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Nordström, M., Lager, A., Hänsel Petersson, G. & Ericson, D. (2024). Karies: världens vanligaste icke smittsamma sjukdom. Läkartidningen, 121, Article ID 23127.
Open this publication in new window or tab >>Karies: världens vanligaste icke smittsamma sjukdom
2024 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 121, article id 23127Article in journal (Refereed) Published
Abstract [en]

More than 2.8 billion individuals worldwide suffer from untreated caries. Over ninety-five percent of all 50-year-olds in Sweden have caries experience. Caries is the most common cause of dental restorations and tooth loss. Tooth loss is associated with cardiovascular diseases, dementia, and death. Periapical tooth infections caused by caries can spread and cause severe infection, however rarely with lethal outcome. Sugars are a common risk factor for caries and other noncommunicable diseases such as cardiovascular diseases, diabetes, and obesity.  Caries is a consequence of sugar-provoked acid production and dysbiosis in the tooth biofilm (dental plaque). There are several conditions which may increase the risk for dental caries, such as different medical conditions and medications which may cause dry mouth. Treatment costs for caries are high.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66561 (URN)38470274 (PubMedID)
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-03-28Bibliographically approved
Nordström, M., Carlsson, P., Ericson, D., Lager, A., Jansson, H., Wolf, E. & Hänsel Petersson, G. (2024). Some young adults can maintain good oral health despite socioeconomic challenges. European Journal of Oral Sciences, Article ID e12985.
Open this publication in new window or tab >>Some young adults can maintain good oral health despite socioeconomic challenges
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2024 (English)In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, article id e12985Article in journal (Refereed) Epub ahead of print
Abstract [en]

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2024
Keywords
salutogenesis, health promotion, dental caries, young adults, socioeconomy, resilience, family support, health behaviour, psychology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66678 (URN)10.1111/eos.12985 (DOI)001189369500001 ()38520668 (PubMedID)
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2024-04-23Bibliographically approved
Nordström, M., Carlsson, P., Ericson, D., Hedenbjörk-Lager, A. & Hänsel Petersson, G. (2023). Common resilience factors among healthy individuals exposed to chronic adversity: a systematic review. Acta Odontologica Scandinavica, 81(3), 176-185
Open this publication in new window or tab >>Common resilience factors among healthy individuals exposed to chronic adversity: a systematic review
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 3, p. 176-185Article, review/survey (Refereed) Published
Abstract [en]

Objective: To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.

Materials and methods: The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).

Results: A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.

Conclusions: Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Dental caries, common risk approach, salutogenesis, resilience, systematic review
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-54102 (URN)10.1080/00016357.2022.2095021 (DOI)000825783700001 ()35811490 (PubMedID)2-s2.0-85133691731 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-08-22Bibliographically approved
Flink, H., Hedenbjörk-Lager, A., Liljeström, S., Nohlert, E. & Tegelberg, Å. (2023). Identification of caries-active individuals in longitudinal data a methodological study using a national registry. Acta Odontologica Scandinavica, 1-6
Open this publication in new window or tab >>Identification of caries-active individuals in longitudinal data a methodological study using a national registry
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, p. 1-6Article in journal (Refereed) Epub ahead of print
Abstract [en]

ObjectiveThe aim was to identify caries active individuals among adults by using a trajectory model of longitudinal data from the Swedish national registry (SKaPa) and comparing them with published data from the Dunedin cohort.Materials and methodsData from two different age groups (30- and 40-year-olds) followed for 10 years were retrieved from SKaPa and were compared with published longitudinal birth-cohort data from the Dunedin study. Using the trajectory model, the subjects were divided into three different trajectories according to their caries development over time (i.e. high, 15%; moderate, 45%; low, 40%).ResultsCaries experience, as measured by mean decayed, missing, and filled surfaces (DMFS) index, revealed significant differences among the three trajectories in both age groups. The patterns were similar to those observed in the Dunedin cohort. The mean increase in DMFS during the 10-year follow-up period from SKaPa was significantly higher for the high trajectories in both age groups compared with the moderate and low trajectories.ConclusionsThe method using three trajectories for presentation of caries experience over time, may be a useful tool to identify subjects with different disease activities. Identification of subjects in the high caries experience trajectory may increase the possibility to explore and evaluate more effective caries prevention for this group in the future.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Caries experience, caries prevention, dental care plan, disease progression, epidemiology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-63501 (URN)10.1080/00016357.2023.2265474 (DOI)001081233400001 ()37831434 (PubMedID)2-s2.0-85174074328 (Scopus ID)
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2023-11-13Bibliographically approved
Odlén, K., Fält, F., Dahl, S., Aidoukovitch, A., Ericson, D., Nilsson, B.-O. & Hedenbjörk-Lager, A. (2020). Odontoblast-like MDPC-23 cells produce pro-inflammatory IL-6 in response to lipoteichoic acid and express the antimicrobial peptide CRAMP. (ed.). Acta Odontologica Scandinavica, 78(3), 210-216
Open this publication in new window or tab >>Odontoblast-like MDPC-23 cells produce pro-inflammatory IL-6 in response to lipoteichoic acid and express the antimicrobial peptide CRAMP.
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2020 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 3, p. 210-216Article in journal (Refereed) Published
Abstract [en]

Odontoblasts are thought to be involved in innate immunity but their precise role in this process is not fully understood. Here, we assess effects of lipopolysaccharide (LPS) and lipoteichoic acid (LTA), produced by Gram-negative and Gram-positive bacteria, respectively, on matrix metalloproteinase-8 (MMP-8), interleukin-6 (IL-6) and cathelin-related antimicrobial peptide (CRAMP) expression in odontoblast-like MDPC-23 cells. Gene activity and protein production was determined by quantitative real-time RT-PCR and ELISA, respectively. Cellular expression of CRAMP was determined by immunocytochemistry. Stimulation with LTA (5 and 25 µg/ml) but not LPS (1 and 5 µg/ml) for 24 h enhanced IL-6 mRNA expression. The LTA-induced up-regulation of IL-6 mRNA levels was associated with increased IL-6 protein levels. Stimulation with either LPS or LTA for 24 h lacked effect on both MMP-8 transcript and protein expression. Immunocytochemistry disclosed that MDPC-23 cells expressed immunoreactivity for CRAMP. MDPC-23 cells showed mRNA expression for CRAMP, but stimulation with either LPS or LTA did not modulate CRAMP transcript expression. We show that MDPC-23 cells possess immune-like cell properties such as LTA-induced IL-6 production and expression of the antimicrobial peptide CRAMP, suggesting that odontoblasts may modulate innate immunity via these mechanisms.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Antimicrobial peptides, cytokine, innate immunity, odontoblast
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6450 (URN)10.1080/00016357.2019.1685679 (DOI)000496584400001 ()31726911 (PubMedID)2-s2.0-85075212946 (Scopus ID)30470 (Local ID)30470 (Archive number)30470 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Bjørndal, L., Fransson, H., Bruun, G., Markvart, M., Kjældgaard, M., Näsman, P., . . . Thordrup, M. (2017). Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up (ed.). Journal of Dental Research, 96(7), 747-753
Open this publication in new window or tab >>Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up
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2017 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 96, no 7, p. 747-753Article in journal (Refereed) Published
Abstract [en]

Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1-26.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up (ClinicalTrials.gov NCT00187837 and NCT00187850).

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
caries treatment, clinical studies, clinical outcomes, dentin, Endodontics, operative dentistry
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6158 (URN)10.1177/0022034517702620 (DOI)000403934500006 ()28410008 (PubMedID)2-s2.0-85021114644 (Scopus ID)23305 (Local ID)23305 (Archive number)23305 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Hedenbjörk-Lager, A., Hamberg, K., Pääkkönen, V., Tjäderhane, L. & Ericson, D. (2016). Collagen degradation and preservation of MMP-8 activity in human dentine matrix after demineralization (ed.). Archives of Oral Biology, 68, 66-72
Open this publication in new window or tab >>Collagen degradation and preservation of MMP-8 activity in human dentine matrix after demineralization
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2016 (English)In: Archives of Oral Biology, ISSN 0003-9969, E-ISSN 1879-1506, Vol. 68, p. 66-72Article in journal (Refereed)
Abstract [en]

OBJECTIVE: Dental caries is a process driven by acids produced by oral microorganisms followed by degradation of the dentine collagen matrix by proteolytic enzymes. Matrix metalloproteinases (MMPs) have been suggested to contribute to caries by degrading collagen. The aim of this study was to develop a method for generating demineralized dentine matrix substrate (DDM) maintaining MMP-8 bioactivity and no interference with later assays. Such a substrate would allow study of the effects of various treatments on MMP-8 activity and collagen degradation in demineralized dentine. DESIGN: Human dentine was powderized in a tissue grinder and frozen (-80°C). The powder was demineralized in dialysis tubes, using EDTA or acetic acid. The demineralized dentine matrix (DDM) was harvested and analyzed for collagen content using SDS-PAGE. The DDM was subsequently suspended in PBS or TESCA buffer. Protein, MMP-8 (ELISA) and collagen (HYP) was analyzed directly or after 1 wk. RESULTS: EDTA or acid demineralization of dentine using dialysis yielded a substrate rich in collagen coupled with preserved MMP-8 activity. Collagen degraded in room temperature, assessed by higher HYP amounts in the soluble fraction of DDM after one wk, indicating that the methods used preserved active DDM-components after the demineralization process. CONCLUSIONS: The presented demineralization methods both provided insoluble DDM substrates suitable for further intervention studies. However, it was found that the substrates differed depending on the demineralization method and buffers used. This needs further study to find an optimal technique for generating DDM with retained proteins as well as enzymatic bioactivity.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Acetic acid, Collagen, Edetic acid, Matrix metalloproteinase, Tooth demineralization
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-5792 (URN)10.1016/j.archoralbio.2016.04.003 (DOI)000379369600011 ()27105041 (PubMedID)2-s2.0-84964389066 (Scopus ID)21847 (Local ID)21847 (Archive number)21847 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Hedenbjörk-Lager, A., Bjørndal, L., Gustafsson, A., Sorsa, T., Tjäderhane, L., Åkerman, S. & Ericson, D. (2015). Caries correlates strongly with salivary levels of Matrix Metalloproteinase-8 (ed.). Caries Research, 49(1), 1-8, Article ID 49.
Open this publication in new window or tab >>Caries correlates strongly with salivary levels of Matrix Metalloproteinase-8
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2015 (English)In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 49, no 1, p. 1-8, article id 49Article in journal (Refereed)
Abstract [en]

The caries process in dentin involves the degradation of both mineral and organic matrix. The demineralization has been demonstrated to be caused by bacterial acids. How-ever, the collagen degradation is considered to be initiated by endogenous proteolytic enzymes, mainly collagenolytic matrix metalloproteinases (MMPs). This paper aims to relate salivary MMP-8 (or salivary collagenase-2) and tissue inhibi-tor of MMP (TIMP-1) levels to manifest caries in a large num-ber of subjects. A random sample of 451 adults (aged 18-87 years) living in the south of Sweden was included in this study. Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentra-tions of MMP-8, TIMP-1 and total protein, using an immuno-fluorometric assay, an enzyme-linked immunosorbent assay and the Bradford assay, respectively. Salivary numbers of mutans streptococci and lactobacilli were determined using a chair-side kit. Subjects with manifest caries lesions present-ed with elevated levels of MMP-8 (p < 0.001) as well as total protein, MMP-8/TIMP-1 ratio, bleeding on probing and plaque index (p = 0.05) compared with subjects without manifest caries. Multiple linear regression analysis with car-ies as the dependent variable revealed MMP-8 as the only significant explanatory variable (p < 0.001). TIMP-1 was not significant in any case. Using MMP-8 as the dependent vari-able revealed total protein concentration, caries lesions (p ≤ 0.001) and salivary secretion rate (p = 0.05) as explanatory variables. In conclusion, our data reveal that subjects with manifest caries lesions have elevated levels of salivary MMP-8 relative to subjects with no caries lesions.

Place, publisher, year, edition, pages
S. Karger, 2015
Keywords
Dental caries, Dentin, Matrix metalloproteinase-8, Saliva, Tissue inhibitor of metalloproteinase-1
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6021 (URN)10.1159/000360625 (DOI)000346584800001 ()25096527 (PubMedID)2-s2.0-84923617486 (Scopus ID)18618 (Local ID)18618 (Archive number)18618 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Hedenbjörk Lager, A. (2014). Dentine caries: acid tolerant microorganisms and aspects on collagen degradation (ed.). (Doctoral dissertation). Malmö University, Faculty of Odontology
Open this publication in new window or tab >>Dentine caries: acid tolerant microorganisms and aspects on collagen degradation
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Karies är en stor folksjukdom, trots att den både kan förebyggas och behandlas effektivt. Om man inte ingriper preventivt och låter det naturliga förloppet råda, kommer kariesangreppet till slut att bryta igenom emaljen och involvera även den underliggande dentinvävnaden. Kariessjukdomen orsakas av orala mikroorganismer, som en konsekvens av dessas nedbrytning av kostrelaterade kolhydrater. Som en biprodukt bildas då syror som löser upp (demineraliserar tandvävnaden), så att synliga hål till slut bildas. Syran kan lösa upp mineralfasen i tanden, men dentin består även till stor del av kollagen, vilket inte kan lösas upp av enbart syror. Man hänförde länge detta till proteinnedbrytande bakterier, men det har visat sig att munhålebakterierna inte har förmågan att lösa upp kollagen, och man tror nu att denna nedbrytning sker med hjälp av kroppsegna enzymer, bland annat matrix metalloproteinaser (MMP). De biologiska mekanismerna bakom kollagennedbrytning vid dentinkaries är emellertid dåligt undersökta, och delar av denna rapport (Studie III och IV) inriktar sig därför på detta område. Syran som bakterierna bildar skapar också en sur närmiljö för dem själva, vilket gör det svårt för dem att överleva, särskilt i ett begränsat utrymme som ett kariesangrepp. Man har länge ansett att endast vissa specifika bakterier har förmågan att leva och trivas i sura miljöer, men nya studier har ifrågasatt detta. I denna rapport (Studie II) undersöks även förekomsten av syratåliga bakterier på olika nivåer i dentinkariesangrepp med hjälp av en ny metod. Målet vid avlägsnande av karies är att ta bort fullständigt förstörd tandvävnad, men att försöka spara så mycket som möjligt av den delvis skadade vävnaden, vilken kan återställas. Detta har också aktualiserats då nya operativa principer och material lanserats under den senaste tioårsperioden. Det är emellertid svårt att avgöra var gränsen går kliniskt, och ett sätt att mäta dentinets ”friskhet” kan vara att mäta antalet bakterier i vävnaden. I den första rapporten (Studie I) undersöks den kvarvarande bakterieförekomsten efter kariesborttagning med två olika operativa metoder. Avhandlingen söker svar på följande frågeställningar: Studie I. Finns det några skillnader vad gäller antal kvarvarande bakterier efter dentinkariesavlägsnande med mekanisk (vanligt borr) eller kemo-mekanisk (Carisolv) metod? Studie II. Hur ser sammansättningen av den syratåliga bakteriefloran ut på tre olika nivåer i olika dentinkariesangrepp? Studie III. Finns det något samband mellan förekomsten av etablerade kariesangrepp och nivåerna av enzymet MMP-8 och dess nedreglerande protein TIMP-1 i saliv? Studie IV. Kan man framställa demineraliserat dentinmatrix med bibehållen biologisk aktivitet inför framtida studier av mekanismerna bakom nedbrytning av kollagen vid dentinkaries? Vad händer spontant med detta demineraliserade dentinmatrix över tid? Huvudfynden i studierna är: 1. Båda metoderna för att avlägsna dentinkaries minskade bakterieantalet radikalt. Det finns dock alltid kvar små mängder av bakterier i kaviteten. 2. Alla de undersökta kaviteterna hade en unik sammansättning av syratåliga bakterier, både till typ och antal, vilket indikerar att ett flertal olika bakterier har förmågan att anpassa sig till sura miljöer och potentiellt bidra till kariesutvecklingen. Vidare, fungerade de pH-specifika odlingsmedierna väl för att få fram de syratåliga bakterierna, något som är svårt med konventionella metoder. 3. Försökspersoner med etablerade dentinkariesangrepp uppvisade mycket högre förekomst av MMP-8 i saliven jämfört med kariesfria försökspersoner. Det nedreglerande proteinet TIMP-1 uppvisade inga samband alls. 4. Dentinmatrix framställt med båda testmetoderna uppvisade förekomst av intakt kollagen, samt aktivt MMP-8. Vidare så uppvisades en spontan nedbrytning av kollagen över tid, vilket tolkades som mestadels ett resultat av det aktiva MMP-8 enzymet. De nyvunna grundkunskaperna bildar underlag för nya studier inom forskningsområdet, samt för nya behandlingsmetoder, framför allt sådana som skulle kunna moderera eller förhindra dentinkariesprogression.

Abstract [en]

Dental caries is a common disease all over the world, despite the fact that it can be both effectively prevented as well as treated. It is driven by acids produced by oral microorganisms as a consequence of their metabolism of dietary carbohydrates. Given enough acid challenge, eventually the enamel barrier will be broken down, and the carious lesion will extend into underlying hard tissue, forming a macroscopic cavity in the dentine. In comparison to plaque biofilm on enamel, this dentine carious lesion will form a vastly different environment for the residing microorganisms. The environment will influence the types and numbers of microorganisms that will be able to colonize the dentine caries lesion. The overall aims for this thesis is to enumerate and further study microorganisms found in established dentine caries lesions, and also to illuminate how host-derived proteolytic enzymes might contribute to this degradation, in order to better understand the caries process in dentine, but also to find incitements for new methods to influence the natural progression of caries lesions. In Paper I, the number of remaining viable microorganisms after completed excavation using two different excavation methods were investigated. Samples of carious dentine tissue was collected before and after excavation, and cultivated on different agar media in different atmospheres. Analysis was performed by counting the number of colony forming units (cfu). Key findings: Numbers of remaining microorganisms after excavation was low for both methods, but some microorganisms always remained in the cavity floors even when the cavities were judged as ”caries free” using normal clinical criteria. In Paper II, the acid tolerant microbiota in established dentine caries lesions were investigated. Samples were taken as in Paper I, but on three levels (superficial, center of lesion, cavity floor). The samples were cultivated in anaerobic conditions on solid pH-selective agar media of different acidity. Key findings: Each investigated lesion harbored a unique microbiota, both in terms of species composition and numbers of microorganisms. This indicate that various combinations of aciduric microorganisms can colonize, survive in and probably also propagate dentine carious lesions. We also found that solid pH-selective agars successfully can be used to select acid tolerant microorganisms in caries lesions. This would preserve their phenotypic traits for further study. In Paper III, the relation between salivary levels of matrix metalloproteinase-8 (MMP-8), salivary levels of tissue inhibitor of MMP (TIMP-1) and presence of manifest caries lesions in a large number of subjects was investigated. Saliva samples were collected and analyzed for concentrations of MMP-8, TIMP-1 and total protein using immunofluorometric assay, enzyme linked immunosorbent assay and Bradford assay, respectively. Key findings: Subjects with manifest caries lesions had significantly elevated levels of salivary MMP-8 compared to subjects without caries lesions. TIMP-1 was not significant in any case. In Paper IV, a new method for generating bioactive demineralized dentine matrix substrate (DDM) was developed, using a dialysis system and two different demineralization approaches (acetic acid (AA) or EDTA). The generated DDM was subsequently analyzed for presence of type 1 collagen, active MMP-8 and hydroxyproline (HYP) levels using SDS-PAGE, ELISA or immunofluorescence assay. Key findings: Both demineralization methods produced a substrate rich in collagen and with preserved MMP-8 activity. The report presents new knowledge on the composition of the acid tolerant dentine caries microbiota from three levels in dentine carious lesions and on the efficacy of operative caries removal on the numbers of viable microorganisms in the caries free cavity using two different operative methods. Moreover, the basic mechanisms behind collagen degradation in the dentine caries process are studied from both a clinical and laboratory perspective. The report provides a reference for further studies on dentine caries microbiology and dentine caries collagen degradation mechanisms, both of which are only known in part.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2014. p. 94
Series
Swedish Dental Journal : Supplement, ISSN 0348-6672 ; 233
Keywords
Dental Caries, Collagen, Cariogenic Agents
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7685 (URN)17596 (Local ID)978-91-7104-398-6 (ISBN)9789171043979 (ISBN)17596 (Archive number)17596 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-14Bibliographically approved
Bjørndal, L., Bruun, G., Markvart, M., Kjaeldgaard, M., Näsman, P., Thordrup, M., . . . Wennström, A. (2012). Randomised clinical trial on deep caries excavation 3-5 yr follow-up (ed.). Paper presented at International Association for Dental Research (IADR), Iguacu Falls, Brazil (2012). Journal of dental research, 91(Spec Iss b), Article ID 3032.
Open this publication in new window or tab >>Randomised clinical trial on deep caries excavation 3-5 yr follow-up
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2012 (English)In: Journal of dental research, Vol. 91, no Spec Iss b, article id 3032Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: Long term follow-up data based on randomised clinical trials are needed in relation to deep caries treatment. The aim of the present trial is to investigate the beneficial and harmful long term effects of stepwise excavation during two visits versus one completed excavation of deep caries in permanent teeth in adults. Methods: Consecutive patients contacting clinical units in Sweden and Denmark were included. The trial is a centrally randomised patient- and observer-blinded multicenter trial, with two parallel intervention groups. A sample size calculation showed that 134 patients were needed in each group. Taking dropouts into account, a total of 314 patients fulfilled well-defined inclusion and exclusion criteria and were centrally block-randomised stratified by age and pain. Inclusion criteria: (i) Person ≥ 18 yrs having deep caries with or without pain (ii) x-ray showing primary caries into the inner 1/4 of the dentin, with the presence of a radiopaque zone at the pulpal wall. Success was defined as unexposed pulp with sustained pulp vitality without apical radiolucency after follow-up. Blinded evaluation of 1½ follow-up has previously been carried out in 106 patients (stepwise excavation group) and 93 patients (direct complete excavation) (Bjørndal et al. 2010, EJOS). Results: At 3-5 yr follow up there was a statistically significantly higher success with stepwise excavation [difference: 11.5%, 95% confidence interval (0.5; 22.2)] versus a direct complete excavation procedure, being similarly with the short term follow-up data. 53.3% (n = 102) of the material has been controlled and no significant differences were noted between the two intervention groups in terms of patients not yet controlled, lost patients and failures (Table). Conclusion: A stepwise excavation procedure still seems preferable after a long term follow up and presumably related to the reduced risk of exposing the inflamed pulp associated with deep caries.

Place, publisher, year, edition, pages
Sage Publications, 2012
Keywords
Caries, Endodontics, Pulp, Randomised trial, Teeth
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6698 (URN)14776 (Local ID)14776 (Archive number)14776 (OAI)
Conference
International Association for Dental Research (IADR), Iguacu Falls, Brazil (2012)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2023-04-20Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6720-3900

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