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Överkäkshörntänderna är den tand i bettet som har längst väg att eruptera och som uppvisar den högsta retentionsprevalensen. Tidig diagnostik av ektopiska hörntänder och efterföljande interceptiv vård är av största vikt för att motverka att ektopiska hörntänder blir retinerade. En korrekt utförd interceptiv behandling kan bidra till att både undvika skador på granntändernas rötter och en omfattande ortodontisk behandling som en framdragning av en hörntand innebär. Interceptiv vård löser inte problemet med alla ektopiska hörntänder. I de fall då hörntanden befinner sig bakom överkäkscentraler, är det viktigt att en effektiv och evidensbaserad friläggning- och ortodontisk framdragningsteknik sätts in., The maxillary canines are the teeth in the dental arch with the longest eruption path and demonstrate the highest prevalence of impaction. Early diagnosis of the palatally displaced canines (PDC) and subsequent interceptive treatment are of paramount importance to prevent the PDC from becoming impacted. Properly executed interceptive treatment can contribute to avoiding root resorptions of the adjacent teeth, as well as extensive and burdensome treatment of PDC involving surgical exposure and subsequent orthodontic treatment. The interceptive treatment, however, does not always success to correct the eruption path of the PDC. In cases with unsuccessful outcomes of the interceptive treatment, it is crucial to opt for an effective and evidence-based exposure and orthodontic traction technique.

It is well established that inflammatory processes in the vicinity of bone often induce osteoclast formation and bone resorption. Effects of inflammatory processes on bone formation are less studied. Therefore, we investigated the effect of locally induced inflammation on bone formation. Toll-like receptor (TLR) 2 agonists LPS from Porphyromonas gingivalis and PAM2 were injected once subcutaneously above mouse calvarial bones. After five days, both agonists induced bone formation mainly at endocranial surfaces. The injection resulted in progressively increased calvarial thickness during 21 days. Excessive new bone formation was mainly observed separated from bone resorption cavities. Anti-RANKL did not affect the increase of bone formation. Inflammation caused increased bone formation rate due to increased mineralizing surfaces as assessed by dynamic histomorphometry. In areas close to new bone formation, an abundance of proliferating cells was observed as well as cells robustly stained for Runx2 and alkaline phosphatase. PAM2 increased the mRNA expression of Lrp5, Lrp6 and Wnt7b, and decreased the expression of Sost and Dkk1. In situ hybridization demonstrated decreased Sost mRNA expression in osteocytes present in old bone. An abundance of cells expressed Wnt7b in Runx2-positive osteoblasts and ß-catenin in areas with new bone formation. These data demonstrate that inflammation, not only induces osteoclastogenesis, but also locally activates canonical WNT signaling and stimulates new bone formation independent on bone resorption.

Background: The long-term effects on dentofacial morphology of interceptive treatment with premolar extractions, in the absence of subsequent orthodontic treatment, have not been fully explored. Objective: The aim was to investigate the effects of premolar extractions (without subsequent orthodontic treatment) on the dentoskeletal and soft tissue profile of patients aged between 12 and 62 years with Class I malocclusion with severe crowding, as compared to untreated controls. Materials and methods: The Extraction group (N = 30 with Class I crowding malocclusion) had their first premolars removed in early adolescence without subsequent orthodontic treatment. The Control group included 30 untreated subjects with Class I normal occlusion. Cephalograms were taken at 12 (T1), 15 (T2), 30 (T3), and 62 (T4) years of age. A superimposition-based cephalometric method was used to assess the dentoskeletal and soft tissue changes. Results: There were no significant differences between the Extraction and Control groups in terms of skeletal sagittal relation, incisor inclination, and protrusion, or most of the soft tissue parameters throughout the observation period. However, significant differences were observed between the groups with respect to the vertical relations in T2-T3, such that the Extraction group showed more-pronounced decreases in the ML/NSL, ML/NL, and Gonial angles and more-pronounced increases in facial heights. Conclusions and implications: Treatment for subjects with Class I malocclusion with severe crowding by the extraction of four premolars, without subsequent orthodontic treatment, does not affect the long-term dentoskeletal and soft tissue profile, as compared to an untreated Control group. The degree of crowding, rather than changes in dentofacial morphology, is crucial in deciding on extraction therapy.

OBJECTIVE: To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. TRIAL DESIGN: Three-armed parallel-group randomized controlled trial. METHODS: The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. RECRUITMENT: October 2010 to December 2012. RESULTS: In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01. CONCLUSIONS: To prevent demineralized lesions

Folkhälsomyndigheten (Fohm) har sedan 2018 regeringens uppdrag att bidra med kunskapshöjande insatser för att minska stigmatiseringen av psykisk ohälsa och suicid. Avtal har inledningsvis slutits med tre regioner för att stärka dessas främjande och preventiva arbete för att minska stigmatisering av psykisk ohälsa och suicid. Umeå universitet har fått uppdraget att genomföra en processutvärderingmed implementeringsperspektiv under 2021. Utvärderingen har syftat till att bidra med en fördjupad förståelse för implementeringen av det regionala utvecklingsarbetet. Utvärderingen vilar på analyser av dokument, enkäter och fokusgruppsintervjuer från de medverkande regionerna. Utvärderingen har delvis tagit sin utgångspunkt i det teoretiska ramverket the Consolidated Framework for Implementation Research (CFIR). CFIR sammanfattar befintlig litteratur om faktorer som påverkar implementeringsprocesser och utfall. Resultaten visar att de undersökta faktorerna, av de allra flesta medverkande aktörerna, betraktas som viktiga förutsättningar för utvecklingsarbetets implementering. Det råder viss variation i deltagarnas uppfattningar om i vilken utsträckning dessa förutsättningar finns på plats och hur väl de fungerar idag. Förutsättningar och utmaningar har varierat i regionerna. De faktorer som en övervägande del respondenter skattat som extra utmanande i genomförandet av utvecklingsarbetet återfinns i organisationernas inre kontext och utgörs av Utvecklingsarbetets givna prioritet; Målens tydlighet och hur dessa kommunicerats; Utvecklingsarbetets organisering och; Hur kända mottagarkontextens behov är i organisationen. Gemensamma framgångsfaktorer som beskrivits är en god samverkan mellan olika aktörer; en ökad medvetenhet i regionerna om vikten av att arbeta med stigma av psykisk ohälsa och suicid; ett yttre tryck från nationella aktörer som bidrar till att prioritera dessa frågor; samt att det finns en bred förankring i politisk- och tjänstemannaledning som ger ett tydligt man

Introduction: During the last decade, structures for ‘knowledge governance’ as a means of strengthening the quality of social services has been used by the Swedish government and national authorities. In this process, regional collaboration and support structures (RCSSs) have been identified as a key asset as an intermediary link between national and local actors. The aim of this study was to explore the perspectives of these regional actors on expectations associated with being an intermediary support structure in knowledge governance processes in social services in Sweden. Methods: The study uses an abductive, qualitative approach, mainly with open questions in an empirical-driven manner (inductively) and partly in a theory-driven manner (deductively). Interviews with representatives from the RCSSs were used for data collection. Conventional content analysis with elements of directed content analysis of the data material was used. Results: A variety of expectations on RCSSs was reported from the national and local levels. According to the respondents, the feeling of inadequacy in relation to the perceived expectations was recurrent because the expectations were hard to meet. They also experienced role ambiguity and that their mission was unclear. Conclusions: The findings show that RCSSs seem to handle the situation by considering, assessing, and prioritising different actors’ needs and expectations in relation to their own perception of the intermediary mission. The findings also indicate a lack of a collective sense-making process with other key actors on different levels in the knowledge governance system. To reach the core purpose of knowledge governance, it is necessary to establish a common understanding of the relationship between expectations and prerequisites for facilitation between national, regional, and local actors.

Background: In long-term studies of orthodontic, orthognathic, and prosthodontic treatments, control subjects are needed for comparison. Objectives: To study the craniofacial (skeletal, soft tissue, and dental) changes that occur in untreated subjects with normal occlusion between13 and 62 years of age. Materials/Methods: Thirty subjects with a Class I normal occlusion and harmonious facial profle were studied. X-ray examinations were performed at 13 (T1), 16 (T2), 31 (T3), and 62 (T4) years of age, and data were obtained from cephalograms. In total, 53 angular and linear parameters were measured using superimposition-based and conventional cephalometric methods to describe the craniofacial changes. Results: The jaws showed signifcant anterior growth from T1 to T2, and signifcant retrognathism from T3 to T4. The anterior face height andjaw dimensions increased signifcantly until T3. Signifcant posterior rotation of the mandible and opening of the vertical jaw relation, in additionto signifcant retroclination of the incisors and straightening of the facial profle, were found from T3 to T4.Limitations: Given the small sample size at T4, it was not possible to analyse the gender dimension. Conclusions/Implications: Craniofacial changes continue up to the sixth decade of life. These changes are consistent, albeit to a lesser extent,with the adolescent growth patterns for most of the studied parameters, with the exceptions of incisor inclination, sagittal jaw position, verticaljaw relation and inclination, and posterior face height.