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To assess the efficiency of AI methods in finding radiographic features in Endodontic treatment considerations. This review was based on the PRISMA guidelines and QUADAS 2 tool. A systematic search was performed of the literature on cases with endodontic treatments, comparing AI algorithms (test) versus conventional image assessments (control) for finding radiographic features. The search was conducted in PubMed, Scopus, Google Scholar and the Cochrane library. Inclusion criteria were studies on the use of AI and machine learning in endodontic treatments using dental X-rays. The initial search retrieved 1131 papers, from which 24 were included. High heterogeneity of the materials left out a meta-analysis. The reported subcategories were periapical lesion, vertical root fractures, predicting root/canal morphology, locating minor apical foramen, tooth segmentation and endodontic retreatment prediction. Radiographic features assessed were mostly periapical lesions. The studies mostly considered the decision of 1–3 experts as the reference for training their models. Almost half of the included materials campared their trained neural network model with other methods. More than 58% of studies had some level of bias. AI-based models have shown effectiveness in finding radiographic features in different endodontic treatments. While the reported accuracy measurements seem promising, the papers mostly were biased methodologically. [ABSTRACT FROM AUTHOR]

Rapid maxillary expansion (RME) is a routine method for correcting transverse maxillary deficiency. This paper investigated the effect of RME on anchorage alveolar bone and examined the differences between micro-implant-assisted RME and conventional RME. Relevant articles were selected from the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Review Manager software (v.5.3) was used for the pooled analysis and Cochran Q and I2 statistic tests were used to assess the heterogeneity. Following conventional RME, the distal buccal alveolar bone thickness and the mesiobuccal alveolar thickness of the maxillary first molars were significantly reduced. Hyrax (standard mean difference [SMD]: −0.93, 95% confidence interval [CI]: −1.20–0.66) and Haas procedures (SMD: −0.88, 95% CI: −1.40–0.36) significantly reduced the buccal vertical alveolar height of the maxillary first molars. Similar results were obtained for the maxillary first premolars following RME. The thickness of the buccal alveolar bone decreased with conventional RME compared to when using the method assisted by micro-implants. Conventional RME can reduce the thickness and vertical height of maxillary alveolar bone, and there is less loss of alveolar bone when using micro-implant-assisted RME. Further research is needed to validate the findings. [ABSTRACT FROM AUTHOR]

The paper reports the demographic characteristics of patients with lichenoid lesions affecting only the upper labial mucosa, with or without associated lesions in the maxillary anterior gingiva, alongside the lesions' clinical and histopathological features, treatment, follow-up and prognosis. Also, a new case with lengthy follow-up is presented. A systematic review was performed in line with PRISMA guidelines. The literature search sources were PubMed, Scopus and Web of Science. In all, 26 patients (21 women, 5 men) were included in the review. 80.8% (n = 21) of the labial lesions were clinically erythematous and 19.2% (n = 5) were accompanied by white striations. The gingiva was affected in 46.2% of cases. All patients (100%, n = 24) reported symptoms. All of the lesions presented histological features of lichenoid inflammation. Granulomas were noted in 65.4% (n = 17) of the lesions. Topical corticosteroid was the most frequent therapy (89.5%, n = 17). Lichenoid lesions found solely in the upper labial mucosa, with or without adjacent gingival lesions, are rarely reported in the literature, and the reporting is often incomplete. A definitive aetiology could not be established for the lesions. Likewise, there is little information about this condition's long-term prognosis. [ABSTRACT FROM AUTHOR]

With an increased number of questionnaire-based knowledge, attitude, practice and other types of studies, there is a need to perform evidence-based research in such designs as well. The systematic reviews (SR) and meta-analyses (MA) of the questionnaire-based studies are difficult to conduct and summarise due to the wide variations in the questions included in each of them. The presentation of these reviews often leads to ambiguous conclusions, and meta-analysis is not possible due to wide heterogeneity. This paper aims to highlight a method known as the 'Knowledge-Attitude-Practice' or 'KAP' Heat Map, which was developed and validated for the effective presentation of the outcomes of varied questionnaires in systematic reviews. [ABSTRACT FROM AUTHOR]

This paper describes and reports the patient-specific characteristics of an urgent dental care clinic for COVID-19 infected, suspected, exposed or quarantined patients from March to December 2020 in the Hospital District of Helsinki and Uusimaa, Finland. The triage and the treatment protocol were established based on the scientific data. Patient files were evaluated from the hospital district's electronic medical record system. IBM SPSS software was used for statistical analysis. There were 1114 consultations and 257 visits at the clinic. Most of the patients were generally healthy with mean age of 35, had toothache and were suspected to be SARS-CoV-2 positive. Seventeen of the patients received positive tests for COVID-19 infection. The main treatment was tooth extraction, mostly due to caries. Statistically significant differences between COVID-19 infected and other patients occurred in age (45 vs 34 years-of-age, p =.009) and number of teeth (25 vs 28, p =.031). No SARS-CoV-2 infection transmission chains were traced to the clinic. During the challenging pandemic time, patients were carefully screened by specialists in clinical dentistry and treated safely and effectively. Patient-specific characteristics revealed no differences between COVID-19 infected and other patients in terms of symptoms or treatment needs. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to identify the 100 top cited systematic reviews and meta-analyses on dental journals so as to gain insight into the influential publications in dentistry.Material and methods: The Web of Science was used to comprehensively identify the 100 most cited papers without year and language restriction. Specific parameters regarding the title, journal, publication year, authors, country of origin, institution and university, collaborations, keyword analysis and field of study of each manuscript were retrieved.Results: The citations ranged from 642 to 140. The most productive years were 2008 and 2009. The majority of top cited papers were published in Clinical Oral Implants Research and Journal of Clinical Periodontology. The leading countries were United States, followed by Switzerland. The University of Zurich was the most productive institution with 8 articles. Major topics of interest in the top 100 most-cited papers were dental implants and periodontology. The most frequently occurring keywords were systematic review, dental implants and meta-analyses.Conclusions: Systematic reviews published in high impact factor Dental journals focused on implantology and periodontology had the highest citation rates. Obviously, the top cited list is dynamic, as scientific interests and research tendencies evolve over the years. [ABSTRACT FROM AUTHOR]

Objective: A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists' autonomy and whether the government's political intentions can be fulfilled.Material and Methods: The paper is based on documents from government authorities and professional theories.Results: The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists' professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations.Conclusions: This article shows that the state's governance does not directly detail dentists' work, which indicates a balance between state governance and dentists' autonomy. However, further research is required to get knowledge on Swedish dentists' view of the governance. [ABSTRACT FROM AUTHOR]

Background: Academic detailing (AD) is a defined form of educational outreach that can be used to influence decision making and reduce unwarranted variation in healthcare delivery. This paper describes the results of the proof of concept phase of the ADVOCATE Field Studies. This study evaluated the feasibility, acceptability and usefulness of AD reinforced with feedback data, to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs). Methods: In the Field Studies, six groups of GDPs (n = 39) were recruited in The Netherlands, Germany and Denmark. Each group had four meetings reinforced with feedback data for open discussions on dental practice and healthcare delivery. Conventional and directed content analysis was used to analyze the qualitative data collected from focus group interviews, debriefing interviews, field notes and evaluation forms. Results: A total of nine themes were identified. Seven themes related to the process of the Field Studies and covered experiences, barriers and facilitators to AD group meetings, data collection and the use of an electronic dashboard for data presentation and storage. Two themes related to the outcomes of the study, describing how GDPs perceived they made changes to their clinical practice as a result of the Field Studies. Conclusions: The ADVOCATE Field Studies approach offers a novel way of collecting and providing feedback to care providers which has the potential to reduce variation oral healthcare delivery. AD plus feedback data is a useful, feasible approach which creates awareness and gives insight into care delivery processes. Some logistic and technical barriers to adoption were identified, which if resolved would further improve the approach and likely increase the acceptability amongst GDPs. [ABSTRACT FROM AUTHOR]

Objective: When dealing with the impact of malocclusion on self-esteem, the terms global and dental self-esteem are sometimes used. Although these terms are related to one another, they do not depict the same concept. The aims of this paper were to explore if the two forms of self-esteem are distinguishable, to find out if they represent different factors, and to investigate how they are related to malocclusion. Materials and methods: A sample consisting of 150 adolescents, aged 13 years, completed self-assessed measures of Dental and Global Self-Esteem. Orthodontic treatment need for each individual was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC). Data were analysed by factor analyses and a 5 (IOTN-DHC grades) by 2 (global vs. dental self-esteem) ANOVA, with the IOTN-DHC grades as the independent and self-esteem (repeated measure) as the dependent variables. Results: The factor analyses showed that the two forms of self-esteem, based on the measures, are distinguishable. More importantly, the results of the ANOVA revealed that Dental and Global Self-Esteem are differentially related to IOTN-DHC. Specifically, Dental Self-Esteem varied across IOTN-DHC scale while Global Self-Esteem did not. There was no effect of gender. Conclusions: Dental self-esteem is related to malocclusion while global self-esteem is not. These findings have implications in areas where the predictive power of dental self-esteem needs to be considered. [ABSTRACT FROM AUTHOR]

Background: Academic detailing (AD) is a defined form of educational outreach that can be deployed to intrinsically motivate practitioners towards improving quality of care. This paper describes the design of the ADVOCATE Field Studies. This proof of concept study aims to evaluate the feasibility, acceptability and usefulness of AD, reinforced with feedback information to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs). Methods: Six groups of GDPs will be recruited; two groups of six to eight GDPs in each of three countries - the Netherlands, Germany and Denmark. GDPs will meet for four Academic Detailing Group (ADG) meetings for open discussions using comparative feedback data to stimulate debate about their dental practice performance and care delivery. Group meetings will be moderated using the AD methodology. Qualitative data will be collected through focus group interviews, an online discussion forum, field notes and debriefs of ADG meetings and analysed by conventional content analysis using MaxQDA software. Discussion: The results of the study will provide novel information on the feasibility, perceived acceptability and usefulness of AD and feedback data for GDPs to improve oral healthcare delivery. [ABSTRACT FROM AUTHOR]

Objectives. Statistical methods play an important role in medical and dental research. In earlier studies it has been observed that current use of methods and reporting of statistics are responsible for some of the errors in the interpretation of results. The aim of this study was to investigate the quality of statistical reporting in dental research articles. Methods. A total of 200 articles published in 2010 were analysed covering five dental journals: Journal of Dental Research, Caries Research, Community Dentistry and Oral Epidemiology, Journal of Dentistry and Acta Odontologica Scandinavica. Each paper underwent careful scrutiny for the use of statistical methods and reporting. A paper with at least one poor reporting item has been classified as 'problems with reporting statistics' and a paper without any poor reporting item as 'acceptable'. Results. The investigation showed that 18 (9%) papers were acceptable and 182 (91%) papers contained at least one poor reporting item. Conclusions. The proportion of at least one poor reporting item in this survey was high (91%). The authors of dental journals should be encouraged to improve the statistical section of their research articles and to present the results in such a way that it is in line with the policy and presentation of the leading dental journals. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the presence of Enterococcus faecalis in primary teeth with primary root canal infections and related to the possible failure of pulpectomy outcome after 36 months.Material and Methods: Root canal samples were obtained from 25 out of 244 patients using the sterile paper cone method. The identification of E. faecalis was done with culture and molecular tests using species-specific 16S rRNA gene-based polymerase chain reaction (PCR). After 36 months, the pulpectomy outcome was evaluated.Results: Enterococcus faecalis was found in five (20%) samples, and dental caries were the cause of primary infection in all of them. Pulpectomy outcome was evaluated only in teeth that completed the entire clinical protocol and were followed up to 36 months (n = 8). From these, 75% (n = 6) were successful and 25% (n = 2) failed. E. faecalis was present in 50% of both successful and failed cases.Conclusions: Enterococcus faecalis was not related to the failure of endodontic treatment of primary teeth. [ABSTRACT FROM AUTHOR]

Objective. This paper aims to provide a systematic review of the caries-prevention effect of fluoridated food, excluding water. The main aim of this review was to evaluate the presence of scientific evidence relating to the effects of fluoride intake via food on the occurrence of carious lesions. The outcome was defined as a clinical outcome, so only papers evaluating a decrease in caries indices were included. Materials and methods. Relevant databases (Medline®, Embase®, The Cochrane Library) were searched. The date range was set from 01.01.1966 to 03.31.2011. One hundred and thirty-nine reports were identified and assessed. Only three papers fulfilled the inclusion criteria and were discussed in detail. Results. No paper related to the use of fluoridated salt in caries prevention fulfilled the inclusion criteria. The use of milk as a vehicle for providing additional fluoride in a dental public health programme was evaluated in two papers. The consumption of fluoridated milk was an effective measure to prevent caries in the primary teeth. The use of fluoridated sugar demonstrated a reduction in caries increment in the permanent dentition in one paper. Conclusions. Literature on the effectiveness of fluoridation in foods in caries prevention is scant and almost all the studies have been conducted in children. There is low evidence that the use of milk fluoridation is effective in reducing the caries increment. [ABSTRACT FROM AUTHOR]

Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the systemic antibiotic usage in the perioperative period of periodontal flaps and its relevance to the infection after surgeries through reviewing the papers of the last decade.Materials and Methods: A search was conducted for the studies of randomized clinical trials between 2005 and 2014 that reported periodontal flaps in chronic periodontitis patients. Data were extracted and the rate of the systemic antibiotic use, the infection rate after surgeries and the number needed to treat (NNT) to prevent one infected case were calculated. The impact of antibiotic use and materials used in surgeries on the infection was evaluated.Results: Eighty-three trials were included. Antibiotics were used in 73.7% of the patients and 75.4% of the flaps. Infection occurred in only five flaps where enamel matrix proteins (EMD) or EMD + bone grafts were used in intrabony defects. Only 0.170% of the surgeries got infected in total. When all kinds of surgeries were included for analysis, the infection rate was 0.073% for the surgeries using antibiotics, which was lower than the infection rate 0.693% for the surgeries not using antibiotics (p < .05). The infection rate was very low in general. NNT was 203 when all the surgeries were included for analysis. Therefore, the difference of the infection rates between using antibiotics and not might lack clinical significance.Conclusions: Considering the very low incidence of the infection and the disadvantages of the systemic antibiotic use, we suggest not using systemic antibiotics in the perioperative period of periodontal flaps to prevent infection. [ABSTRACT FROM AUTHOR]

Objective: Concerns over adverse effects of mercury released from dental amalgam sometimes lead patients to request removal of their amalgam restorations. Several studies report improvement of subjective health after removal of amalgam restorations, but the mechanisms are unclear. The aim of this paper is to present data on long term changes in intensity of health complaints after amalgam removal in a group of patients with health complaints self-attributed to dental amalgam. Data from the five years follow-up in a clinical trial are presented and related to potential determinants of change.Materials and Methods: Patients previously referred to a specialty unit for health complaints attributed to amalgam restorations were included in the study. The 20 participants who were allocated to the treatment group had all amalgam restorations removed and replaced with other dental restorative materials. Intensity of health complaints was calculated from questionnaire data and personality variables were measured by MMPI-2.Results: At the follow-up five years after the amalgam removal was completed, intensity of general health complaints was significantly reduced (p=.001), but the symptom load was still high. The reduction was significantly correlated with concentration of mercury in urine at pre-treatment. There were no significant correlations with personality variables.Conclusions: Removal of amalgam restorations was followed by a long term reduction of general health complaints, which was associated with mercury concentration in urine before amalgam removal. Additional studies are needed to confirm the potential mechanisms for the observed reduction. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the scientific evidence regarding laser technology for removal of carious tissue. Material and methods. A search for literature on the effect of treatment and on economic aspects of laser technology identified 23 papers. No relevant studies on economic aspects were found. Regarding the effect of treatment, 16 papers were selected for assessment according to established criteria. Results. Cavity preparation and caries excavation by erbium laser were evaluated in three studies of medium quality. The time required to remove carious tissue was evaluated in five studies assessed as being of medium quality for this outcome. In four studies the effect of laser treatment on the dental pulp was included as an outcome but, due to the short follow-up time, the quality was assessed as low. Two studies that included the longevity of the restoration as an outcome were also assessed as being of low quality because the follow-up time was inadequate. Patient response was evaluated in three studies, which were assessed as being of medium quality with respect to this outcome. Conclusions. There is limited scientific evidence that laser treatment is as effective as a rotary bur for removing carious tissue. Treatment time is prolonged. There is limited scientific evidence that adults prefer laser treatment. No conclusions can be drawn regarding biological or technical complications, children's perception of laser treatment or the cost-effectiveness of the method. [ABSTRACT FROM AUTHOR]

Objectives. The aims of this literature review are to provide answers to questions on how to improve bonding between titanium and dental porcelain and how to further implement, in clinical practice, ceramic-veneered titanium as an alternative to conventional metal–ceramic systems. Material and methods. A literature search of PubMed and also among referenced published scientific papers was performed and 24 fulfilled the search criteria, namely mentions of titanium, ceramics and bond strength. These papers were compiled for comparison and evaluated regarding the bond strength achieved with different methods. Results. The results strongly indicate that there are possibilities to improve both the present materials and methods for titanium–ceramic veneering. Conclusions. The results indicate that present knowledge is sufficient to conclude that veneering titanium with low-fused porcelain for crowns and fixed partial dentures can be recommended for routine clinical use. [ABSTRACT FROM AUTHOR]

Objective. Oral health-related quality of life (OHRQoL) is considered an important aspect of different oral conditions. It has also gained increased attention in temporomandibular disorders (TMDs) in recent years. The purpose of this study was to systematically review the literature on OHRQoL and TMDs. Material and methods. A systematic search of the dental literature was performed using the Medline and Cochrane Library databases, supplemented by a hand search. Various combinations of search terms related to OHRQoL and TMDs were used. Among numerous titles found in Medline, abstracts and eventually full papers of potential interest were reviewed. Twelve papers fulfilled the inclusion criteria and were included in the review. Results. Most studies used the Oral Health Impact Profile, an instrument with good psychometric properties, for evaluation. All articles described a substantial impact on OHRQoL in TMD patients. Only a small proportion of all patients, a few percent, reported no impact at all. The difference between men and women was small and not significant. The impact appeared to be more pronounced in patients with more signs and symptoms. The perceived impact of pain on OHRQoL seems to be substantial. Two studies found that the impact increased with age among TMD patients. Conclusions. The reviewed studies convincingly demonstrated that OHRQoL was negatively affected among TMD patients. [ABSTRACT FROM AUTHOR]

Monocaprin is a 1-monoglyceride of capric acid that has antimicrobial activity against enveloped viruses, certain bacteria, and the yeast Candida albicans. Solutions containing monocaprin were formulated and tested in vitro against a number of micro-organisms, including species found in the oral cavity and common pathogenic species. The antimicrobial activity of monocaprin was tested with strains growing on a surface as well as in the planktonic phase. Micro-organisms tested were: Streptococcus mutans , Candida albicans , Lactobacillus sp., Staphylococcus aureus , Echerichia coli , and Pseudomonas aeruginosa . Two sets of dilutions were prepared for each test strain; one to be inoculated with the micro-organism growing in the planktonic phase and the other with the same strain growing on a filter paper disk. Control solutions were also prepared to find out if any of the excipients were affecting the microbicidal effect of monocaprin. Test strains growing on the filter paper surface were less sensitive to monocaprin than the same strain growing in its planktonic phase. C. albicans was the micro-organism that was most sensitive to monocaprin, but S. mutans also showed appreciable sensitivity. The indication that monocaprin may have potential as a topical agent against Candida was tested in an open study of denture disinfection in 32 patients attending a geriatric daycare centre. A significant, but short-term, reduction in counts of Candida on the fitting surface of full dentures was observed. [ABSTRACT FROM AUTHOR]

The aim of this paper was systematically to evaluate the caries-preventive effect of professional fluoride varnish treatments. A search of the literature for articles published between 1966 and August 2003 was carried out in electronic databases, reference lists of articles, and selected textbooks in accordance with the strategy of the Swedish Council on Technology Assessment in Health Care. Out of 302 identified papers, 24 randomized and controlled clinical trials comparing fluoride varnish with placebo, no active treatment or other fluoride preventive regimens of at least 2 years' study duration were included. The trials that met the inclusion criteria were assessed independently and systematically by at least two reviewers and scored from A to C according to predetermined criteria for methodology and performance. The main outcome measure was the preventive fraction expressed as a percentage. The results displayed limited evidence (evidence level 3) for the caries preventive effect of topical applications of fluoride varnishes in permanent teeth. The average prevented fraction was 30% (0-69%) when compared with untreated controls. Inconclusive evidence (evidence level 4) was found for fluoride varnish treatment in the primary dentition and in adults. This systematic review reinforces the need for future clinical research of high quality, incorporating modern concepts of clinical performance and evaluation to assess dental caries control using professional fluoride varnish. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this systematic review and meta-analysis was to evaluate the reliability of the Carisolv system with respect to drilling regarding the full removal of decayed hard tissues in primary dentition. A systematic review of the literature was conducted to identify controlled trails, randomized controlled trials and clinical trials that compared the Carisolv system to the traditional mechanical caries removal in the primary dentition. Materials and methods. The main relevant databases were searched: MEDLINE via PUBMED, Web of Science and SCOPUS. Complete caries removal, length of working time and need of local anesthesia were the outcomes evaluated. Results. A total of 195 studies were identified and complete analysis of 28 studies was performed; finally, 10 papers were included. The trials included involved a total of 348 patients for 532 treated teeth. There was no significant difference in terms of clinical efficacy between the Carisolv and the rotary instrument (z = 0.68, p = 0.50), whereas the treatment with Carisolv was significantly longer in terms of time with respect to the rotary instruments (z = 10.49, p < 0.01). The chemo mechanical technique reduces the need for local anesthesia, with a difference between two types of treatment near to statistical significance (z = 1.91 p = 0.06). Conclusions. This systematic review indicates that the clinical efficacy of chemo-mechanical removal with Carisolv seems as reliable as the rotary instruments. However, the results should be interpreted cautiously due to the heterogeneity among study designs and to the shortage of available data. Further large-scale, well-designed randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]

Objective. To give an overview of the periodontal-systemic connection seen from a microbiologist. Methods. Original research papers, review articles and workshop proceedings were consulted. Results. Periodontal bacteria can cross epithelial cells, enter the circulation, invade endothelial cells, induce endothelial cell dysfunction and activate inflammatory and immune responses. Several studies support the association between periodontitis (PD) and cardiovascular disease. Severe PD involves a risk for development of type 2 diabetes. Maternal PD is moderately associated with adverse pregnancy outcome and pre-eclampsia. Dental plaque can contain respiratory pathogens able to promote chronic obstructive pulmonary disease and pneumonia. Periodontal bacterial DNA has been detected in synovial fluid of patients with rheumatoid arthritis. Minor evidence exists for associations between PD and chronic kidney disease, obesity, cancer, metabolic syndrome and cognitive impairment. Concerns can be raised as to the interpretation of some study results due to heterogeneity in definitions used for PD, too much weight upon in vitro studies with a few selected organisms and failing recognition that the majority of the periodontal microbiota is not yet cultivated. Conclusion. Periodontal bacteria may participate in extra-oral infections such as CVD, diabetes, APO, pre-eclampsia, COPD, pneumonia, RA, CKD, obesity, cancer, MetS and cognitive impairment. Most knowledge is based on associations which do not necessarily imply causality. Future studies should reach consensus on the definition of PD and systemic disease outcomes, recognize the full spectrum of the microbiota in PD and bacteremia, including not-yet-cultivated organisms and delineate the clinical significance of genetic strain variations and the role of periodontopathogenic vs gut organisms within atheromatous lesions. For demonstration of causality, large, long-term clinical studies should use well-defined criteria for PD and robust disease outcomes to elucidate the importance of PD intervention and prevention. [ABSTRACT FROM AUTHOR]

This systematic review of the dental literature (1966-98) concerns risk periods associated with dental fluorosis in the maxillary permanent central incisors. A literature search was organized through the MedLine and the ISI databases. In addition, one unpublished paper (in manuscript) was obtained, as well as one paper published before 1966. However, out of 143 catches, only 10 studies were included in this review. The main reason for exclusions was that the data presented did not meet the criteria given for the present meta-analysis. Among the included papers, 7 pertained to subjects whose exposure to fluoride started at different ages during the enamel formation (Group 1), and 3 were based on subjects who had been exposed from birth and then experienced an abrupt reduction in daily fluoride exposure at different ages during the amelogenesis period (Group 2). The meta-analysis for Group 1 found the odds ratio (OR) for dental fluorosis in children exposed to fluoride early in life (before 2 years of age) to be 7.24 (95% CI; 4.71-11.13) as compared to children exposed later in life (after 2 years of age). The meta-analysis for the studies in Group 2 found the overall OR to be 1.88 (95% CI; 1.35-2.61) for children who had a reduction in fluoride intake after 2 years of age, as compared to individuals who experienced reduction earlier (during the first 2 years). The studies from both groups were pooled and the duration of exposure to fluoride during the first 4 years of life was the independent variable. The meta-analysis now revealed an overall OR of 5.83 (95% CI; 2.83-11.94) for long periods of fluoride exposure (>2 out of the first 4 years) versus shorter periods of exposure (<2 out of the first 4 years of life) during the enamel formation in the maxillary central incisors. Based on the findings of the meta-analysis, no specific period of enamel formation is singled out as being the most critical for the development of dental fluorosis. The duration of fluoride exposure during the amelogenesis, rather than specific risk periods, would seem to explain the development of dental fluorosis in the maxillary permanent central incisor. [ABSTRACT FROM AUTHOR]

Objective. A major aspect in evaluating the quality of dental materials is their physical properties. Their properties should be a best fit of the ones of dental hard tissues. Manufacturers give data sheets for each material. The properties listed are characterized by a specific value. This assumes (but does not prove) that there is no direction dependence of the properties. However, dental enamel has direction-dependent properties which additionally vary with location in the tooth. The aim of this paper is to show the local direction dependence of physical properties like the elastic modulus or the thermal expansion in dental hard tissues. With this knowledge the 'perfect filling/dental material' could be characterized. Materials and method. Enamel sections of ∼400-500 μm thickness have been cut with a diamond saw from labial/buccal to palatal/lingual (canine, premolar and molar) and parallel to labial (incisor). Crystallite arrangements have been measured in over 400 data points on all types of teeth with x-ray scattering techniques, known from materials science. Results. X-ray scattering measurements show impressively that dental enamel has a strong direction dependence of its physical properties which also varies with location within the tooth. Dental materials possess only little or no property direction dependence. Therefore, a mismatch was found between enamel and dental materials properties. Conclusion. Since dental materials should possess equal (direction depending) properties, worthwhile properties could be characterized by transferring the directional properties of enamel into a property 'wish list' which future dental materials should fulfil. Hereby the 'perfect dental material' can be characterized. [ABSTRACT FROM AUTHOR]

Objective. This study investigated the effect of different drying methods of dentin surface on the bonding efficacy of self-adhesive resin cements (SRCs). Materials and methods. Three SRCs (RelyX U200, RU; Maxcem Elite, ME; and BisCem, BC) and one resin-modified glass ionomer cement (RelyX Luting 2, RL) were used. The characteristics of the materials were evaluated using thermogravimetric analysis and surface roughness and contact angle measurements. Human dentin surfaces were finished with 600-grit silicon carbide paper and assigned to three groups according to these drying methods: ethanol dehydration, drying by waiting for 10 s after blot-drying and blot-drying. The four cements were used for luting composite overlays to the dried dentin. After 24 h storage at 37°C and 100% relative humidity, stick-shaped specimens with a cross-sectional area of 0.8 mm2 were prepared and stressed to failure in tension at a crosshead speed of 0.5 mm/min ( n = 27). Failure modes of fractured specimens were assessed by optical and scanning electron microscopy. Results. RL was the most hydrophilic, followed by BC and ME and then RU. All the luting cements luted to ethanol-dehydrated dentin showed zero bond strengths. For the three SRCs, drying by waiting produced higher microtensile bond strengths than blot-drying. RU showed the best bonding performance in the above two dentin conditions. RL showed significantly higher bond strength in blot-drying condition than in drying-by-waiting ( p < 0.001). Conclusions. This study suggests that dentin surface moisture has a crucial effect on the bond strength of SRCs. [ABSTRACT FROM AUTHOR]

Objectives. Doses induced by individual dental examinations are low. However, dental radiography accounts for nearly one third of the total number of radiological examinations in the European Union. Therefore, special attention is needed with regard to radiation protection. In order to lower patient doses, the staff performing dental examinations must have competence in imaging as well as in radiation protection issues. This paper presents a systematic review about the core competencies needed by the healthcare staff in performing digital dental radiological imaging quality assurance. Materials and methods. The following databases were searched: Pubmed, Cinahl, Pro Quest and IEEXplore digital library. Also volumes of some dental imaging journals and doctoral theses of the Finnish universities educating dentists were searched. The search was performed using both MeSH terms and keywords using the option 'search all text'. The original keywords were: dental imaging, digital, x-ray, panoramic, quality, assurance, competence, competency, skills, knowledge, radiographer, radiologist technician, dentist, oral hygienist, radiation protection and their Finnish synonyms. Results. Core competencies needed by the healthcare staff performing digital dental radiological imaging quality assurance described in the selected studies were: management of dental imaging equipment, competence in image quality and factors associated with it, dose optimization and quality assurance. Conclusions. In the future there will be higher doses in dental imaging due to increasing use of CBCT and digital imaging. The staff performing dental imaging must have competence in dental imaging quality assurance issues found in this review. They also have to practice ethical radiation safety culture in clinical practice. [ABSTRACT FROM AUTHOR]

Objective. The aim of this paper was to study the association between dental satisfaction and oral health-related quality-of-life (OHRQoL) when controlling for individual, clinical and psychological factors. Materials. Secondary analysis was conducted using data from a large study carried out in the Swedish region of Värmland in 2004. The questionnaire included demographic variables, clinical assessment and the following instruments: the Dental Visit Satisfaction Scale (DVSS), the short version of Oral Health Impact Profile (OHIP-14) and a modified version of the revised helping alliance questionnaire. Internal consistency analysis was undertaken on the instruments to assess reliability; bivariate comparisons were assessed to compare DVSS scores with individual factors (age, gender and education). In addition, a three step hierarchical multiple regression analysis was performed with DVSS as a dependent variable. Results. Data were completed for 485 randomly selected patients. The mean age of participants was 43.5 years, 54.6% were women,and 41.2% had high education. The median DVSS score was 48 (range 10-50) and the median OHIP was 3.0 (range 0-56). All the instruments showed good reliability. Bivariate analysis showed that females were more satisfied than males ( p ≤ 0.01) and patients of 50 years or older were more satisfied than the younger ones ( p ≤ 0.05). Finally, the following variables explained 31% of the variance of being very satisfied with dental visit: a good OHRQoL and patients' positive perceptions of the relationship with their care provider. Conclusion. This study showed positive associations between dental satisfaction and OHRQoL when controlling for related factors. The result suggests that care providers should take into account the various dimensions of OHRQoL rather than use only clinical measurements when they evaluate patient satisfaction. [ABSTRACT FROM AUTHOR]

Objective. To assess the ability of multivariate models and single factors to correctly identify future caries development in pre-school children and schoolchildren/adolescents. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion criteria. Abstracts and full-text articles were assessed independently by two reviewers. The quality of studies was graded according to the QUADAS tool. The quality of evidence of models and single predictors was assessed using the GRADE approach. Results. Ninety original articles fulfilled the inclusion criteria. Seven studies had high quality, 35 moderate and the rest poor quality. The accuracy of multivariate models was higher for pre-school children than for schoolchildren/adolescents. However, the models had seldom been validated in independent populations, making their accuracy uncertain. Of the single predictors, baseline caries experience had moderate/good accuracy in pre-school children and limited accuracy in schoolchildren/adolescents. The period of highest risk for caries incidence in permanent teeth was the first few years after tooth eruption. In general, the quality of evidence was limited. Conclusions. Multivariate models and baseline caries prevalence performed better in pre-school children than in schoolchildren/adolescents. Baseline caries prevalence was the most accurate single predictor in all age groups. The heterogeneity of populations, models, outcome criteria, measures and reporting hampered the synthesis of results. There is a great need to standardize study design, outcome measures and reporting of data in studies on caries risk assessment. The accuracy of prediction models should be validated in at least one independent population. [ABSTRACT FROM AUTHOR]

Objective. Plasma-related technologies are essential in modern industries. Recently, plasma has attracted increased attention in the biomedical field. This paper provides a basic knowledge of plasma and a narrative review of plasma applications in dentistry. Materials and methods. To review plasma applications in dentistry, an electronic search in PubMed, SCOPUS and Google scholar up to December 2012 was done. This was followed by extensive hand searching using reference lists from relevant articles. Conclusion. There have been attempts to apply plasma technology in various fields of dentistry including surface modifications of dental implants, adhesion, caries treatment, endodontic treatment and tooth bleaching. Although many studies were in early stages, the potential value of plasma for dental applications has been demonstrated. To enlarge the scope of plasma applications and put relevant research to practical use, interdisciplinary research with participation of dental professionals is required. [ABSTRACT FROM AUTHOR]

Objective. The aims of the oral part of the Danish Health Examination Survey (DANHES 2007-2008) were (1) to establish an oral health database for adult Danes and (2) to explore the influence of general diseases and lifestyle on oral health. This paper presents the study population, examination methods, questionnaire and baseline results. Materials and methods. The study population comprised 4402 subjects, aged 18-96, consecutively enrolled from 18 065 DANHES participants from 13 municipalities in Denmark. The oral part consisted of a validated questionnaire and a clinical examination, carried out in mobile units by three trained and calibrated dental hygienists. The data were processed with descriptive statistics and mono- and bivariate analyses. Results. The mean age was 54.1 years and 60% were women. The mean number of natural teeth was 26.6; the mean DMFT/DMFS values were 18.9 and 61.0, and varied with age (DMFT 8.7-24.3). A higher proportion of females suffered from dental erosion in the younger age groups. Forty per cent of all subjects had a mean clinical attachment loss ≥ 3 mm, varying from 4% among those aged 18-34 to 80% in those over 75. A sub-optimal saliva secretion rate was more common among females than males (17.7% vs 10.4%) and this was reflected by the reported frequency of dry mouth. Conclusion. This extensive cross-sectional study provides a platform for obtaining future knowledge of the impact of health- and lifestyle-related factors on oral diseases. The validated questionnaire and the clinical characteristics enable robust analyses, although the conclusions may be hampered by limited external validity. [ABSTRACT FROM AUTHOR]

Objective. To assess the diagnostic accuracy of adjunct methods used to detect and quantify dental caries. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion and exclusion criteria. Abstracts and full text articles were assessed independently by two reviewers. The study characteristics were compiled in tables and quality graded according to the QUADAS tool. The level of evidence for each diagnostic technology (fiber-optic methods, fluorescence methods, electrical methods) was based on studies of high or moderate quality according to the GRADE approach. Results. Twenty-five reports fulfilled the inclusion criteria. One study was of high quality, 10 were graded as moderate, while the remaining 14 reports were of low quality. Electrical methods (ECM) and laser fluorescence (DIAGNOdent) displayed sensitivities and specificities around 70-80% regarding occlusal dentin lesions with a mean Youden's index of 0.52-0.54. The mean accuracy of laser fluorescence for detecting enamel and dentin lesions was 0.68 and 0.91, respectively. The heterogeneity of the published reports hampered the analysis. Conclusions. There was insufficient scientific evidence for diagnostic accuracy regarding fiber-optic methods and quantitative light-induced fluorescence (+OOO). The electrical methods and laser fluorescence could be useful adjuncts to visual-tactile and radiographic examinations, especially on occlusal surfaces in permanent and primary molars, but evidence was graded as limited (++OO). No conclusions could be drawn regarding the cost-effectiveness of the methods. There is an obvious need to standardize study designs for in vitro and in vivo validation of the different methods. [ABSTRACT FROM AUTHOR]

Objective. This paper focuses on clinical responses after 7 days of oral exposure to two resin-based materials as desensitizing agents compared to a fluoride varnish and on morphological and analytical study as a means to elucidate the mechanism of action. Materials and methods. The elemental composition of Vertise™ Flow (VF), Universal Dentine Sealant (UDS) and Flor-Opal® Varnish (FOV) were investigated by using an X-ray energy dispersive spectrometer (EDX) in conjunction with a scanning electron microscope (SEM). SEM morphology of the material-treated dentine surfaces and pain reduction ability according to the Visual Analogue Scale (VAS) were evaluated in selected hypersensitive teeth. Post treatments and 7 day controls were recorded with SEM and VAS measurements. Clinical data was analysed with the Student's t-test for paired data, with a 5% significance level. Results. Silicon, ytterbium and alumina were the most present elements in VF, whilst calcium, chloride, silicon and alumina were highest in UDS. Within a 7 day oral environment all the tested materials modified the treated-dentine surfaces showing tubular occlusion of different morphology. Clinically, the efficacy of all materials was similar after a 7-day examination. However, VAS scores were significantly reduced if compared with the baseline ( p < 0.05). Conclusions. Within the limits of this study, data indicate that both resins are effective in sealing tubules and reducing VAS. A resin-related effect on the dentine's morphology was observed, which may influence the long-term response of the resins in the treatment of dental hypersensitivity, which requires further investigation. [ABSTRACT FROM AUTHOR]

Objective. The significant number of complications in kidney graft recipients can not be easily explained. The paper assesses whether poor oral health increases the risk of acute rejections and hospitalizations in kidney allograft recipients. Materials and methods. Ninety-one kidney transplant recipients were divided into three sub-groups according to post-transplant time (< 1, 1-5 and > 5 years). Dental examination evaluated oral hygiene index (OHI-S) and Community Periodontal Index of Treatment Needs (CPITN), which were correlated with the occurrence of post-transplant complications. Results. Within the first year after transplantation the indicators of the increased risk of hospitalizations and acute rejection episodes was the OHI-S (hazard ratio 1.02 and 1.11, respectively), also CPITN score correlated with acute rejections ( R = 0.82, p < 0.01). Conclusion. The neglect in oral health is associated with the increased risk of clinical complications within first year after kidney transplantation. [ABSTRACT FROM AUTHOR]

Objective. The purpose of the current study was to evaluate the effect of thione-based metal priming agents on the adhesive behavior of a Ag-Pd-Cu-Au alloy and component metals bonded with an acrylic resin. Materials and methods. Disk specimens (10 mm in diameter by 3 mm thick) were prepared from a silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy (Castwell M.C.12), high-purity silver, palladium, copper and gold. Four single-liquid priming agents containing organic sulfur compound (Alloy Primer, Metaltite, M.L. Primer and V-Primer) and three acidic priming agents (All Bond II Primer B, Estenia Opaque Primer and Super-Bond Liquid) were assessed. The metal specimens were flat-ground with abrasive papers, primed with one of the agents and bonded with a tri- n-butylborane initiated resin. The shear bond strengths were determined both before and after repeated thermocycling (5°C and 55°C, 1 min each, 20,000 cycles). The results were statistically analyzed with a non-parametric procedure ( p = 0.05 level). Results. The post-thermocycling bond strengths in MPa (median; n = 11) associated with the Alloy Primer, Metaltite, M.L. Primer and V-Primer materials were, respectively, 20.8, 22.8, 17.8 and 18.4 for the Ag-Pd-Cu-Au alloy; 19.6, 21.9, 14.4 and 20.1 for silver; 5.4, 4.5, 12.8 and 5.3 for palladium; 17.1, 19.2, 0.7 and 6.6 for copper; and 18.5, 17.7, 22.8 and 15.4 for gold. Conclusions. It can be concluded that the use of the four priming agents, which are based on organic sulfur compounds, effectively enhanced bonding to the Ag-Pd-Cu-Au alloy and the component metals, although the bonding performance varied among the priming agents and metal elements. The priming agents appeared to have more of an effect on the alloy, silver and gold than on the palladium and copper. [ABSTRACT FROM AUTHOR]

Objectives. The aim of the study was to investigate the clearance of PVP-iodine applied as a gel or solution in periodontal pockets. Methods. Teeth of 12 subjects with at least eight periodontal pockets of ≥5 mm probing depth were isolated with a rubber dam to allow contamination-free access to the pockets. In each subject, three pockets were filled with PVP-iodine gel (10%) and three with PVP-iodine solution (10%). One pocket of each subject without iodine application served as a negative control. The treatment allocation was assigned randomly. Any excess material was removed subsequently. After 1, 5 and 15 min, a paper point was used to collect the sulcus liquid and the concentration of PVP-iodine was chemically determined. In addition, PVP-iodine gel was administered into 12 periodontal pockets immediately after sub-gingival ultrasound debridement and the concentration of PVP-iodine was determined after 1 min. Results. Descending concentrations of PVP-iodine were determined at 1, 5 and 15 min after the application. No PVP-iodine was found in the pockets serving as negative controls. The mean concentrations of the gel and solution were 6.14 μg/ml and 4.44 μg/ml (1 min; p ≥ 0.028), 3.20 μg/ml and 1.44 μg/ml (5 min; p ≥ 0.126), 0.69 μg/ml and 0.23 μg/ml (15 min; p ≤ 0.019), respectively. In the pockets with previous debridement the mean concentration was 1.68 ± 1.97 μg/ml. Conclusion. The application of PVP-iodine gel in periodontal pockets allows a prolonged remnant effect as compared to that of the solution formula. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this paper is to compare the differences in stress between Ti-6Al-4V and PS-ZrO2 dental implant during clenching and whether these changes are clinically significant to limit the use of zirconia in oral implantology. Materials and methods. The model geometry was derived from position measurements taken from 28 diamond blade cut cross-sections of an average size human adult edentulous mandible and generated using a special sequencing method. Data on anatomical, structural, functional aspects and material properties were obtained from measurements and published data. Ti-6Al-4V and PS-ZrO2 dental implants were modelled as cylindrical structure with a diameter of 3.26 mm and length of 12.00 mm was placed in the first molar region on the right hemimandible. Results. The analysis revealed an increase of 2-3% in the averaged tensile and compressive stress and an increase of 8% in the averaged Von Mises stress were recorded in the bone-implant interface when PS-ZrO2 dental implant was used instead of Ti-6Al-4V dental implant. The results also revealed only relatively low levels of stresses were transferred from the implant to the surrounding cortical and cancellous bone, with the majority of the stresses transferred to the cortical bone. Conclusion. Even though high magnitudes of tensile, compressive and Von Mises stresses were recorded on the Ti-6Al-4V and PS-ZrO2 dental implants and in the surrounding osseous structures, the stresses may not be clinically critical since the mechanical properties of the implant material and the cortical and cancellous bone could withstand stress magnitudes far greater than those recorded in this analysis. [ABSTRACT FROM AUTHOR]

It is the aim of this paper to give a few examples of dogmas related to prosthodontics and oral implants and to discuss the controversial role of occlusion in the aetiology of temporomandibular disorders. New knowledge is developing at a rapidly increasing rate in dentistry, as in other areas of society. Our lecturers at university taught us many useful things. But, as time goes by, what is still relevant? Some methods are so well established that they deserve to be called dogmas. It is implied that a dogma is not supported by strong evidence, even though it has existed and been practised for a long time. In the era of evidence-based dentistry it is appropriate to scrutinize such issues. A review of the current literature indicates that conflicting opinions exist concerning a number of common procedures in clinical dentistry, mainly due to a scarcity of good studies with unambiguous results. There is therefore a need for more high-quality clinical research in attempting to reach the goal of evidence-based clinical practice. The dental community should take an active part in this process. [ABSTRACT FROM AUTHOR]

This aim of this paper is to spur a discussion of the direction of caries-lesion detection activities in clinical dental practice. It is argued that since the dental clinician's caries-related decision making is a script-matching enterprise in which clinical decisions are made on the basis of ‘this-lesion-needs-this-kind-of-treatment’ reasoning, the methods and strategies employed for caries lesion detection should accommodate this fact. This may be done by employing a clinical visual–tactile method for caries lesion detection that evaluates the two aspects that are crucial for appropriate caries management: lesion activity and surface integrity. The use of diagnostic methods that do not assess these features directly but involve assumptions about activity status and surface integrity should be avoided. This includes the use of bite-wing radiography for the detection of approximal caries lesions, as it may be shown that plain reliance on radiographs leads to considerable overtreatment. If clinical dentistry is to retain its status as a profession committed to doing good, changes in diagnostic practices along these lines are warranted. [ABSTRACT FROM AUTHOR]

Objective. To compare collagenase activity and collagenolytic matrix metalloproteinase (MMP) levels in gingival crevicular fluid (GCF) and in peri-implant sulcular fluid (PISF) in gingivitis (G), chronic periodontitis (CP), and peri-implantitis (PI) human subjects. Material and Methods. GCF and PISF were collected on filter paper strips, volume was determined, and samples were extracted in buffer containing general proteinase but not MMP inhibitors. Collagenase activity was measured using a DNP-synthetic octapeptide, and molecular and activation forms of collagenase-2 by Western immunoblotting. Results. GCF from CP and G sites exhibited elevated collagenase activity and flow, but collagenase concentrations expressed per µl were not significantly different between the healthy and G sites. Minimal fluid was obtained from healthy PISF, and collagenase concentration was the same or lower than in healthy GCF. Although PISF flow was 34% lower than GCF flow in CP subjects, collagenase concentration in CP and in PI sites was 78% and 971% greater, respectively, than in the appropriate healthy sites. Western immunoblot revealed MMP-8 in both PISF and GCF; fibroblast-type MMP-8 was not detected in healthy GCF and PISF. Immunoreactivity level and inactive and activated forms of PMN-type MMP-8 in GCF and PISF increased with the severity of periodontitis and peri-implantitis. Enhanced levels of fibroblast-type MMP-8 in active form were detected only in severe CP GCF and PI PISF. Conclusions. Peri-implantitis PISF contained higher collagenase-2 levels and activity than GCF from similar deep CP sites. GCF and PISF from severe CP and PI exhibited the highest activation of MMP-8 isoenzymes species (PMN and fibroblast-type). [ABSTRACT FROM AUTHOR]

Objective. Amelogenesis imperfecta (AI) is a disease primarily affecting amelogenesis, but other aberrations have been reported. The purposes of this review were: (1) to identify other anomalies associated with AI, and (2) to describe the impact of the disease and its associated conditions on the oral health-related quality of life of patients, and the economic consequences. Material and methods. A literature search was conducted in the following databases: PubMed, EMBASE, Bibliotek.dk, The Cochrane Library, Web of Science, and OMIM, supplemented by a search for selected authors. Based on titles and abstracts, 137 papers were identified. Results. Most articles were case reports or case series with few cases. Aberrations were reported in the eruption process, in the morphology of the crown, in the pulp-dentine organ, and in the number of teeth. Gingival conditions and oral hygiene were usually reported to be poor, and calculus was a common finding. Open bite was the most commonly reported malocclusion. A negative impact on patients' oral health-related quality of life was described, but information was scarce. No information was found on the economic impact. Conclusions. A number of aberrations associated with AI have been reported, but not sufficiently systematic to allow for a secondary analysis and synthesis of the findings. The impact on patients in terms of reduced quality of life and economic burden needs to be studied. [ABSTRACT FROM AUTHOR]

Delamination or fracture of composite veneers can occur as a result of improper design of the fiber-reinforced composite (FRC) framework. This in vitro study tested the repair bond strength of restorative composite to aged FRC. The substrate was multiphase polymer matrix FRC (everStick) aged by boiling for 8 h and storing at 37 degrees C in water for 6 weeks. The aged substrate surfaces were wet-ground flat with 1200-grit silicon carbide paper and subjected randomly to 5 different surface treatments: 1) An adhesion primer (Composite Activator) and resin (CA), 2) Silane (EspeSil) and resin (SIL-MP), 3) Silane, adhesive primer, and resin (Clearfil Repair) (CF), 4) Air particle-abrading (CoJet), silane, and resin (CJ-SIL-MP), 5) Resin (Scotchbond Multipurpose Resin) only as control (MP). Restorative composite resin (Z250) was added to the substrate in 2 mm layer increments and light-cured. Subsequently, every surface treatment group was divided into 2 subgroups of 12 specimens each. The specimens were either 48 h water-stored or thermocycled (6000 x 5-55 degrees C). The shear bond strengths of composite resin to FRC were measured at a crosshead speed of 1.0 mm/min. The data were analyzed by ANOVA for factors 'treatment type' and 'storage condition'; Tukey's post-hoc tests and Weibull analysis were performed. ANOVA showed a significant difference as a function of surface treatment (P<0.05) and storage condition (P<0.05). The CJ-SIL-MP group showed highest bond strength and Weibull modulus after thermocycling. Repair of multiphase polymer matrix FRC may show reliable bond strength when silane treatment is used along with air-particle abrading. [ABSTRACT FROM AUTHOR]

The aims of this systematic review were to identify the study designs and topics of Swedish orthodontic articles, to elucidate their international position, and to verify in which scientific journals the articles had been published in the past decade. A search of the Medline database for papers published between 1992 and 2002 was made using the Medical Search Heading terms 'orthodontics', 'malocclusion', 'cephalometry', and 'facial bones and growth'. Two independent reviewers selected the articles of Swedish origin and categorized each article according to research design and principal topic. Overall, 15,571 articles in orthodontic research were found, and the Swedish contribution was 1.9% with the majority of these (71.5%) being submitted by universities. Most of the Swedish articles (84.5%) had been published in 10 journals and many high-quality studies with orthodontic interest were published in non-orthodontic journals with higher impact factor scores than the orthodontic journals. Every second study was prospective, and of these, 15 (5.2% of all Swedish articles) were randomized clinical trials (RCTs). It was found that nearly every third study, prospective as well as retrospective, was uncontrolled. The main classification was treatment studies (51.9%), followed by development (18.6%) and diagnostic information (10.7%) studies. Thus, the majority of the articles evaluated therapeutic interventions; however, although the RCT is the preferred study design in evaluation studies, few used this method. In an era focused on evidence-based medicine, studies with an RCT design will be the future challenge for research in the field of orthodontics. [ABSTRACT FROM AUTHOR]

The aim of this paper is to describe and understand people's views on dental self-efficacy and its formation. The qualitative data were collected by means of focused interviews with five patients selected on the basis of poor orientation to dental-care matters, measured using test scores from a previous questionnaire. The first stage of the analysis is a description of the background of the subjects from their own accounts; two proved to have internalized preventive dental beliefs and behavior deeply while two others had traumatic experiences as a reason for irregular dental appointments. One subject with poor oral health behavior seemed to have limited preventive action to his yearly dental appointment. The second stage of the analysis focuses on interpretation of the subjects' perception of self-efficacy and related comments. Among sources of self-efficacy that prove important in dental care are the cognitive, experiential, supportive and emotional dimensions, and beliefs and values learned in the family and at school. This qualitative research increases our understanding of the oral health behavior of patients and emphasizes the importance of patient-centered oral health education. [ABSTRACT FROM AUTHOR]

This paper reviews some relevant citations regarding the non-specific forces that must be considered in oral bioadhesive events. These range from forces related to restorative dentistry to those related to prevention and molecular biology. Types of interactions discussed are: 1. Van der Waal's forces; 2. electrostatic double-layer forces; 3. solvent-dependent interactions; 4. hydrogen bonding; 5. hydrophobic interactions; 6. hydration forces; 7. steric forces; and 8. covalent bonds. Examples are given of the various types of interaction that occur at different surface separation (≤400 Å) between adsorbed films of a pure salivary protein fraction (PRP1). [ABSTRACT FROM AUTHOR]

The use of experimental intra-oral caries models has increased in fluoride research. This paper focuses on the pre-clinical intra-oral models, the in situ and in vivo models, the various types, their benefits and disadvantages. Both preparation and sterilization of the hard tissue substrates can affect the substrates and therefore the results. Care needs to be taken that dentine samples are not exposed to drying and consequently shrinking during preparation and evaluation. Sterilization by γ-radiation is at present the least tissue-damaging method. The most realistic experimental model is the in vivo model, followed by the in situ model using specimens with natural surfaces. The most accurate and direct evaluation technique for demineralization and remineralization studies is quantitative transversal microradiography, whereas confocal laser scanning microscopy (CLSM) is the most sensitive qualitative evaluation technique. Other evaluation techniques discussed are microhardness testing and the iodine permeability test. In light of the present skewed caries situation in western countries we suggest that fluoride research focuses on experimental caries models that can mimic severe cariogenic challenge. Testing of fluoride combinations and dosages that can prevent lesion development rather than promote remineralization would then be a practical consequence. [ABSTRACT FROM AUTHOR]

In most but not all the Nordic countries, the National Boards of Health have issued guidelines governing the utilization of fluoride. The purpose of this paper is to outline the process of policy formation, describe the current fluoride guidelines in the Nordic countries, and discuss compliance with and appropriateness of the guidelines. The fluoride guidelines summarize current knowledge and make recommendations on choice of fluoride preparations (supplements, toothpaste, and varnish) and doses. Fluoride policies in the Nordic countries in the late 1990s state that use of fluoride toothpaste twice a day is the preferred and sufficient source of fluoride for the majority of the population. The policies of the Nordic countries are similar, but there are differences, some of them self-explanatory others not so obvious. In the case of supplements, for example, there are differences in the recommended dosage schedules. In the case of toothpaste, it is unclear what concentrations of fluoride are recommended both for children and for adults. Starting time for the use of fluoride, whether toothpaste or supplements, varies between countries. The clinicians' compliance with fluoride guidelines has not been systematically evaluated. Comparing the advice and treatments offered by dentists in the Nordic countries with current guidelines suggests that national policies influence the practice of clinicians. For government policy to be appropriate, it is imperative that the guidelines are based on sound scientific evidence. It is thus concluded that if non-evidence-based elements are included in national guidelines, this should be clearly stated to prevent confusion and enhance compliance from professionals and the public. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effects of a chlorhexidine/thymol-containing dental varnish on the levels of prostaglandin E2 (PGE2), prostaglandin I2 (PGI2), leukotriene B4 (LTB4), and interleukin-1β (IL-1β) in gingival crevicular fluid (GCF). The material consisted of 15 adolescents undergoing treatment with fixed orthodontic appliances. Four buccal sites adjacent to bands or brackets and exhibiting a mild chronic gingival inflammation were selected in the upper quadrants of each patient. According to a split-mouth technique, the first and second quadrants were randomly treated with either a varnish (Cervitec®) containing 1% chlorhexidine diacetate and thymol (CHX/thymol) or a placebo varnish without active ingredients. The varnishes were applied immediately after the baseline registration, and follow-up examinations were carried out after 3, 8, and 30 days. GCF was sampled with the aid of a paper strip and the volume was determined using a Periotron® 8000. The concentrations of PGE2, PGI2, LTB4, and IL-1β in GCF were assessed using radioimmunoassay and ELISA techniques. The results unveiled statistically significant reductions of PGE2, PGI2, and LTB4 levels in GCF following the active varnish treatment when compared to baseline values. A slight drop in IL-1β levels was registered after both active and placebo varnish applications, but the differences were not significant. The results suggest that treatment with an antibacterial varnish decreases the levels of inflammatory mediators PGE2, PGI2, and LTB4 in gingival crevicular fluid and further support the concept that topical application of a CHX/thymol-containing varnish is beneficial in patients with chronic gingival inflammation. [ABSTRACT FROM AUTHOR]

Oligodontia is a rare condition, and only limited data are available on its prevalence. The present paper is based on data from Danish schoolchildren. When these data are combined with comparable data on Danish schoolchildren published previously by the senior author, it is shown that oligodontia occurs in 0.16% of the children (95% confidence interval, 0.07% to 0.30%). Two of every three congenitally missing teeth were upper or lower second premolars or upper lateral incisors. When data from Danish schoolchildren were combined with population data from similar groups of schoolchildren from the Nordic countries, the condition was found to be more frequent in girls than in boys (P = 0.05). [ABSTRACT FROM AUTHOR]

Details highlights of a symposium held on the occasion of the meeting of the Nordic Society of Dentistry for Children and the 80th Annual Meeting of the Scandinavian Association for Dental Research in Reykjavij, Iceland, in August 1997. Focus of the papers presented; Agreement among the speakers on the importance of population-based strategies in caries prevention; Discussion of the cost of preventing caries.