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Studies on measured physical fitness and oral health are sparse. The aim of this study was to investigate the associations between self-reported physical activity and measured physical fitness and oral health of young men. The study population consisted of 13,564 Finnish male conscripts who had mandatory clinical oral examinations and physical fitness tests at the beginning of military service in 2011. Finally, around 10,800 conscripts had physical fitness test outcomes available and a total of 8552 conscripts answered a computer-based questionnaire on background factors. Decayed Tooth (DT) and Decayed, Missing, or Filled Tooth (DMFT) indices, outcomes of surveys and fitness tests were used in analyses by cross-tabulation and multivariable logistic regression model (odds ratios [OR] with 95% confidence interval [CI]) were calculated. Regularly exercising conscripts had a reduced need for dental restorative treatment than those reporting no physical activity (p < 0.0001). The proportion of participants with sound dentition (DT = 0) increased steadily with increasing physical activity (39.0–59.4%). Good measured physical fitness was a protective factor against increased dental restorative treatment need. A low prevalence of smoking and low use of alcohol and energy drinks were associated with frequent exercise, whereas consumption of sport drinks and snuff use were common among those who exercised frequently. Good measured physical fitness and self-reported physical activity are associated with reduced caries burden. There is a need for information about the harms of tobacco products and the benefits of a healthy diet, even for the increased energy needs of the physically active.

This Position Statement on root resorption represents the consensus of an expert committee convened by the European Society of Endodontology (ESE). The statement is based on current clinical and scientific evidence as well as the expertise of the committee. The aim is to provide clinicians with authoritative information on the aetiology, histopathology, clinical presentation and recommendations for the management of root resorption. It is the intention of the committee to update this position statement at appropriate intervals as further evidence emerges.

Introduction: Finland’s security policy relies heavily on its own independent national defense, which is based on conscription. In 2011, 26,492 conscripts started their military service in Finland. Of these, 1,706 interrupted their military service and 191 changed to civilian service. Conscripts who interrupt their service seem to have an increased tendency to smoking, alcohol consumption, and taking snuff, which previous studies suggest to have strong associations with the need for restorative dental treatment and with lower socioeconomic status. The aim of this study was to compare the general and oral health habits between Finnish conscripts who interrupt their service and those who completed their military service and to find out what general- and oral-health-related factors could be used in predicting interruption of service. Methods: The study population consisted of 13,819 conscripts taking an oral examination during the service. Of these, 8,449 answered a computer-based anamnestic questionnaire and 264 interrupted their service. Predisposing factors on the anamnestic questionnaire for interrupting military service were evaluated by using a binary logistic regression model. The statistically significant factors were selected to form a sum variable which finally consisted of seven predisposing questions. Odds ratio (OR) values and 95% confidence intervals were calculated for each question and for the sum variable. Predictive accuracy was assessed by area under the receiver-operating curve. Results: The most obvious predisposing factor among those who interrupted their service compared to the reference group was lack of weekly physical exercise (OR = 5.80). The risk for interruption of military service was 68.6 times higher in cases where a subject exhibited six predisposing factors out of seven compared to those who had none. Conclusion: As a conclusion, a set of statistically chosen anamnestic questions could help identify conscripts who have an incr

Tiivistelmä Karieksen aiheuttamat komplikaatiot, hampaan voimakas kuluminen tai muu ulkoinen ärsytys voivat johtaa hammasytimen eli pulpan oireiseen tai oireettomaan inflammaatioon, jota seuraa pulpakudoksen osittainen tai etenevä hajoaminen ja kuolio. Sairaan pulpan asianmukaisella hoidolla pyritään säilyttämään hampaan vitaliteetti joko täydellisesti tai osittain, ja tällaista hoitoa voidaan siten pitää ”ehkäisevänä endodontiana”. Dentiini-pulpakompleksin fysiologian ja patologian ymmärtäminen on oikean diagnoosin ja näin ollen oikean hoidon edellytys. Tässä katsauksessa kuvataan terveen pulpan perusrakenne ja fysiologia. Lisäksi käydään läpi tulehdusreaktioiden käynnistymisen ja etenemisen periaatteita pulpakavumissa ja juurikanavissa, jotka ovat tulehdusprosessin kannalta joustamaton ympäristö. Tämän ohella käsitellään kivun ja hypersensitiivisyyden mekanismeja sekä keinoja, joilla dentiini-pulpakompleksi voi reagoida toistuvaan tai persistoivaan, kipua aiheuttavaan ärsytykseen. Pulpan tulehduksen hoitomuodot voivat vaihdella karieksen ekskavoinnista ja kaviteetin sulkemisesta sekä osittaisesta tai täydellisestä pulpotomiasta aina endodonttiseen hoitoon, ja niitä pohditaan tarkemmin tämän teeman muissa artikkeleissa, jotka käsittelevät diagnostiikkaa, vitaalin pulpan hoitoa ja kiireellistä hoitoa., Pulp Biology Pulpal complications of caries, extensive wear or other external irritations may result in symptomatic or asymptomatic inflammation, followed by partial or progressing pulp tissue degradation and necrosis. Appropriate treatment of diseased pulp may aim to preserve the vitality of the pulp, either completely or partially, and can thus be regarded as “preventive endodontics”. Understanding of the physiology and pathology of dentin-pulp complex is a prerequisite for the proper diagnosis and is thus the correct choice of treatment. This review describes the basic structure and physiology of a healthy dental pulp and the principles of the initiation and progression of inflammatory reactions in the low-compliance environment of the pulp chamber and root canals. The mechanisms of the pain and hypersensitivity, as well as the means that the dentin-pulp complex may react to a repeated or persistent pain-producing irritation, are also discussed. The chosen treatment modalities may vary from caries excavation and cavity sealing, partial or complete pulpotomy to an endodontic treatment, and will be discussed in detail in other articles in this issue dealing with the diagnostics, vital pulp therapies and emergency treatments.

The main aim of this cross-sectional study was to examine the prevalence of dental fear among Finnish conscripts. Other aims were to study the association between dental fear and cariological status as well as their self-reported, dentition-related well-being. The study material consisted of 13,564 men and 255 women conscripts who underwent oral examinations. Of those, 8713 responded to a computer-based questionnaire. The mean number of decayed teeth (DT) was used in analyses for cariological status. Self-reported dental fear, dentition-related well-being and regular check-ups were analysed. Data were analysed with cross tables, Pearson Chi-Square tests, Fisher’s exact test and binary logistic regressive analysis. High dental fear or finding dental visits very scary was associated with DT > 2 both among women (14.6%, when DT = 0; 33.3%, when DT > 2) and men conscripts (2.3% and 10.8%, respectively). In addition, those reporting that dental health had a negative impact on their well-being and had no regular check-ups were more likely to need cariological treatment than the rest. A high education level, both one’s own and parental, was a protective factor for restorative treatment need in male conscripts. The findings of this study support the concept of a vicious cycle of dental fear and dental caries. A preventive, interactive way of work by dental teams would most likely be beneficial for dental health, avoiding the development of dental fear, and dentition-related well-being.

Tiivistelmä Hammasperäinen poskiontelotulehdus määritellään paikalliseksi poskiontelon limakalvon paksuuntumiseksi, joka liittyy tulehtuneeseen tai laajasti hoidettuun hampaaseen tai suukirurgiseen toimenpiteeseen. Hammasperäinen syy saattaa olla taustalla 15 %:ssa poskiontelotulehduksista, erityisryhmien osalta jopa 40 %:ssa. Hampaan tukikudos- ja juurikanavatulehdukset aiheuttavat yli puolet hammasperäisistä poskiontelotulehduksista. Hammasperäiset tulehdukset ovat yleensä anaerobivoittoisia ja polymikrobisia. Tyypillisimmät oireet ovat toispuolinen märkäinen erite sekä tukkoisuus, paha maku tai haju, toispuolinen poskikipu tai -arkuus, liman valuminen nenänielusta, epämukava tunne kasvoissa tai ikenissä ja hammassärky. Kuvantamisessa käytetään panoraamakuvausta, intraoraalikuvia ja kartiokeilatietokonetomografiaa, joihin liittyy kuitenkin virhelähteitä. Hoito onnistuu, jos suun tulehdus hoidetaan. Hammashoidon lisäksi tarvitaan yleensä mikrobilääkehoito, usein poskiontelopunktio ja joskus sivuontelokirurgiaa.

Objectives: To evaluate the long-term effect of chlorhexidine (CHX) and dimethyl sulfoxide (DMSO) on the sealing ability and biomineralization of two different calcium silicate cements (CSC) in root canal. Methods: Sixty human third molar root canals were obturated with ProRoot MTA or Biodentine. Before obturation the canals were irrigated with saline (control), 2% CHX or 5% DMSO. Microleakage was tested after three days and after six months. After additional six months (12 months after root filling) the roots were cut into 2 mm thick dentine discs. The discs were stored in artificial saliva for one year. The bond strength was measured with the push-out method, and the failure mode was evaluated with a stereomicroscope. The most apical disc of each tooth was used for Vickers hardness test. Results: No significant differences between the groups was found in initial microleakage. The leakage increased significantly during the 6-month storage in all groups except in Biodentine-CHX group and Biodentine-DMSO group. CHX and DMSO irrigation significantly increased the leakage with ProRoot MTA with time, but there was no statistically significant difference compared to the ProRoot MTA-control group at six months’ time point. CHX significantly reduced the push-out bond strength of ProRoot MTA. With Biodentine irrigation with CHX or DMSO resulted with significantly higher push-out strength compared to the Biodentine control group. Fracture analysis showed statistically significant difference in the distribution of the fractures between the groups, but neither CHX nor DMSO change the fracture pattern statistically significantly. With Vickers hardness test ProRoot MTA with and without DMSO as the final irrigant showed significantly higher dentin hardness than any Biodentine-group. Significance: Considering that aging increased the leakage in all groups except with Biodentine-DMSO and the differences in the push-out strength and surface microhardness data, it appears th

Aim: To study whether oral parameters such as endodontic infections, root canal fillings, number of teeth or wearing removable dentures at baseline are associated with cardiovascular- and all-cause mortality in a follow-up of approximately 8 years. Methodology: The Finnish Parogene cohort consists of 508 Finnish adults (mean age 63.3 years, SD 9.1) with cardiac symptoms, all of whom had undergone coronary angiography for accurate baseline coronary status. Extensive clinical and radiographic oral examinations were performed, and additional data were acquired from medical records and questionnaires. Root canal fillings and endodontic lesions, as well as their co-occurrence, were determined from panoramic radiographs. The mortality data were assessed via record linkage with the Finnish Causes of Death register (mean follow-up time 7.81 years, SD 1.45 years). A total of n = 471 dentate patients were included in the statistical analyses. Results: A total of n = 69 deaths were recorded, of which n = 41 were due to cardiovascular diseases (CVDs, ICD-10 I00–I99). The deceased had fewer root canal fillings (mean 1.57; SD 1.64 vs. mean 2.30; SD 2.34, P = 0.03) than the survivors. The number of missing teeth was associated with smoking, occluded coronary arteries and diabetes. Cox regression with Firth’s penalized maximum-likelihood method using age as timescale revealed an inverse association (HR; 95%CI) between mortality and number of teeth (all-cause 0.91; 0.86–0.96, CVD mortality 0.89; 0.83–0.96), use of removable dentures (all-cause 0.24; 0.09–0.62, CVD mortality 0.20; 0.06–0.72), root canal fillings (all-cause 0.82; 0.70–0.94, CVD mortality 0.79; 0.63–0.96) and having root canal fillings in all teeth with apical rarefactions (all-cause 0.27; 0.06–0.79, CVD mortality 0.09; 0.01–0.63), when gender, smoking, occluded coronary arteries, periodontal inflammatory burden index and the number of teeth were adjusted for. Conclusions: The number of missing teeth appeared

Saliva is a complex oral fluid, and plays a major role in oral health. Primary Sjögren’s syndrome (pSS), as an autoimmune disease that typically causes hyposalivation. In the present study, salivary metabolites were studied from stimulated saliva samples (n = 15) of female patients with pSS in a group treated with low-dose doxycycline (LDD), saliva samples (n = 10) of non-treated female patients with pSS, and saliva samples (n = 14) of healthy age-matched females as controls. Saliva samples were analyzed with liquid chromatography mass spectrometry (LC-MS) based on the non-targeted metabolomics method. The saliva metabolite profile differed between pSS patients and the healthy control (HC). In the pSS patients, the LDD treatment normalized saliva levels of several metabolites, including tyrosine glutamine dipeptide, phenylalanine isoleucine dipeptide, valine leucine dipeptide, phenylalanine, pantothenic acid (vitamin B5), urocanic acid, and salivary lipid cholesteryl palmitic acid (CE 16:0), to levels seen in the saliva samples of the HC. In conclusion, the data showed that pSS is associated with an altered saliva metabolite profile compared to the HC and that the LLD treatment normalized levels of several metabolites associated with dysbiosis of oral microbiota in pSS patients. The role of the saliva metabolome in pSS pathology needs to be further studied to clarify if saliva metabolite levels can be used to predict or monitor the progress and treatment of pSS.

Aim: To evaluate the regional variation in restorative treatment need among Finnish young people based on the socioeconomic factors. Materials and methods: This cross-sectional study was conducted in 20 garrisons of the Finnish Defence Forces in January and July 2011. The study population comprised 13,819 Finnish conscripts born in the beginning of 1990s, including females. A computer-based survey was done together with clinical oral examination to gather background information, e.g., educational status. Furthermore, average annual income of the conscript’s residence municipality was achieved from the Statistics of Finland. The zip code of the place of residence of each conscript was later extracted from the Mildoc® system. Georeferenced place of residence and income status were merged as information on provinces’ level in a dataset. The association between the outcome variable and explanatory variables was determined by using the generalized linear mixed model, and geomaps were constructed. Results: Mean D value was 1.41 ranging from 0.89 (Kymenlaakso) to 2.33 (Kainuu). Higher education and high-income level were protective factors for restorative treatment need. Restorative treatment need was also low in those areas with high (OR: 0.70, 95% CI: 0.56–0.87) and medium (OR: 0.79, 95% CI: 0.70–0.89) yearly income compared to low yearly income. The high odds for the need of restorative treatment were discovered in Northern Ostrobothnia (OR: 2.26, 95% CI: 1.53–3.33) followed by Central Ostrobothnia (OR: 2.08, 95% CI: 1.17–3.70), Uusimaa (OR: 1.55, 95% CI: 1.16–2.08), and Central Finland (OR: 1.54, 95% CI: 1.10–2.16) compared to Varsinais-Suomi. Conclusion: In conclusion, there is a significant regional variation in restorative treatment need among Finnish young people in their twenties based on the socioeconomic factors.

The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine–pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.

Objectives: Bitewing radiographs are mainly used to confirm clinical findings in caries diagnostics. The objective here was to investigate the quality of bitewing radiographs after short brush-up training and additional findings besides caries in a low-caries population. Methods: The material of this cross-sectional study comprised 377 pairs of bitewing radiographs of 19- to 20-year-olds taken by dentists. Radiography was considered indicated if one dentinal caries lesion was present on clinical examination. A senior oral radiologist evaluated quality and diagnosed the findings afterwards unaware of clinical status. The association between variables was analysed using cross tabulation and chi-squared testing. Results: Almost half of the images were of compromised quality (44.1%). Dentinal caries lesions were detected in 82.3% and enamel lesions in 73.5% of the subjects. On average, the subjects had 1.7 (SD 0.52) dentinal lesions. Fillings were found in 81.8%, fractures/cracks in 11.7%, and attrition in 7.4% of the subjects. Signs of excessive bite force were recorded in 19.4%, whereas marginal bone loss was detected in 6.4%. No significant correlation was detected between fractures, attrition, and excessive bite forces. Conclusions: Effort must be taken to ensure high quality of bitewing radiographs. In addition to caries detection, bitewing radiographs offer additional value, such as detecting excessive bite forces, tooth wear, and marginal bone loss among young adults.

Studies on the role of physical fitness, physical activity and obesity as risk factors for temporomandibular disorders (TMD) are scarce. The aim of the present study was to evaluate the association of TMD symptoms with physical fitness, physical activity and body mass index (BMI) among Finnish conscripts. The study sample consisted of 8685 Finnish conscripts. Data on self-reported TMD symptoms were used as outcome variables. Physical activity (questionnaire), physical fitness (measured with physical tests: Cooper test, push-ups, sit-ups and standing long jump) and body mass index (BMI) were used as explanatory variables. The associations between TMD symptoms and explanatory variables were evaluated using Chi-squared test and logistic regression analysis. The prevalence of all TMD symptoms was significantly higher among those who exercised more rarely than weekly. Pain-related TMD symptoms were also significantly more frequent among those who were overweight (BMI ≥ 25). Poor push-up results and overweight (BMI ≥ 25) were significantly associated with jaw pain and TMJ pain at jaw rest. The present study showed that good physical fitness may be a protective factor against TMD pain. Dentists should also be prepared to motivate TMD patients to physical activity and regular exercise as part of the treatment.

Background: A wide range in the prevalence of molar-incisor-hypomineralization (MIH) has been reported. Population-based studies are recommended. However, such studies are expensive and time-consuming. Objectives: To estimate the magnitude of MIH condition among 8-year-olds based on routine oral health examinations and to associate first permanent molar (FPM) affection with that of other permanent teeth over time. Materials and methods: This retrospective study, with cross-sectional and longitudinal components, was based on electronic oral health records; all 8-year-olds examined between 2002 and 2016 were included. Results: The average estimated prevalence of MIH was 8.3%; yearly range was 4.8–15.9%. The mean number of affected teeth was 1.4; 62% had one affected tooth. One-surface defects were the most frequent (66%). Asymmetric distribution of affected teeth was observed. In follow-up, 10.7%, 8.4%, and 11.2% had at least one affected permanent canine, premolar, or second permanent molar, respectively. The proportion of children with other MIH-affected permanent teeth was higher in the group with ≥2 MIH-affected teeth than in group with one affected FPM at the age of 8. Conclusions: The average prevalence of MIH was comparable to that reported elsewhere. The number of MIH-affected teeth at early mixed dentition predicts the affection of other permanent teeth over time, mainly that of permanent canines. Further screening of children with MIH is recommended to improve individually tailored early preventive and restorative dental care.

Apical periodontitis is an inflammatory reaction at the apex of an infected tooth. Its microbiota resembles that of marginal periodontitis and may induce local and systemic antibodies binding to bacteria- and host-derived epitopes. Our aim was to investigate the features of the adaptive immune response in apical periodontitis. The present Parogene cohort (n = 453) comprises patients with cardiac symptoms. Clinical and radiographic oral examination was performed to diagnose apical and marginal periodontitis. A three-category endodontic lesion score was designed. Antibodies binding to the bacteria- and host-derived epitopes were determined from saliva and serum, and bacterial compositions were examined from saliva and subgingival samples. The significant ORs (95% CI) for the highest endodontic scores were observed for saliva IgA and IgG to bacterial antigens (2.90 (1.01–8.33) and 4.91 (2.48–9.71)/log10 unit), saliva cross-reacting IgG (2.10 (1.48–2.97)), serum IgG to bacterial antigens (4.66 (1.22–10.1)), and Gram-negative subgingival species (1.98 (1.16–3.37)). In a subgroup without marginal periodontitis, only saliva IgG against bacterial antigens associated with untreated apical periodontitis (4.77 (1.05–21.7)). Apical periodontitis associates with versatile adaptive immune responses against both bacterial- and host-derived epitopes independently of marginal periodontitis. Saliva immunoglobulins could be useful biomarkers of oral infections including apical periodontitis—a putative risk factor for systemic diseases.

Objective: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. Material and methods: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. Results: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. Conclusions: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing.