aim: The aim of this survey study was to investigate the use of digital impressions among dentists and dental technicians in Sweden. Pros and cons with the digital impression techniques were investigated as well as the areas in which it is used.  Method: Questionnaires were sent by post to dentists and dental technicians with different questions suited to each profession. The questionnaires were distributed to four regions representing the southern, western, eastern, and northern parts of the country. The questions contained information about the use of digital impressions.   Results: Fixed prosthodontics and the production of mouth guards are areas in which the digital impression techniques are most frequently used. Dentists believed that precision, time saving impression procedure and patient comfort were the greatest advantages with the digital impression techniques. Dental technicians thought that time, cost, possibility to reuse digital impressions and the minimization of the sources of error were the greatest advantages with the digital impression techniques.    Conclusions: The digital impression techniques are widely used among dentists and dental technicians, specifically within fixed prosthodontics and the production of mouth guards.

ABSTRACT Patients with poorly controlled blood sugar levels and type 2 diabetes have been suggested to be at greater risk of tooth decay; however, the number of studies on this topic is scarce. This study aims to evaluate the association between self-reported diabetes, blood sugar levels, and dental caries in Swedish 40-year-old Swedes. Here we utilized the Gene Lifestyle Interactions in Dental Diseases (GLIDE) database, which provides access to self-reported diabetes, blood sugar levels, and the Decay, Missing, Filled Surfaces (DMFS) status in approximately 90,000 individuals. For this study, we identified 1,617 self-reported diabetes patients, and for each case, two sex- and age-matched controls were randomly selected (n = 3,234). Logistic and linear regression were employed, with appropriate adjustment for age, sex, and years between the dental caries examination and the reported diabetic diagnosis. Patients with self-reported type 2 diabetes displayed a 2.2 DMFS increase (p = 0.019). Additionally, increased blood sugar levels were associated with self-reported type (p < 0.001) and an increased DMFS score (p < 0.001). In conclusion, patients with self-reported type 2 diabetes and poorly controlled blood sugar are associated with an increased DMFS score in Sweden.

The purpose of this in vitro study was to investigate and to compare the precision of two different impression techniques for oral prosthetic construction, namely the analogue modified double tray method, and the digital three-dimensional scanning with Trios 3D shape intraoral scanner. The analog method used was a modified double tray method where the tray had been removed to diminish vertical discrepancies in occlusion. All testing was based on a master model with a prepared acrylic tooth from which a total of 20 milled crowns in polymethylmethacrylate was produced, 10 from each impression method.  The fit of the crowns was evaluated according to a clinical protocol and the cement gap was measured with a measuring microscope. Each crown was fitted on to the master model with Flexitime light body, mimicking a cementing procedure. The resulting “cement layer” was after setting of the silicone impression material removed and divided into 4 equal pieces which subsequently were measured in a measuring microscope. Statistical analysis of the resulting measurements showed no significant differences in precision when comparing the impression methods. Because of a manufacturing error in the milling procedure, all of the milled plastic crowns showed suboptimal fit on the master model. However, it was concluded that no statistical - nor clinical difference between the two methods could be established. Most likely, both methods can be used for fabrication of single unit prosthetic reconstructions with adequate precision for effective treatment.

Purpose The purpose of the present study was to assess the clinical outcomes of mandibular overdentures supported by dental implants (ISMO - implant-supported mandibular overdenture) based on a systematic review of the literature.   Materials and methods An electronic search, limited to studies published between 2018-2021, was performed in three databases, supplemented by hand searching of selected journals. Eligibility criteria included clinical human studies, either randomized or not, reporting case series of patients rehabilitated with ISMO. Interval survival rate (ISR) and cumulative survival rate (CSR) of implants and prosthesis were calculated in life-table survival analyses.   Results Sixty studies were included in the review, which reported 2261 ISMOs, supported by 4495 implants. A total of 111 implants and 191 ISMOs failed. The correlation between the survival rate of implants and the number of implants was very weak. Patients with less implants presented higher prosthesis failure rates than patients with more implants per prosthesis. There was no influence of the attachment system on the implant failure rates. The estimated CSR for the implants and the prostheses were 92.2% and 75.6%, respectively (23-year period). Replacement of attachment components was very often needed, as well as relining of the ISMO base. Complete transverse fracture of the ISMO was the most common technical complication.   Conclusion Using only one implant to support a mandibular overdenture is risky and should be avoided. In addition, metal reinforcement of the prosthesis base is recommended to minimize or prevent ISMO fractures, a common technical complication. / Syfte Syftet med denna studie var att undersöka de kliniska effekterna av implantatretinerade täckproteser i underkäken genom en systematisk översikt av befintlig litteratur. Material och metod En elektronisk sökning av studier publicerade mellan år 2018–2021, utfördes på tre olika databaser och kompletterades med en manuell sökning i utvalda tidskrifter. Studier som inkluderades var humana kliniska fall-kontrollstudier på patienter som behandlades med täckprotes. Både randomiserade och icke-randomiserade studier inkluderades. Intervall avöver överlevnadsfrekvensen och den kumulativ överlevnadsfrekvensen för implantat och täckproteser beräknades med hjälp av överlevnadsanalyser. Resultat I denna studie inkluderades 60 kliniska studier med totalt 2261 täckproteser som stöddes av 4495 implantat. Totalt misslyckades det 111 implantat och 191 täckproteser. Korrelationen mellan antal implantat som installerades och deras överlevnadsgrad var inte tydlig, däremot så uppvisade patienter med färre implantat mer omfattande problem med deras täckproteser jämfört med de proteser som stöddes av fler implantat. Val av retentionselement hade ingen påverkan på misslyckade frekvensen av implantaten. Den uppskattade kumulativa överlevnadsfrekvensen för implantaten och proteserna var 92,2 % respektive 75,6 % över en uppföljning på 23 år. Byte av retentionselement var vanligt förekommande och behövde utföras ofta, likaså relining av täckproteserna. Den vanligast förekommande tekniska komplikationen av täckproteser var en komplett tvärgående fraktur. Slutsats Att endast använda ett implantat för att stödja en täckprotes i mandibeln är riskabelt och bör undvikas. Metallförstärkning av protesbasen rekommenderas för att minska eller förhindra frakturer av täckprotesen, vilket var den vanligaste tekniska komplikationen som påträffades.

Syfte: Syftet med studien är att undersöka förekomsten av tekniska komplikationer på behandlingar med implantatstödda rekonstruktioner utförda på Odontologiska Fakulteten, Malmö Universitet. Material och metod: Studien är en retrospektiv journalstudie där journalhandlingar från patienter som erhållit implantatbehandling på Odontologiska Fakulteten, Malmö Universitet mellan 2008 och 2015 och genomgått 5-årsuppföljning. Implantatoperationer utfördes av specialister i oral kirurgi och protetisk behandling samt uppföljning utfördes av studenter. 116 patienters journaluppgifter undersöktes. Patienter som inte hade genomgått 5-årsuppföljning och/eller behandlats med avtagbara implantatstödda rekonstruktioner exkluderades.  Resultat: 107 patienter uppfyllde inklusionskriterierna. 47 patienter (43,9%) fick någon form av teknisk komplikation under sin 5-årsuppföljningsperiod. Den vanligaste komplikationen på patientnivå var chip off-fraktur (26,2%), följt av skruvbrunnsförseglingsförlust (17,8%) och lös broskruv (12,1%). Statistisk signifikans uppnåddes för sambandet mellan suprakonstruktionens utsträckning och chip off-fraktur (p = 0,013) samt fonetiska komplikationer (p = 0,000) Slutsats: Under en femårsperiod inträffade tekniska komplikationer på implantatstödda protetiska rekonstruktioner utförda av studenter vid Odontologiska Fakulteten, Malmö Universitet i hög frekvens (³ 30%). Större rekonstruktioner drabbades statistiskt signifikant oftare av chip off-frakturer och fonetiska komplikationer än mindre rekonstruktioner.  . / Objective: The objective of this study was to examine the frequency of technical complications in dental implant treatments performed at the Faculty of Odontology, Malmö University. Material and method: The present study is a retrospective journal study of patients who had received treatment with fixed implant supported prosthodontics, performed at the Faculty of Odontology, Malmö University between 2008 and 2015, and had gone through three control visits during a five-year follow-up period. All surgery was performed by oral surgeons and prosthodontic treatment and follow-up was performed by students. The records of 116 patients were studied. Patients who hadn’t completed the five-year follow-up period and/or were treated with removable implant prosthodontics were excluded from the study.  Results: 107 patients met the inclusion criteria. 47 patients (43,9%) were affected by at least one technical complication during the follow-up period. The most common complication was chipping (26,2%), followed by loss of access hole restoration (17,8%) and loose prosthetic screw (12,1%). Statistical significance was achieved for the relation between the extension of the superstructure and chipping (p = 0,013) and phonetic complications (p = 0,000). Conclusion: During a follow-up period of five years, technical complications in treatment with implant-supported prosthodontics performed by students at the Faculty of Odontology, Malmö University occurred frequently (³ 30%). Larger prostheses suffered a higher frequency of chipping-fractures and phonetic complications than smaller prostheses. These findings were statistically significant.

Aim: To assess and compile current knowledge and recommendations forinfection prevention and control (IPC) in dentistry during the COVID-19pandemic. Furthermore, to assess whether previous knowledge about IPC hascontributed to constructing evidence-based measures for IPC that can beuniversally applicable. Also, identifying knowledge gaps that need to beaddressed regarding IPC to be used effectively in future pandemics.Method: Searches were made in PubMed, Web of Science, Scopus, Cochrane,and Embase, according to PRISMA guidelines. There were no time or publicationtype restrictions. Studies that met the inclusion criteria were read in full text andresulted in 44 included articles. Quality assessment and risk of bias (RoB) wereperformed using checklists by AMSTAR-2 and ROBIS.Results: The four main recommended measures for IPC in dentistry were: triage,personal protective equipment, antimicrobial mouthwash before the procedure,and surface disinfection. Most of the included studies were literature reviews withlow quality and a high RoB.Conclusion: Measures taken during this pandemic were based on evidence,previous knowledge, and subjective opinions. However, there were limitations inthe included studies as their evidence was of lower quality and had a high RoB.Future research is needed to minimize the risk of infection spreading in dentistryduring the pandemic. The lack of research on SARS-COV-2 was considered aknowledge gap that should be addressed to be used effectively in futurepandemics. This present study shows that IPC policies were to some extent basedon evidence but not regarding the current virus. / Syfte: Syftet med studien var att bedöma och sammanställa nuvarandekunskapsläget samt rekommendationerna för infektionspreventionen och kontroll(IPC) inom tandvården under COVID-19 pandemin. Vidare var syftet attgenomföra en bedömning av huruvida tidigare kunskap om infektionspreventionhar bidragit till att konstruera evidensbaserade åtgärder för infektionspreventionsom kan bli universellt applicerbara. Dessutom, att identifiera kunskapsluckorsom behöver åtgärdas gällande infektionsprevention och kontroll för att effektivtkunna användas för framtida pandemier.Material och metod: Sökningar gjordes i PubMed, Web of Science, Scopus,Cochrane och Embase, enligt PRISMA riktlinjer. Det fanns inga tids- ellerpublikationstypsbegränsningar. Studier som uppfyllde inklusionskriterierna lästesi fulltext och resulterade i 44 inkluderade artiklar. Kvalitetsbedömning och riskenför bias av de inkluderade studierna utfördes med hjälp av checklistor avAMSTAR-2 och ROBIS.Resultat: De fyra främsta rekommenderade åtgärderna för IPC inom tandvårdenvar: triage, personlig skyddsutrustning, antimikrobiell munsköljning föreproceduren samt ytdesinfektion. De flesta av de inkluderade studierna varlitteraturöversikter med låg kvalitet och hög risk för bias.Slutsats: Åtgärder som vidtogs under denna pandemi baserades på både bevis ochtidigare kunskap men också subjektiva åsikter. Det fanns dock begränsningar i deinkluderade studierna på grund av att deras evidens inte var av god kvalitet samthade en hög RoB. Framtida forskning behöver göras för att minimera risken förinfektionsspridning inom tandvården under COVID-19-pandemin. Brist påforskning om SARS-COV-2 ansågs vara en kunskapslucka som måste åtgärdasför att effektivt kunna användas för framtida pandemier.

Aim. The present licentiate thesis investigated the prevalence of TMDpainand related factors, the prevalence and severity of tooth wear, andthe etiology and factors related to tooth wear in adults in southern Sweden.Methods. The methods used included a questionnaire, history, clinical examination,intraoral photographs, and saliva sample. In Paper I, twoscreening questions for TMD pain were used to query a study samplecomprising 6123 questionnaire participants about their pain experience.In Paper II, a clinical examination and intraoral photographs helped determinethe presence and severity of tooth wear. Information from a questionnaire,patient histories, and participant saliva samples were analyzedregarding tooth wear-related factors. The study sample comprised 831 individuals.Results. Paper I found a prevalence of TMD pain once a week or moreoften in 11% of the study sample. Related factors were female gender,subjects under 50 years of age, weekly headache, self-reports of poor generalhealth, impaired oral health-related quality of life, and tooth wear.Paper II showed tooth wear in all individuals. Attrition, the most commontooth wear, was found in over 90% of the study sample. Signs of erosionwere found in almost 80% of the individuals. Men had more tooth wearthan women, but none of the factors that were investigated as related factorsdiffered between the genders. Only some of the individuals, includingthe group with severe tooth wear reported having received information about tooth wear from their clinician. Participants reported receiving informationabout tooth wear due to extensive tooth brushing more thanabout erosion.Conclusions. Paper I found a prevalence of TMD pain in 11% of the studysample. In Paper II, attrition was found in over 90% of the study sample.Almost 80% of the individuals exhibited signs of erosion. Only a few reportedhaving received information about tooth wear due to erosion fromtheir clinician. / <p>Paper I is not included in the fulltext online</p>