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Endodontic treatment in young permanent teeth: prevalence, quality and potential risk factors
Malmö högskola, Odontologiska fakulteten (OD).ORCID-id: 0000-0002-4501-6976
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [sv]

Nationell statistik över tandhälsan hos barn och ungdomar redovisar uteslutande uppgifter om karies som till exempel genomsnittligt antal karierade och fyllda tänder och antal karierade och fyllda tandytor i olika åldersgrupper. Det innebär att de saknas kunskaper om mer komplicerade och tidskrävande behandlingar som rotbehandling av unga permanenta tänder. Syftet med denna avhandling var därför att undersöka förekomst av och kvalitet på rotbehandlingar av unga permanenta tänder samt att undersöka faktorer som kan innebära ökad risk för framtida rotbehandling på grund av karies. Materialet bestod av patientjournaler och röntgenbilder tillhörande en åldersgrupp 19-åringar (arbete I-III) och en åldersgrupp 15-åringar (arbete IV) från Folktandvården i Malmö. I arbete III ingick också en kontrollgrupp som inte hade rotbehandlade tänder. I arbete I studerades förekomsten av och orsakerna till rotbehandlingar av unga permanenta tänder. Resultaten visar att nio procent av alla 19-åringar hade minst en rotbehandlad tand. Den vanligaste orsaken var karies följt av olycksfallskador. Endast en liten andel berodde på störningar under tandens utvecklingsfas. Den första kindtanden, den s.k. sexårstanden, var den oftast rotbehandlade tanden tätt följd av framtänderna i överkäken. Andelen 19-åringar med någon rotbehandlad tand varierade avsevärt mellan olika kliniker. I arbete II studerades förekomsten av sjukliga förändringar runt rotspetsarna på de rotfyllda tänderna och kvaliteten på rotfyllningen, dvs om den var tät och hade en optimal längd. Resultaten visade att sjukliga förändringar förekom i 51 % av alla rotfyllda tänder, och att hälften av rotfyllningarna hade bristfällig kvalitet. Potentiella riskfaktorer för framtida rotbehandling på grund av karies undersöktes i arbete III. Det konstaterades att individer med minst en rotbehandlad tand på grund av karies hade mer karies vid 10 års ålder, oftare uppvisade tandvårdsrädsla eller behandlingsproblem och oftare uteblev från tandbehandlingar jämfört med en kontrollgrupp som inte hade någon rotbehandlad tand. I arbete IV undersöktes förekomsten av obehandlad dentinkaries och djupa fyllningar vid 15 års ålder. Utvecklingen av obehandlade dentinkariesskador mellan 14 och 15 år studerades också. Tjugotvå procent av individerna hade minst en obehandlad dentinkariesskada och ungefär var femte individ hade en fyllning som var djupare än halva dentinets tjocklek enligt röntgenbilden. Nio procent av individerna hade minst en kariesskada som hade utvecklats till en djup kariesskada mellan de två undersökningstillfällena. Sammanfattning: Rotbehandling av permanenta tänder var relativt vanligt hos 19-åringar. Den vanligaste orsaken var karies. Sjukliga förändringar i käkbenet kring den rotfyllda tanden sågs hos hälften av tänderna. Den tekniska kvalitén var också bristfällig i ungefär hälften av de rotfyllda tänderna. Potentiella riskfaktorer för kommande rotbehandling på grund av karies var hög kariesförekomst vid 10 års ålder, tandvårdsrädsla/behandlingsproblem och många uteblivanden. Obehandlad dentinkaries och djupa fyllningar var vanliga hos 15-åringar och måste ses som en potentiell riskfaktor för rotbehandling.

Abstract [en]

National epidemiologic data on oral health in children and adolescents in Sweden are restricted to caries, such as the number of decayed and filled teeth (DFT) and decayed and filled surfaces (DFS). Information about more complicated and time-consuming procedures such as endodontic treatment is scarce. The aims were to study the prevalence, quality and potential risk factors for endodontic treatment in young permanent teeth. The material consisted of dental records and radiographs. The subjects were all 19-year-olds born in 1979 (paper I-III) and all 15-year-olds born in 1990 (paper IV) belonging to the public dental clinics in Malmö. Paper III also included a control group. Aims and results of the four papers in this thesis: Paper I. The prevalence and causes of endodontic treatment were studied. Nine percent of the individuals had at least one endodontically treated tooth; in the majority of the cases the cause was caries. The most commonly treated tooth was the first molar. Paper II. The periapical status and technical quality of these rootfilled teeth were studied. Apical periodontitis and inadequately sealed teeth were found in about half of the cases. Technical quality was statistically significantly correlated with periapical status at follow-up. Paper III. The association between potential risk factors and future endodontic treatment due to caries was assessed. Individuals with endodontic treatment had more caries at age 10, more often dental anxiety and more missed dental appointments than a control group with no endodontic treatment. Paper IV. The prevalence of unrestored dentin caries, frequency of deep restorations, and lesion progression between ages 14 and 15 was evaluated. Twenty-two percent of the individuals had one or more surfaces with dentin caries left unrestored. About one out of five had one or more surfaces with deep dentin restorations. Nine percent of the dentin lesions progressed to deep dentin lesions. Conclusions: Endodontic treatment was fairly common in 19-year-olds and caries was the most common cause. The technical quality and periapical status of the root-filled teeth were unsatisfactory in about half of the teeth. The predominant risk factors were high caries prevalence at age 10, dental anxiety and many missed dental appointments. Unrestored dentin lesions and deep dentin restorations were common and must be regarded as potential risk factors for endodontic treatment during adolescence.

Ort, förlag, år, upplaga, sidor
Swedish Dental Journal , 2008.
Serie
Swedish Dental Journal. Supplement, ISSN 0348-6672 ; 193
Nationell ämneskategori
Odontologi
Identifikatorer
URN: urn:nbn:se:mau:diva-7657Lokalt ID: 5940ISBN: 9171042962 (tryckt)OAI: oai:DiVA.org:mau-7657DiVA, id: diva2:1404597
Anmärkning

Paper IV in dissertation as accepted manuscript.

Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-03-14Bibliografiskt granskad
Delarbeten
1. Endodontic treatment during childhood and adolescence. A survey of 19-year-olds living in the city of Malmö, Sweden
Öppna denna publikation i ny flik eller fönster >>Endodontic treatment during childhood and adolescence. A survey of 19-year-olds living in the city of Malmö, Sweden
2003 (Engelska)Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 27, nr 2, s. 83-89Artikel i tidskrift (Övrigt vetenskapligt)
Abstract [en]

The aim of the present study was to determine the prevalence and reasons for endodontic treatment in a sample of 19-year-old adolescents living in the city of Malmö, Sweden. Dental records and available radiographs of all 19-year-olds (1,971) registered at the 20 Public Dental Service (PDS) clinics in Malmö were reviewed and data were collected on the following: endodontic treatment, number and type of teeth involved, and diagnosis leading to treatment. Endodontic treatment had been performed in 180 (9.1%) patients. The percentage of 19-year-olds at a PDS clinic who had undergone such treatment varied between 1.2% and 25.2%. One tooth had been treated endodontically in 138 (76.7%) of these patients. In three patients four teeth and in two patients five teeth had needed treatment. The molars were the teeth most frequently treated (46.5%), followed by the anteriors (39.5%), and the premolars (14.0%). The most commonly treated tooth was the maxillary central incisor and the most common diagnosis was caries (56.4%) followed by trauma (22.2%) and tooth developmental disturbances (1.6%). In conclusion, endodontic treatment seems to be fairly common among 19-year-olds in the city of Malmo. The great variation seen between the different PDS clinics most likely reflected variations in the socio-economic structure of the catchment areas of the clinics.

Nationell ämneskategori
Odontologi
Identifikatorer
urn:nbn:se:mau:diva-6051 (URN)3110 (Lokalt ID)3110 (Arkivnummer)3110 (OAI)
Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-03-14Bibliografiskt granskad
2. Periapical status and technical quality of root-filled teeth in Swedish adolescents and young adults: A retrospective study
Öppna denna publikation i ny flik eller fönster >>Periapical status and technical quality of root-filled teeth in Swedish adolescents and young adults: A retrospective study
2006 (Engelska)Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, nr 2, s. 104-110Artikel i tidskrift (Övrigt vetenskapligt) Published
Abstract [en]

Objective. The aim was to study periapical status and the technical quality of root-filled teeth in Swedish adolescents and young adults in Malm, Sweden. Material and Methods. The sample, collected from dental records in the Public Dental Service, consisted of notes and radiographs of all root-filled permanent teeth in all 19-year-olds born in 1979 (mean age at root filling = 16.2 years). The sample for assessing periapical status and technical quality consisted of 124-153 teeth. The criterion for inclusion for assessing periapical status was a follow-up time of at least one year. Periapical status was assessed with the Periapical Index (PAI). Technical quality was analyzed from radiographs in two respects: sealing quality of the root canal and distance from the root filling to the radiographic apex. The radiographs were analyzed independently by two observers with inter-examiner kappa values of 0.82-0.85. Results. Apical periodontitis was found in 52% of the teeth and occurred significantly more often among molars than among anterior teeth. As judged radiographically, 51% of the teeth were inadequately sealed. In 38%, the distance to the apex was >2 mm and overfilling was registered in 14% of the teeth. Compared with anterior teeth, significantly more root fillings of molars had a distance to the apex of >2 mm. Technical quality was statistically significantly correlated with periapical status at follow-up. Conclusions. The technical quality and periapical status of root-filled teeth in adolescents and young adults were unsatisfactory in about half of the teeth.

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2006
Nyckelord
epidemiology, radiology
Nationell ämneskategori
Odontologi
Identifikatorer
urn:nbn:se:mau:diva-15908 (URN)10.1080/00016350500367637 (DOI)16546852 (PubMedID)2-s2.0-33645137782 (Scopus ID)8629 (Lokalt ID)8629 (Arkivnummer)8629 (OAI)
Tillgänglig från: 2020-03-30 Skapad: 2020-03-30 Senast uppdaterad: 2024-03-14Bibliografiskt granskad
3. Background factors associated with endodontic treatment due to caries in young permanent teeth
Öppna denna publikation i ny flik eller fönster >>Background factors associated with endodontic treatment due to caries in young permanent teeth
2007 (Engelska)Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, nr 4, s. 219-223Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective. The aim of this retrospective cohort study was to assess the association between background factors and future endodontic treatment due to caries in young permanent teeth. Material and methods. The material comprised all 19-year-olds born in 1979 in a city in Sweden who had experienced endodontic treatment due to caries in permanent teeth and a control group with no endodontic treatment. From dental records, the following independent variables were derived from age 7 to age 19: immigrant background, caries prevalence (DMFT values) at age 10, occurrence of dental anxiety, and missed or cancelled appointments before endodontic treatment. The outcome variable was presence or absence of endodontic treatment due to caries. Bivariate analysis and a multiple logistic regression model were used to analyse the data. Results. In the bivariate analyses, all independent variables except cancelled appointments were statistically significantly associated with future endodontic treatment. Of these, immigrant background did not remain as a statistically significant factor in the multiple regression model. The highest odds ratios were 4.3 for DMFT at age 10 and 4.1 for 20% missed appointments. Conclusion. In the present sample, with a relatively high proportion of individuals with an immigrant background, DMFT at age 10, many missed appointments and dental anxiety were all risk indicators for future endodontic treatment due to caries up to age 19. Key Words: Dental anxiety, dental avoidance, dental caries, immigrants, risk assessment

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2007
Nyckelord
dental anxiety, risk assessment, dental caries, immigrants
Nationell ämneskategori
Odontologi
Identifikatorer
urn:nbn:se:mau:diva-7064 (URN)10.1080/00016350701364904 (DOI)000249180800006 ()17762984 (PubMedID)2-s2.0-34548362139 (Scopus ID)5948 (Lokalt ID)5948 (Arkivnummer)5948 (OAI)
Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-03-14Bibliografiskt granskad
4. Unrestored dentin caries and deep dentin restorations in Swedish adolescents
Öppna denna publikation i ny flik eller fönster >>Unrestored dentin caries and deep dentin restorations in Swedish adolescents
2008 (Engelska)Ingår i: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 42, nr 3, s. 164-170Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The objectives of this longitudinal study were to assess: (a) the prevalence of unrestored dentin caries among 15-year-olds, (b) the proportion of these lesions that had progressed to deep dentin lesions (inner half of dentin) since the immediately preceding examination at the age of 14 and (c) the frequency of deep restorations (extending into the inner half of the dentin). The sample consisted of all 15-year-olds (n = 2,487) born in 1990 and included in the Public Dental Service in Malmo, Sweden. Bitewing radiographs taken during 2005-2007 and the immediately preceding radiographs were analysed and scored by two examiners. The main radiographic scores were: sound; radiolucency in the outer or inner half of dentin; restored surface. The results showed that 22% of the individuals had 1 or more dentin lesions left unrestored from the time of the examination at the age of 14 until the next recall examination at the age of 15. During the observation period (median time 1.2 years), 9% of the unrestored outer dentin lesions progressed to deep dentin lesions. The majority of these (93%) were in molars. One or more deep restorations were found in 22% of the 15-year-olds; the majority involved occlusal surfaces of first molars. In conclusion, unrestored dentin lesions were common in 15-year-olds. Progression to deep dentin lesions occurred in 9% of these lesions and was most common in first molars. Occlusal surfaces of first molars had the highest frequency of deep restorations. (c) 2008 S. Karger AG, Basel

Nationell ämneskategori
Odontologi
Identifikatorer
urn:nbn:se:mau:diva-6760 (URN)10.1159/000128560 (DOI)000255895900002 ()18446024 (PubMedID)2-s2.0-43949111027 (Scopus ID)6760 (Lokalt ID)6760 (Arkivnummer)6760 (OAI)
Tillgänglig från: 2020-02-28 Skapad: 2020-02-28 Senast uppdaterad: 2024-03-14Bibliografiskt granskad

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