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Lofthag-Hansen S.,Gothenburg University | Thilander-Klang A.,Gothenburg University | Thilander-Klang A.,Sahlgrenska University Hospital | Grondahl K.,Gothenburg University | Grondahl K.,Institute for Postgraduate Dental Education
European Journal of Radiology | Year: 2011

Aims: To evaluate subjective image quality for two diagnostic tasks, periapical diagnosis and implant planning, for cone beam computed tomography (CBCT) using different exposure parameters and fields of view (FOVs). Materials and methods: Examinations were performed in posterior part of the jaws on a skull phantom with 3D Accuitomo (FOV 3 cm × 4 cm) and 3D Accuitomo FPD (FOVs 4 cm × 4 cm and 6 cm × 6 cm). All combinations of 60, 65, 70, 75, 80 kV and 2, 4, 6, 8, 10 mA with a rotation of 180° and 360° were used. Dose-area product (DAP) value was determined for each combination. The images were presented, displaying the object in axial, cross-sectional and sagittal views, without scanning data in a random order for each FOV and jaw. Seven observers assessed image quality on a six-point rating scale. Results: Intra-observer agreement was good (κ w = 0.76) and inter-observer agreement moderate (κ w = 0.52). Stepwise logistic regression showed kV, mA and diagnostic task to be the most important variables. Periapical diagnosis, regardless jaw, required higher exposure parameters compared to implant planning. Implant planning in the lower jaw required higher exposure parameters compared to upper jaw. Overall ranking of FOVs gave 4 cm × 4 cm, 6 cm × 6 cm followed by 3 cm × 4 cm. Conclusions: This study has shown that exposure parameters should be adjusted according to diagnostic task. For this particular CBCT brand a rotation of 180° gave good subjective image quality, hence a substantial dose reduction can be achieved without loss of diagnostic information. © 2010 Elsevier Ireland Ltd. Source

Berden J.,Institute for Postgraduate Dental Education
European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry | Year: 2010

AIM: To present a series of clinical cases of children treated for large dentigerous cysts with a conservative and tissue preserving surgical approach. METHODS: A follow-up study of 11 children aged 5-11 years old treated for large dentigerous cysts with decompression. The children were followed from the first appointment when the cysts were diagnosed until the full eruption of the involved and displaced teeth. The treatment procedure is described step by step. Three of the 11 cases are presented in detail. RESULTS: All permanent teeth displaced by the dentigerous cysts, except a wisdom tooth and a maxillary canine, erupted in a correct position and in good occlusion. No facial disfigurations or defects of oral tissues occurred. CONCLUSIONS: A decompression approach, as described in this paper, is rewarding for the patient and the surgeon. It would be unethical and destructive to the maxillofacial bone structure not to treat large dentigerous cysts in children by decompression. Source

Johansson V.,Malmo University | Axtelius B.,Malmo University | Soderfeldt B.,Malmo University | Sampogna F.,Malmo University | And 3 more authors.
Community Dentistry and Oral Epidemiology | Year: 2010

Objectives: Since 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, has two co-existing patient financial systems, i.e. ways for the patient to pay for dental care services. Alongside the traditional system of fee-for-service payment, i.e. paying afterwards for provided services, a new system of contract care is offered. In this system, dental care is covered by a contractual agreement, for which the patient pays an annual fee and receives care covered by the contract without additional costs. The aim of this article was to study whether patient financial system was associated with oral health-related quality of life (OHRQoL). Methods: A questionnaire was answered by 1324 randomly selected patients, 52% from contract care and 48% from fee-for-service. The questionnaire contained questions about how much one was prepared to pay for dental care, how much one paid for dental care the previous year, OHIP-14 (measured OHRQoL), dental anxiety, humanism of caregiver, SF-36 (measured general health), multidimensional health locus of control, sense of coherence (SOC), self-esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The material was analysed with a hierarchical block method of multiple regression analysis. Results: When controlling for all other variables, patient financial system was one of the strongest associations with OHRQoL: patients in fee-for-service had worse OHRQoL than those in contract care. OHRQoL was also associated with general health, SOC and to some extent also with psychological and economic factors. Of the social variables, only being foreign born was significant: it was associated with worse OHRQoL. Conclusions: Patient financial system was associated with OHRQoL when controlling for confounding factors: patients in contract care had better OHRQoL than those in fee-for-service care. © 2010 John Wiley & Sons A/S. Source

Alm A.,Karnsjukhuset | Wendt L.K.,Health Science University | Koch G.,Institute for Postgraduate Dental Education | Birkhed D.,Gothenburg University | Nilsson M.,Futurum The Academy of Healthcare
Community Dentistry and Oral Epidemiology | Year: 2012

Objective: To analyse the relationship between caries determinants in early childhood and caries prevalence in proximal surfaces in adolescents at the age of 15 years. Methods: The present longitudinal study is part of a series of surveys of oral health in 671 children followed from 1 to 15 years of age. Data were selected from examinations, interviews and questionnaires at 1, 3 and 6 years and bitewing radiographs at 15 years of age. Uni- and multivariable logistic regression analyses were performed to identify caries-related determinants. The outcome variable was carious lesions and fillings (DFa) in approximal tooth surfaces at 15 years of age. Statistical comparisons were made between caries-free teenagers, DFa = 0 and teenagers with DFa > 0, DFa ≥ 4 and DFa ≥ 8, respectively. Results: In the final logistic regression analyses, caries experience at 6 years and mother's self-estimation of her oral health care as being less good to poor remained statistically significant and were related to caries in all three caries groups (i.e. DF > 0, ≥4 and ≥8) at 15 years of age. The consumption of sweets at 1 year remained statistically significant, with a caries experience of DF ≥ 4 and ≥ 8. The variables 'parents born abroad' and female gender were statistically significantly associated with DFa ≥ 4 and DFa ≥ 8, respectively. Furthermore, infrequent toothbrushing habits at 3 years of age and failure to attend the examination at 1 year were statistically significantly associated with caries at 15 years in the univariable analyses. Conclusion: Early caries experience, consumption of sweets at an early age and mother's self-estimation of her oral health care as being less good to poor are associated with approximal caries in adolescents. The study indicates that caries determinants identified during early childhood have a strong impact on approximal caries in adolescence. © 2011 John Wiley & Sons A/S. Source

Thorstensson H.,Institute for Postgraduate Dental Education | Thorstensson H.,National University of Health Sciences | Johansson B.,University Institute of Health Sciences | Johansson B.,Gothenburg University
Gerodontology | Year: 2010

Objectives: To analyse the importance of caries, periodontitis, and medical and psychosocial factors for risk of becoming edentulous across their lifespan and to examine factors critical for retaining functional dentition into very old age. Methods: From the longitudinal population-based Octogenarian Twin study which analysed psychosocial and health variables, 357 individuals aged 82 + in 1995-1998 were collected. Information about number of teeth, decayed and filled surfaces percentage and periodontal disease experience were drawn from dental records. Reasons for and time of edentulousness were recorded. Results: Outcome varied - depending on perspective and factors for losing or retaining teeth. Significant factors for losing teeth varied over the lifespan. Losing teeth early in life was related to lower social class; in middle age, to lower education; and in old age, to poor lifestyle factors and low social class. Caries constituted the main reason for tooth loss (about 55%). This increased substantially in the >80 year age-group (75%). Maintaining a functional dentition into old age was significantly associated with non-smoking, more education, being married and good periodontal health. Conclusion: It is important to apply life-span and cohort perspectives to oral health and disease. In our sample of persons born before World War I, caries was the main reason for losing all teeth, with substantially increased prevalence by age. Lifestyle factors were significant for losing and for retaining teeth. Periodontal condition had a significant influence on the likelihood of retaining functional dentition, and also when taking psychosocial variables into account. © 2009 The Gerodontology Society and John Wiley & Sons A/S. Source

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