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Bohm-Starke, N., Pukall, C., Österberg, M., Ahlberg, M., Jonsson, A. K., Tranæus, S., . . . Hellberg, C. (2024). Development of a core outcome set for treatment studies for provoked vestibulodynia.. Journal of Sexual Medicine, 21(6), 556-565, Article ID qdae035.
Open this publication in new window or tab >>Development of a core outcome set for treatment studies for provoked vestibulodynia.
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2024 (English)In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 21, no 6, p. 556-565, article id qdae035Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is an inconsistency in treatment outcomes used in clinical trials for provoked vestibulodynia (PVD), which makes it impossible to compare the effects of different interventions.

AIM: In this study, we completed the first step in creating a core outcome set (COS), defining what outcomes should be measured in clinical trials for PVD.

METHODS: Identification of outcomes used in studies was done by extracting data from clinical trials in a recently published systematic review and via review of clinical trials for PVD registered on ClinicalTrials.gov. The COS process consisted of 2 rounds of Delphi surveys and a consensus meeting, during which the final COS was decided through a modified nominal group technique.

OUTCOMES: Consensus on what outcomes to include in a COS for PVD.

RESULTS: Forty scientific articles and 92 study protocols were reviewed for outcomes. Of those, 36 articles and 25 protocols were eligible, resulting in 402 outcomes, which were then categorized into 63 unique outcomes. Participants consisted of patients, relatives/partners of patients, health care professionals, and researchers. Out of 463 who registered for participation, 319 and 213 responded to the first and second surveys, respectively. The consensus meeting consisted of 18 members and resulted in 6 outcomes for the COS to be measured in all treatment trials regardless of intervention: insertional pain (nonsexual), insertional pain (sexual), provoked vulvar pain by pressure/contact, pain-related interference on one's life, pain interference on sexual life, and sexual function.

CLINICAL IMPLICATIONS: Critical outcomes to be measured in clinical trials will allow for accurate comparison of outcomes across treatment interventions and provide solid treatment recommendations.

STRENGTHS AND LIMITATIONS: The major strengths of the study are the adherence to methodological recommendations and the intentional focus on aspects of diversity of participating stakeholders (eg, status such as patients with lived experience and researchers, inclusiveness with respect to sexual identity), the latter of which will allow for broader application and relevance of the COS. Among the limitations of the study are the low rate of participants outside North America and Europe and the lower response rate (about 50%) for the second Delphi survey.

CONCLUSION: In this international project, patients, health care professionals, and researchers have decided what critical outcomes are to be used in future clinical trials for PVD. Before the COS can be fully implemented, there is also a need to decide on how and preferably when the outcomes should be measured.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
clinical trials, core outcome set, provoked vestibulodynia, treatment outcome, vulvodynia
National Category
Gynaecology, Obstetrics and Reproductive Medicine
Identifiers
urn:nbn:se:mau:diva-66697 (URN)10.1093/jsxmed/qdae035 (DOI)001188681200001 ()38515322 (PubMedID)2-s2.0-85195228095 (Scopus ID)
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2025-02-11Bibliographically approved
Werkö, S. S., Mattsson, T., Tranæus, S., Östlund, P. & Sundell, K. (2024). The transition of assessing health technologies to social interventions in Sweden. International Journal of Technology Assessment in Health Care, 40(1), Article ID e66.
Open this publication in new window or tab >>The transition of assessing health technologies to social interventions in Sweden
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2024 (English)In: International Journal of Technology Assessment in Health Care, ISSN 0266-4623, E-ISSN 1471-6348, Vol. 40, no 1, article id e66Article, review/survey (Refereed) Published
Abstract [en]

Since the 1970s the Swedish government has been promoting social work based on research into methods which work in practice for practitioners and patients. In 2015, the Swedish Agency for Health Technology Assessment (SBU), a government agency instigated in 1987, was commissioned to expand its remit, to review empirical research on social work interventions and to disseminate the results to stakeholders. SBU was then renamed The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). This article describes the fusion of health technology assessment (HTA) and Social Intervention Assessment (SIA), including advantages and challenges.

Place, publisher, year, edition, pages
Cambridge University Press, 2024
Keywords
evidence-based policy, systematic literature review, health technology assessment, social intervention assessment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-72605 (URN)10.1017/S0266462324000606 (DOI)001368615100001 ()39610279 (PubMedID)2-s2.0-85210741145 (Scopus ID)
Available from: 2024-12-09 Created: 2024-12-09 Last updated: 2025-01-21Bibliographically approved
Kirkinen, T., Naimi-Akbar, A., Cederlund, A., Tranæus, S., Carlson, C. & Klingberg, G. (2023). Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden. Acta Odontologica Scandinavica, 81(8), 615-621
Open this publication in new window or tab >>Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 8, p. 615-621Article in journal (Refereed) Published
Abstract [en]

Objectives This study evaluates the agreement of data on dental caries between electronic dental records and data retrieved from the national SKaPa-registry (Swedish Quality Registry for caries and periodontal disease), with special reference to e/M in deft/DMFT.

Methods In a random sample of 500 6- and 12-year-old children having received dental care in 2014 in the county region of Värmland, Sweden, the diagnostic accuracy of data in electronic dental records with corresponding data obtained from the SKaPa-registry was compared by using Cohen’s Kappa and Intraclass correlation coefficient (ICC).

Results For dft/DFT the Kappa was 0.95, and ICC 0.98 (total population). For deft/DMFT in the total population the Kappa was 0.80 and ICC 0.96. For 6-year-olds (deft) the Kappa was 0.89 and ICC 0.99 and for 12-year-olds (DMFT) the Kappa was 0.70, and ICC 0.83. The corresponding figures for Kappa and ICC when excluding individuals without caries (deft/DMFT = 0) were: Total population 0.63 and 0.94; 6-year-olds 0.79 and 0.99; 12-year-olds 0.42 and 0.68.

Conclusion Agreement between data in the dental records and SKaPa was very high for dft/DFT confirming that transfer from the dental records to the SKaPa-registry is safe and correct. As the accuracy of deft/DMFT was considerably lower than for dft/DFT we advise against using deft/DMFT data from SKaPa for research purposes at this point.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
data accuracy, registries, child, dental caries
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-61741 (URN)10.1080/00016357.2023.2235422 (DOI)001032787700001 ()37470405 (PubMedID)2-s2.0-85165443093 (Scopus ID)
Funder
Region Värmland
Available from: 2023-07-26 Created: 2023-07-26 Last updated: 2024-04-08Bibliographically approved
Klingberg, G., Benchimol, D., Berlin, H., Bring, J., Gornitzki, C., Odeberg, J., . . . Domeij, H. (2023). How old are you?: a systematic review investigating the relationship between age and mandibular third molar maturity. PLOS ONE, 18(5), 1-14, Article ID e0285252.
Open this publication in new window or tab >>How old are you?: a systematic review investigating the relationship between age and mandibular third molar maturity
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, p. 1-14, article id e0285252Article, review/survey (Refereed) Published
Abstract [en]

Introduction and objective: Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years.

Methods: The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H).

Results: A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment.

Conclusion: The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-59643 (URN)10.1371/journal.pone.0285252 (DOI)000993222400034 ()37200251 (PubMedID)2-s2.0-85159764106 (Scopus ID)
Available from: 2023-05-23 Created: 2023-05-23 Last updated: 2023-09-05Bibliographically approved
Johansson, K., Götrick, B., Holst, J., Tranæus, S. & Naimi-Akbar, A. (2023). Impact of direct oral anticoagulants on bleeding tendency and postoperative complications in oral surgery: a systematic review of controlled studies. Oral surgery, oral medicine, oral pathology and oral radiology, 135(3), 333-346, Article ID S2212-4403(22)01047-1.
Open this publication in new window or tab >>Impact of direct oral anticoagulants on bleeding tendency and postoperative complications in oral surgery: a systematic review of controlled studies
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2023 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 135, no 3, p. 333-346, article id S2212-4403(22)01047-1Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE: The recommendations for the management of direct oral anticoagulants (DOACs) in oral surgery are inconsistent. The present review evaluated whether DOACs increase the risk of bleeding during oral surgery and postoperative complications.

STUDY DESIGN: The patients undergoing oral surgery and receiving a DOAC were compared with the patients receiving a DOAC different from the exposure, a vitamin K antagonist (VKA), or no anticoagulant. Three electronic databases were searched for eligible clinical trials and systematic reviews. The risk of bias was assessed, data were extracted, a meta-analysis was done, and the Grading of Recommendations, Assessment, Development and Evaluations certainty-of-evidence ratings were determined.

RESULTS: Three clinical trials comparing patients receiving DOAC medication with patients on a VKA were eligible. A meta-analysis of bleeding 7 days postoperatively detected no significant differences between patients continuing DOAC or VKA medication during and after surgery. All of the point estimates favored uninterrupted DOAC over VKA therapy. Tranexamic acid was topically administered to some patients.

CONCLUSIONS: Based on an interpreted trend among 3 studies with mixed patient populations, the risk of bleeding during the first 7 postoperative days may be lower for patients on uninterrupted DOAC than VKA therapy (⨁⨁⭘⭘), but the effect size of the risk is unclear. 80 of 274 included patients experienced postoperative bleeding.

Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-56338 (URN)10.1016/j.oooo.2022.07.003 (DOI)000990228100001 ()36100547 (PubMedID)2-s2.0-85137711821 (Scopus ID)
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2024-11-12Bibliographically approved
Davidson, T., Blomma, C., Bågesund, M., Krevers, B., Vall, M., Wärnberg Gerdin, E. & Tranæus, S. (2021). Cost-effectiveness of caries preventive interventions: a systematic review. Acta Odontologica Scandinavica, 79(4), 309-320
Open this publication in new window or tab >>Cost-effectiveness of caries preventive interventions: a systematic review
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2021 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 4, p. 309-320Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The primary purpose of this study was to assess the cost-effectiveness of caries preventive interventions.

MATERIAL AND METHODS: A systematic review was conducted, following the PRISMA Statement. Four electronic databases were searched (final search 16 March 2020). Studies fulfilling the inclusion criteria were independently critically appraised, by two reviewers in parallel. Data from each included study were extracted and tabulated: the analysis used a narrative approach to present the results of the estimated cost-effectiveness.

RESULTS AND CONCLUSIONS: Twenty-six publications fulfilled the inclusion criteria and were of low or moderate risk of bias. Ten publications were economic evaluations, directly based on empirical studies, and the other 16 were modelling studies. Most of the studies concerned interventions for children and the most common were analyses of fluoride varnish and risk-based programs. Some of the studies showed both reduced cost and improved outcomes, but most studies reported that the improved outcome came with an additional cost. The results disclosed several cost-effectiveness evaluations of caries preventive interventions in the literature, but these target primarily children at high risk. There is a scarcity of studies specifically targeting adults and especially the elderly.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Caries, cost-effectiveness, economics, prevention, systematic review
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-37773 (URN)10.1080/00016357.2020.1862293 (DOI)000603892200001 ()33370544 (PubMedID)2-s2.0-85098552599 (Scopus ID)
Available from: 2021-01-05 Created: 2021-01-05 Last updated: 2023-10-24Bibliographically approved
Mensah, T., Tranæus, S., Cederlund, A., Naimi-Akbar, A. & Klingberg, G. (2021). Swedish quality registry for caries and periodontal diseases (SKaPa): validation of data on dental caries in 6- and 12-year-old children. BMC Oral Health, 21, Article ID 373.
Open this publication in new window or tab >>Swedish quality registry for caries and periodontal diseases (SKaPa): validation of data on dental caries in 6- and 12-year-old children
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2021 (English)In: BMC Oral Health, E-ISSN 1472-6831, Vol. 21, article id 373Article in journal (Refereed) Published
Abstract [en]

Background

The Swedish Quality Registry for caries and periodontal disease (SKaPa) automatically collects data on caries and periodontitis from patients’ electronic dental records. Provided the data entries are reliable and accurate, the registry has potential value as a data source for registry-based research. The aim of this study was to evaluate the reliability and accuracy of the SKaPa registry information on dental caries in 6- and 12-year-old children.

Method

This diagnostic accuracy study compared dental caries data registered at an examination with dental health status registered in the patient’s electronic dental records, and with corresponding data retrieved from the SKaPa registry. Clinical examinations of 170 6- and 12-year-old children were undertaken by one of the researchers in conjunction with the children’s regular annual dental examinations where the number of teeth were registered, and dental caries was diagnosed using ICDAS II. Teeth with fillings were defined as filled and were added to the ICDAS II score and subsequently dft/DFT was calculated for each individual. Cohen’s Kappa, the intraclass correlation coefficient (ICC), and sensitivity and specificity were calculated to test the agreement of the ‘decayed and filled teeth’ in deciduous and permanent teeth (dft/DFT) from the three sources.

Results

Cohen’s Kappa of the dft/DFT-values was calculated to 0.79 between the researcher and the patient record, to 0.95 between patient dental record and SKaPa, and to 0.76 between the researcher and SKaPa. Intraclass correlation coefficient (ICC) was calculated to 0.96 between the researcher and the patient journal, to 0.99 between the patient dental record vs. SKaPa, and to 0.95 between the researcher and SKaPa.

Conclusion

The SKaPa registry information demonstrated satisfactory reliability and accuracy on dental caries in 6- and 12-year-old children and is a reliable source for registry-based research.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Data accuracy, Registries, Child, Dental caries, Validation study, Diagnosis, Sensitivity and specificity
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-44806 (URN)10.1186/s12903-021-01705-x (DOI)000679325700001 ()34301237 (PubMedID)2-s2.0-85111283402 (Scopus ID)
Funder
Region Värmland
Note

Trial registration The study was registered in Clinical Trials (www.ClinicalTrials.gov, NCT03039010)

Available from: 2021-08-11 Created: 2021-08-11 Last updated: 2024-07-04Bibliographically approved
Klinge, A., Tranaeus, S., Becktor, J. P., Winitsky, N. & Naimi-Akbar, A. (2021). The risk for infraposition of dental implants and ankylosed teeth in the anterior maxilla related to craniofacial growth, a systematic review. Acta Odontologica Scandinavica, 79(1), 59-68
Open this publication in new window or tab >>The risk for infraposition of dental implants and ankylosed teeth in the anterior maxilla related to craniofacial growth, a systematic review
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2021 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 1, p. 59-68Article in journal (Refereed) Published
Abstract [en]

Background The aim of the study was to evaluate a potential association between individuals with different craniofacial types or other exposures, and the risk of infraposition due to continued growth/eruption of adjacent teeth in the anterior maxilla. Materials and methods This is a systematic review in which primary studies as well as other systematic reviews are scrutinised. A search of PubMed (Medline), Scopus, Web of science and Health technology assessment (HTA) organisations and a complementary handsearch was carried out. Selected studies were read in full-text by several reviewers. The quality of the included primary studies was assessed using a protocol for assessment of risk of bias in exposure studies. Results The literature search resulted in 3,296 publications. Title and abstract screening yielded 25, whereof one systematic review, potential publications allocated for full-text inspection. The quality assessment resulted in a total of seven studies with a low/moderate risk of bias and four studies with a high risk of bias. Conclusion In conclusion, a long-term risk for infraposition of dental implants, or ankylosed teeth, among natural teeth can be observed in some cases. The predisposing factors are still not fully understood since the current scientific evidence is very limited.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Dental implants, ankylosed teeth, infraposition, continued development, systematic review
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-18205 (URN)10.1080/00016357.2020.1807046 (DOI)000562207800001 ()32835562 (PubMedID)2-s2.0-85089779722 (Scopus ID)
Available from: 2020-09-10 Created: 2020-09-10 Last updated: 2024-06-17Bibliographically approved
Mensah, T., Hjern, A., Håkanson, K., Johansson, P., Jonsson, A. K., Mattsson, T., . . . Klingberg, G. (2020). Organisational models of health services for children and adolescents in out-of-home care: health technology assessment (ed.). Acta Paediatrica, 109(2), 250-257
Open this publication in new window or tab >>Organisational models of health services for children and adolescents in out-of-home care: health technology assessment
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2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 2, p. 250-257Article in journal (Refereed) Published
Abstract [en]

AIM: Decades of research confirm that children and adolescents in out-of-home care (foster family, residential care) have much greater healthcare needs than their peers. A systematic literature review was conducted to evaluate organizational healthcare models for this vulnerable group. METHODS: A systematic literature search was undertaken of the following databases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomized and non-randomized controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion. RESULTS: No study with low or medium risk of bias was identified. CONCLUSION: In the absence of studies of acceptable quality, it is not possible to assess the impact of organizational models intended to ensure adequate health and dental care for children and adolescents in out-of-home care. Therefore, well-designed follow-up studies should be conducted following the implementation of such models. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-6035 (URN)10.1111/apa.15002 (DOI)000492446900001 ()31483896 (PubMedID)2-s2.0-85074010186 (Scopus ID)30261 (Local ID)30261 (Archive number)30261 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
Klinge, A., Khalil, D., Klinge, B., Lund, B., Naimi-Akbar, A., Tranæus, S. & Hultin, M. (2020). Prophylactic antibiotics for staged bone augmentation in implant dentistry. Acta Odontologica Scandinavica, 78(1), 64-73
Open this publication in new window or tab >>Prophylactic antibiotics for staged bone augmentation in implant dentistry
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2020 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 1, p. 64-73Article, review/survey (Refereed) Published
Abstract [en]

Background: The objective of the study was to assess the effect of prophylactic antibiotics on the outcome of bone augmentation and subsequent dental implant placement by combining the recommended quality assessment methods for systematic reviews and primary studies.

Materials and methods: This is a complex systematic review in which systematic reviews as well as primary studies are scrutinised. A search of Medline (OVID), The Cochrane Library (Wiley) and EMBASE, PubMed and Health technology assessment (HTA) organisations as-well as a complementary hand-search was carried out. Selected primary studies were assessed using GRADE. Each study was reviewed by three authors independently.

Results: Abstract screening yielded six potential systematic reviews allocated for full-text inspection. A total of ten primary studies were read in full-text. No relevant systematic reviews regarding the topic of this article were found. The quality assessment resulted in two primary studies with a moderate risk of bias. Of the two studies with a moderate risk of bias, one compared a single dose of clindamycin 600 mg preoperatively with the same preoperative dose followed by four doses of 300 mg every 6 h. The second study compared a single dose prophylaxis of two different types of antibiotic compounds.

Conclusion: In conclusion, the scientific evidence regarding the use of antibiotic prophylaxis for reducing the risk of infection in conjunction with bone augmentation procedures during dental implant placement is very limited. The infection rate as compared to nonusage of prophylactic antibiotics, selection of the most suitable compound, and the optimal duration of prophylactic treatment is still unknown.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Antibiotic prophylaxis, bone transplantation, dental implants, systematic review
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-14290 (URN)10.1080/00016357.2019.1656819 (DOI)000484952700001 ()31483177 (PubMedID)2-s2.0-85072043042 (Scopus ID)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-06-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2597-1025

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