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  • 1.
    Ahlgren, Camilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ahnlide, Ingela
    Malmö högskola, Odontologiska fakulteten (OD).
    Björkner, Bert
    Malmö högskola, Odontologiska fakulteten (OD).
    Bruze, Magnus
    Malmö högskola, Odontologiska fakulteten (OD).
    Liedholm, Rolf
    Malmö högskola, Odontologiska fakulteten (OD).
    Möller, Halvor
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Contact allergy to gold is correlated to dental gold.2002Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 82, nr 1, s. 41-4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Questionnaire studies have indicated that patients with dental gold will more frequently have contact allergy to gold. This study aimed at investigating the relationship between contact allergy to gold and the presence and amount of dental gold alloys. A total of 102 patients were referred for patch testing because of suspicion of contact allergy. Patch tests were performed with gold sodium thiosulphate 2% and 5%. The patients underwent an oral clinical and radiological examination. Contact allergy to gold was recorded in 30.4% of the patients, and of these 74.2% had dental gold (p=0.009). A significant correlation was found between the amount of gold surfaces and contact allergy to gold (p=0.008), but there was no statistical relationship to oral lesions. It is concluded that there is a positive relationship between contact allergy to gold and presence and amount of dental gold alloys.

  • 2.
    Ahlgren, Camilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Bruze, Magnus
    Möller, Halvor
    Gruvberger, Birgitta
    Axéll, Tony
    Liedholm, Rolf
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Contact Allergy to Gold in Patients with Oral Lichen Lesions2012Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 92, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aetiology of oral lichen lesions is obscure. In this study the frequency of contact allergy to gold in 83 patients with oral lichen lesions was compared with that in two control groups, comprising 319 age- and gender-matched patients with dermatitis selected from files and 83 clinically examined dermatitis patients. All patients were tested epicutaneously with gold sodium thiosulphate. The two control groups tested were under examination for a tentative diagnosis of allergic dermatitis not related to oral problems. The frequency of contact allergy to gold was 28.9% in the patients with oral lichen lesions, 18.2% in patients selected from files, and 22.9% in the clinically examined control patients. The difference in frequency between patients with oral lichen lesions and those taken from files was statistically significant.

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  • 3.
    Ahlgren, Camilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Molin, M
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Lundh, T
    Guld i plasma efter insättning av guldinlägg2006Konferensbidrag (Övrigt vetenskapligt)
  • 4.
    Ahlgren, Camilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Molin, Margareta
    Malmö högskola, Odontologiska fakulteten (OD).
    Lundin, Thomas
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Levels of gold in plasma after dental gold inlay insertion.2007Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, nr 6, s. 331-334Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Several studies have reported increased levels of gold (Au) in the blood of patients with dental gold restorations. This study analyzed gold levels in blood plasma before dental gold inlay insertion, 0-12 months after, and 15 years after. MATERIAL AND METHODS: Plasma samples from 9 patients were taken before and 0-10 months after gold inlay insertion. Fifteen years after gold inlay insertion, further blood samples taken from 8 of these patients were analyzed for gold using inductively coupled plasma mass spectrometry. An oral examination was also carried out before and 15 years after gold inlay insertion. RESULTS: Gold levels in plasma were significantly higher 0-12 months after gold inlay insertion than before treatment (p=0.008). No significant difference in gold plasma levels was found between 0-12 months after and 15 years after insertion (p=0.109), although there was a significant correlation between the number of gold alloy surfaces and the amount of gold in plasma 15 years after insertion (p=0.028). CONCLUSIONS: This study supports a dose-related release of gold into plasma from dental gold restorations, a release that appears to be stable over time.

  • 5. Ahnlide, Ingela
    et al.
    Ahlgren, Camilla
    Malmö högskola, Odontologiska fakulteten (OD).
    Björkner, Bert
    Bruze, Magnus
    Lundh, Thomas
    Möller, Halvor
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Schütz, Andrejs
    Gold concentration in blood in relation to the number of gold restorations and contact allergy to gold.2002Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, nr 5, s. 301-5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Previous studies have demonstrated an association between gold allergy and the presence of dental gold restorations. The aim of the present study was to investigate the relationship between the concentration of gold in blood (B-Au) and the number of tooth surfaces with gold alloys in subjects with and without contact allergy to gold. In 80 patients referred for patch testing because of eczematous disease, blood samples were taken and analyzed for B-Au using inductively coupled plasma mass spectrometry. The detection limit for the Au determination was 0.04 microg/L. In addition, a dentist made a clinical and radiological examination of the patients and registered the number of dental gold surfaces. Patients with dental gold restorations had a statistically significantly higher B-Au in Mann-Whitney U test (P = 0.025), (range < 0.04-1.07 microg/L) than patients without (range < 0.04-0.15 microg/L). Furthermore, a positive correlation was found between B-Au and the number of dental gold surfaces (P < 0.01). There was no statistically significant difference in B-Au between persons with and without contact allergy to gold. The study thus indicates that gold is released from dental restorations and taken tip into the circulation.

  • 6. Axelsson, Susanna
    et al.
    Davidsson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Håkansson, Kickan
    Jemt, Torsten
    Kedebring, Therese
    Lekholm, Ulf
    Lindholm, Jonas
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Nordenram, Gunilla
    Norlund, Anders
    Sunnegårdh-Grönberg, Karin
    Tranæus, Sofia
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Tandförluster: En systematisk litteraturöversikt2010Rapport (Övrigt vetenskapligt)
  • 7. Bergkvist, Göran
    et al.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Sahlholm, Sten
    Karlsson, Ulf
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Immediate loading of implants in the edentulous maxilla: use of an interim fixed prosthesis followed by a permanent fixed prosthesis: a 32-month prospective radiological and clinical study2009Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 11, nr 1, s. 1-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aim of this study was to prospectively evaluate the survival rate of splinted and immediately loaded Straumann sandblasted, large-grit, acid-etched, solid-screw dental implants in the edentulous maxilla after 32 months of loading. MATERIALS AND METHODS: Twenty-eight patients (mean age 63 years) with edentulous maxillae received 168 implants (six each) and an implant-supported fixed interim prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patients received permanent screw-retained prostheses. Clinical and radiological examinations were made at implant placement and after 8, 20, and 32 months of loading. All permanent prostheses were removed at the 32-month follow-up; implant stability was checked with a torque device, and the implant stability quotient was determined with resonance frequency analysis. RESULTS: Mean marginal bone loss from baseline to 8 months after loading was 1.6 mm (SD 1.16; p = .094), from 8 to 20 months 0.41 mm (SD 0.63; p = .094), and from 20 to 32 months 0.08 mm (SD 0.49; p = .039). The 32-month cumulative survival rate was 98.2%. CONCLUSIONS: The 32-month survival of solid-screw implants - immediately loaded within 24 hours after placement - was similar to survival rates reported for solid-screw implants with conventional loading. Immediate loading and splinting of implants in the edentulous maxilla is a viable treatment alternative.

  • 8.
    Bergkvist, Göran
    et al.
    Implantatcentrum, SE-602 36 Norrköping, Kneippgatan 4, Sweden.
    Sahlholm, Sten
    Department of Oral and Maxillofacial Surgery, University Hospital, Linköping, Sweden.
    Karlsson, Ulf
    Department of Prosthetic Dentistry, Public Dental Service, Norrköping, Sweden.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Immediately Loaded Implants Supporting Fixed Prostheses in the Edentulous Maxilla: A Preliminary Clinical and Radiologic Report2005Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 20, nr 3, s. 399-405Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    PURPOSE: To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. MATERIALS AND METHODS: Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. RESULTS: The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. DISCUSSION: The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. CON-CLUSION: ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.

  • 9. Bergkvist, Göran
    et al.
    Sahlholm, Sten
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Implant-supported Fixed Prostheses in the Edentulous Maxilla. A 2-year Clinical and Radiological Follow-up of Treatment with Non-submerged ITI Implants2004Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 15, nr 3, s. 351-359Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    OBJECTIVES: To evaluate the survival rate of non-submerged solid-screw ITI dental implants with a rough (titanium plasma sprayed, TPS) surface in the edentulous maxilla after 1 and 2 years of loading. MATERIAL AND METHOD: Twentyfive patients (mean age 64 years) with edentulous upper jaws received five-seven implants and, after a mean healing time of 6.9 months, screw-retained implant-supported fixed prostheses. A total of 146 ITI solid screw TPS implants were inserted. The diameter of 56% of the implants was smaller (3.3 mm) than the standard (4.1 mm) and the diameter of the rest (44%) was standard. The bone quantity of the majority of the patients was low and the bone quality poor. Clinical parameters were registered at baseline and at two annual follow-ups. Radiological examinations and assessments were also made at these times. RESULTS: Mean marginal bone level at baseline was measured at a point 4.52 mm (range 1.45-7.70, SD 1.2) apical of the reference point. Mean bone loss from baseline to 1 year of loading was 0.24 mm (SD 0.9, P=0.002) and from 1 year to 2 years of loading 0.15 mm (SD 0.4, P<0.001). Five implants failed, four of which were early failures prior to loading. One implant failed shortly after bridge installation. The cumulative survival rate was 96.6% after 1 and 2 years. CONCLUSION: ITI TPS solid-screw implants in combination with fixed prostheses had successful survival rates and were found to be a viable treatment alternative in the edentulous maxilla.

  • 10.
    Collin Bagewitz, Ingrid
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Palmqvist, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Dimensions of Oral Health-related Quality of Life in an Adult Swedish Population2005Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, nr 6, s. 353-360Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    The concept of oral health-related quality of life (OHRQOL) is investigated in this study. The aim was to explore the dimensionality of variables measuring OHRQOL in an adult Swedish population and to discuss the findings in relation to existing indices. The study was based on responses to a 1998 questionnaire sent to a random sample of 1974 persons aged between 50 and 75 years. There were 22 variables based on questions concerning oral situation and the impact on 7 theoretically different dimensions of QOL. The majority were satisfied with their oral health situation. During the previous 12 months, 16% of the population had experienced problems with their mouth or teeth on at least one occasion per mouth. Principal components analysis was used to analyze the dimensionality of the variables. Three factors accounted for 59% of the variance: (1) Physical and social disability, (2) psychological discomfort and disability, and (3) functional limitation and physical pain. The perception of OHRQOL is multidimensional, but the dimensions are not equally important. The dimensions of OHRQOL found in the present study are similar to those of existing instruments.

  • 11.
    Collin Bagewitz, Ingrid
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Palmqvist, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Oral prostheses and oral health-related quality of life: a survey study of an adult Swedish population2007Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 20, nr 2, s. 132-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The purpose of the study was to investigate whether oral health-related quality of life (OHRQOL) in an adult Swedish population could be explained by social attributes; individual attributes; dental status, with a special focus on the role of prosthodontics; and dental care attitudes. MATERIALS AND METHODS: The study was based on responses to a questionnaire sent in 1998 to a random sample of 1,974 persons aged 50 to 75 years (66% response rate). Three factors representing various aspects of OHRQOL were set as dependent variables in multiple-regression models: oral health impact on everyday activities, oral health impact on the psychologic dimension, and oral health impact on oral function. Independent variables in the models were social attributes, individual attributes, number of teeth, denture (ie, type of denture, if present), and dental care attitudes. RESULTS: General health in relation to age peers had the strongest association with all 3 dependent variables, followed by number of teeth and need care--cost barrier. When number of teeth was excluded, removable denture was found to covary with the dependent variables in each of the 3 regression models. CONCLUSION: The number of remaining teeth is more important than the type of denture in explaining OHRQOL. It is less important that a denture is fixed for those with few remaining teeth, in contrast to all others. Explanations are also found in general health and various aspects of dental care costs.

  • 12.
    Collin Bagewitz, Ingrid
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Palmqvist, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Dental care utilization: a study of 50- to 75-year-olds in southern Sweden.2002Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, nr 1, s. 20-4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigates dental care utilization in an adult population in Southern Sweden in relation to dental and social conditions, attitudes to costs, and perceived need to obtain dental services. The study was based on responses to a questionnaire sent in 1998 to a random sample, 1974 persons, aged 56-75 years. The response rate was 66%. A significantly higher probability of dental care utilization less than once a year was found for men, for those with few remaining teeth, and for those with removable dentures. A higher probability of dental care utilization less than once a year was found for those who stated perceived need to obtain dental care with no possibility because of the cost and for those who stated that the cost had influenced their attendance for dental care. The results showed that there were differences for sex and dental conditions in dental care utilization and that dental care utilization was related to attitudes towards costs of dental care.

  • 13. Davidson, Thomas
    et al.
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Hultin, Margareta
    Jemt, Torsten
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Sunnegardh-Gronberg, Karin
    Tranæus, Sofia
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilsson, Mats
    Malmö högskola, Odontologiska fakulteten (OD).
    Reimbursement systems influence prosthodontic treatment of adult patients2015Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, nr 6, s. 414-420Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.

  • 14. Dierens, M.
    et al.
    Vandeweghe, Stefan
    Malmö högskola, Odontologiska fakulteten (OD).
    Kisch, J.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Cosyn, J.
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Cost estimation of single-implant treatment in the periodontally healthy patient after 16-22 years of follow-up2015Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, nr 11, s. 1288-1296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Costs for single-implant treatment are mostly described for the initial treatment. Information on the additional cost related to aftercare is scarce. Objective: To make an estimation of complication costs of single implants in periodontally healthy patients after 16-22years and to compare costs for various prosthetic designs. Materials and methods: Patients with a single implant were recalled for a clinical examination and file investigation. Prosthetic designs included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Costs related to failures or technical, biologic, and aesthetic complications were retrieved from patient's records. Total and yearly additional complication costs were calculated as a percentage relative to the initial cost. Chair time needed to solve the complication was recorded and prosthetic designs were compared by Kruskal-Wallis tests. Results: Fifty patients with 59 surviving implants were clinically investigated. Additional complication costs after a mean follow-up of 18.5years amounted to 23% (range 0-110%) of the initial treatment cost. In total, 39% of implants presented with no costs, whereas 22% and 8% encountered additional costs over 50% and 75%, respectively. In 2%, the complication costs exceeded the initial cost. The mean yearly additional cost was 1.2% (range 0-6%) and mean complication time per implant was 67min (range 0-345min). Differences between prosthetic designs (CO, ST-PFM, ST-ACR) were statistically significant for total cost (P=0.011), yearly cost (P=0.023), and time (P=0.023). Pairwise comparison revealed significant lower costs for CO compared with ST-ACR reconstructions. Conclusion: Patients should be informed about additional costs related to complications with single implants. The mean additional cost spent on complications was almost one-quarter of the initial treatment price. A majority of implants presented with lower additional costs, whereas the highest complication costs were related to a smaller group with 22% of the implants needing more than half of the initial cost for complication management. Expenses were significantly different for various prosthetic designs.

  • 15. Dierens, M.
    et al.
    Vandeweghe, Stefan
    Malmö högskola, Odontologiska fakulteten (OD).
    Kisch, Jenö
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Long-term follow-up of turned single implants placed in periodontally healthy patients after 16–22 years: radiographic and peri-implant outcome2012Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, nr 2, s. 197-204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Retrospectively evaluate the survival, radiographic and peri-implant outcome of single turned Brånemark™ implants after at least 16 years. Materials and methods: From 134 patients (C-group), 101 could be contacted concerning implant survival and 50 (59 remaining implants) were clinically examined (I-group). Marginal bone level was radiographically measured from the implant–abutment junction at baseline (=within 6 months after abutment connection) and 1–4, 5–8 and 16–22 years post-operatively. Probing depth, gingival and plaque index were measured. Marginal bone-level changes were analyzed using Friedman's and Wilcoxon's signed ranks tests. Spearman's correlations between radiographic and clinical parameters were calculated. Results: In the C-group, 13 out of 166 implants in 11 out of 134 patients failed (CSR=91.5%). In the I-group (28 males–22 females; mean age 23.9 years at baseline; range 14–57), the mean follow-up was 18.4 years (range 16–22). The mean bone level was 1.7±0.88 mm (range −0.8 to 5) after 16–22 years. Changes in the mean marginal bone level were statistically significant between baseline and the second measuring interval (1–4 years). Thereafter, no significant differences could be demonstrated. The mean interproximal probing depth, gingival and plaque indices were 3.9±1.27 mm, 1.2±0.81 and 0.2±0.48, respectively. Probing depth was moderately correlated with gingival inflammation (r=0.6; P<0.001) but not with bone level (P>0.05). 81.4% of the implants had a bone level ≤2nd thread and 91.5% had a probing depth ≤5 mm. 76.3% had both bone level ≤2nd thread and probing depth ≤5 mm. Conclusions and clinical implications: The single turned Brånemark™ implant is a predictable solution with high clinical survival and success rates. In general, a steady-state bone level can be expected over decades, with minimal signs of peri-implant disease. A minority (5%), however, presents with progressive bone loss.

  • 16.
    Dierens, Melissa
    et al.
    Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, Ghent, Belgium; Oral and Maxillofacial Imaging Unit, Faculty of Medicine and Health Sciences, Dental School, University Hospital Ghent, Ghent, Belgium.
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD). Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, Ghent, Belgium.
    Kisch, Jenö
    Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Cosyn, Jan
    Dental Medicine, Faculty of Medicine and Pharmacy, Free University of Brussels (VUB), Brussels, Belgium; Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, Ghent, Belgium.
    Vandeweghe, Stefan
    Malmö högskola, Odontologiska fakulteten (OD). Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, University of Ghent, Ghent, Belgium.
    Prosthetic Survival and Complication Rate of Single Implant Treatment in the Periodontally Healthy Patient after 16 to 22 Years of Follow-Up2016Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 18, nr 1, s. 117-128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Single implants were introduced in the 1980s, but long-term follow-up is scarce. Purpose The study aims to retrospectively investigate the prosthetic survival and complication rates of single implants in periodontally healthy patients after 16-22 years, and to evaluate the influence of different prosthetic procedures Materials and Methods Patients with a single implant were recalled for clinical examination. Prosthetic procedures included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Prosthetic survival, success, and occurrence of biological, technical, and aesthetic complications were obtained. Procedures were compared by log-rank tests Results Fifty patients attended the examination. All implants were functional; however, 15% of abutments and 27% of crowns had been renewed. Replacements (1/4) were related to technical issues whereas the main cause was aesthetics. The abutment cumulative survival rate (CSR) differed significantly between ST-PFM (74%), ST-ACR (0%), and CO reconstructions (97%). The crown CSR was significantly lower for ST-ACR crowns (0%) compared with ST-PFM (68%) and CO (81%). Thirty-nine percent of implants remained complication free throughout the mean 18.5 years. Complications (1/3) required component replacement, and 53% occurred within 5 years after surgery Conclusion Prosthetic survival rates of single implants are encouraging after 16 to 22 years. However, 66% of the patients encountered at least one complication during follow-up.

  • 17. Fernandes, Cláudio Pinheiro
    et al.
    Glantz, Per-Olof
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    On the Accuracy of Some In Vitro Models for Mechanical Studies of Maxillary Removable Partial Dentures2003Ingår i: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 19, nr 2, s. 127-136Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    OBJECTIVES: Comparative in vitro/in vivo studies show wide differences in functional strain magnitudes and patterns of functional strain distribution in prosthetic devices. The aim of this study was to evaluate the accuracy of three in vitro models for biomechanical studies of prosthetic devices. METHODS: Strain gages were attached to the test RPDs of six subjects. In vitro maxillary models with simple (model A), intermediate (model B) and advanced (model C) features for the anatomical simulation of supporting structures were manufactured for each subject. The dentures were subjected to two separate series of standardized functional and laboratorial loading tests. The principal maximum strain value (epsilon (1)) obtained for each gage and experiment was used to calculate the intra-experiment variance and inter-experiment variance for the in vivo and in vitro experiments. The integrated strain gage difference value between the in vitro and in vivo data (Sigma(diff)) was calculated for every loading test and compared to the in vivo inter-experiment variance with ANOVA and Scheffes test. RESULTS: The bite forces recorded were similar for each subject and loading position and between the two loading sessions. The inter- and intra-experiment variance was found to be higher for in vivo loadings than for in vitro. Results showed that the (Sigma(diff)) values for model B and model C were significantly different from the in vivo strain interexperiment variance (p<0.05). SIGNIFICANCE: This study showed that the anatomical simulation of in vitro models is insufficient to allow for accurate mechanical analyses of maxillary RPDs and that only simple verifications of the strain levels in prosthetic appliances can be attained in vitro.

  • 18. Gotfredsen, Klaus
    et al.
    Carlsson, Gunnar E
    Jokstad, Asbjørn
    Arvidson Fyrberg, Kristina
    Berge, Morten
    Bergendal, Birgitta
    Bergendal, Tom
    Ellingsen, Jan Eirik
    Gunne, Johan
    Hofgren, M
    Holm, Betty
    Isidor, Flemming
    Karlsson, Stig
    Klemetti, Esa
    Lang, Niklaus P
    Lindh, Tomas
    Midtbø, Marit
    Molin, Margareta
    Närhi, Tommi
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Öwall, Bengt
    Pjetursson, Bjarni
    Saxegaard, Erik
    Schou, Sören
    Stokholm, Rie
    Thilander, Birgit
    Tomasi, Cristiano
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Implants and/or teeth: consensus statements and recommendations2008Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 35, nr Suppl 1, s. 2-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In August 23-25, 2007, the Scandinavian Society for Prosthetic Dentistry in collaboration with the Danish Society of Oral Implantology arranged a consensus conference on the topic 'Implants and/or teeth'. It was preceded by a workshop in which eight focused questions were raised and answered in eight review articles using a systematic approach. Twenty-eight academicians and clinicians discussed the eight review papers with the purpose to reach consensus on questions relevant for the topic. At the conference the consensus statements were presented as well as lectures based on the review articles. In this article the methods used at the consensus workshop are briefly described followed by the statements with comments.

  • 19. Haag, Per
    et al.
    Andersson, Martin
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Porcelain bonding to titanium with two veneering principles and two firing temperatures2013Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, nr 3, s. 143-151Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dental literature, as well as dental laboratories, has described problems with ceramic veneering of titanium, while clinical and in vitro studies have reported good results. The objective of this study was to investigate the effect of firing temperature, thermo cycling, and veneering methods on bond strength between porcelain and titanium. Eighty titanium specimens were prepared with one of two methods: a bonding agent firing or an oxidation firing. During veneering, half of the specimens in each group were fired at 30 degrees C above and half at the manufacturer's recommended temperature. In the bonding agent group and in the oxidation group, half of each firing group was thermocycled. Bond strength was calculated in a three-point bending test. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analyses of the titanium and the porcelain fracture surfaces of one specimen from each subgroup was used in order to study the composition of the interface between titanium and porcelain surfaces after fracture. No significant difference in bond strength was found when firing at a higher temperature compared with firing at the recommended temperature. An oxidation firing before veneering yielded significantly higher bond strength in a three-point bending test than when firing with a bonding agent. SEM and EDS analyses indicated a higher frequency of titanium oxide fractures in the oxidation than in the bonding agent group.The main finding is that firing at 30 degrees C above the recommended temperature does not significantly affect bond strength between titanium and porcelain. SEM and EDS analysis indicate that fractures occur in the titanium oxide layer by oxidation firing and in the interface between titanium oxide layer and veneering material by bonding agent firing.This finding might indicate that three- point bending test is not a relevant method for determining bond strength in this case, since the firing methods might influence the ductility of the samples.

  • 20. Haag, Per
    et al.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Bonding between titanium and dental porcelain: A systematic review2010Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, nr 3, s. 154-164Artikel, forskningsöversikt (Övrigt vetenskapligt)
    Abstract [en]

    Objectives. The aims of this literature review are to provide answers to questions on how to improve bonding between titanium and dental porcelain and how to further implement, in clinical practice, ceramic-veneered titanium as an alternative to conventional metal-ceramic systems. Material and methods. A literature search of PubMed and also among referenced published scientific papers was performed and 24 fulfilled the search criteria, namely mentions of titanium, ceramics and bond strength. These papers were compiled for comparison and evaluated regarding the bond strength achieved with different methods. Results. The results strongly indicate that there are possibilities to improve both the present materials and methods for titanium-ceramic veneering. Conclusions. The results indicate that present knowledge is sufficient to conclude that veneering titanium with low-fused porcelain for crowns and fixed partial dentures can be recommended for routine clinical use.

  • 21.
    Haag, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Questions and answers on titanium-ceramic dental restorative systems: a literature study2007Ingår i: Quintessence International, ISSN 0033-6572, Vol. 38, nr 1, s. e5-e13Artikel, forskningsöversikt (Övrigt vetenskapligt)
    Abstract [en]

    OBJECTIVE: Titanium ceramics has become a topic of interest for prosthetic applications, thanks to the documented biocompatibility of commercially pure titanium. A number of concepts have been presented, including metal frameworks produced by casting or milling and a number of materials and methods for veneering. However, the concept has not reached a clinical breakthrough since failures have been reported from clinical experiences. METHOD AND MATERIALS: A PubMed search on the following key words was performed: titanium ceramics, long-term results. RESULTS: This review illustrates the fact that it is possible to have success with titanium ceramics on crucial criteria: fit and marginal adaptation, bond strength between metal and ceramics, and esthetic outcome. A review of clinical studies indicates a tendency for success rates to increase with time, which must be explained as a normal learning curve for a technical concept. The learning curve also includes development of materials and methods and the fact that there is a certain amount of technique sensitivity involved in the success rate for titanium ceramics. CONCLUSIONS: There is reason to believe that the outstanding clinical properties of titanium will further catalyze the development of titanium ceramics, and recent experiences clearly indicate that titanium ceramics, being a clinical product ready for use in fixed partial dentures, might already today challenge standard metal ceramics.

  • 22. Helldén, Leif
    et al.
    Ericson, Gunnel
    Elliot, Agnetha
    Fornell, Jan
    Holmgren, Kurt
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Olsson, Carl Olof
    A prospective 5-year multicenter study of the Cresco implantology concept2003Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 16, nr 5, s. 554-562Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    PURPOSE: The purpose of this study was to investigate the clinical and radiographic outcome of a prospective 5-year longitudinal multicenter test of a simplified implantology concept comprising an abut-ment-free implant system (Cresco) and a new method for fabrication of passively fitting superstructures, the Cresco Ti Precision method. MATERIALS AND METHODS: The tests were carried out at three different centers. Sixty partially or completely edentulous patients were restored by fixed implant-supported superstructures fabricated according to the Cresco Ti Precision method. In all, 215 Cresco implants were placed for the support of the superstructures. For various reasons, eight patients (13%) could not be followed through the 5 years. The radiographic measurements were recorded from radiographs exposed perpendicular to the implants. RESULTS: The initial implant failure rate (during the healing phase) was 2%, and the survival rate after loading was 98%. The mean peri-implant bone loss was 0.29 mm (SD 0.57). Of the measured sites, 71% showed a crestal bone loss of less than 0.5 mm. Very few mechanical complications were observed. This was attributed to the passively fitting superstructures. CONCLUSION: The results from the present multicenter test demonstrated that the abutment-free Cresco implantology concept is a reliable alternative method for implant-supported fixed prosthetic rehabilitation of edentulous and partially edentulous jaws.

  • 23. Hermerén, Göran
    et al.
    Carlsson, Gunnar E
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Öwall, Bengt
    Glimstedt, Bengt
    Scholander, Sven
    Etik och estetisk tandvård2006Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 98, nr 15, s. 62-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this article is to present the background and the rules of regulations for the ethic considerations that are mandatory in aesthetic dentistry. It also presents a systematic approach in the handling of the ethic analysis.

  • 24. Hultin, Margareta
    et al.
    Davidson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Nordenram, Gunilla
    Norlund, Anders
    Sunnegårdh-Grönberg, Karin
    Tranæus, Sofia
    Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL2012Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, s. 543-552Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health–related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.

  • 25. John, Mike T
    et al.
    Larsson, Pernilla
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Bandyopadhyay, Dipankar
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Validation of the orofacial esthetic scale in the general population2012Ingår i: Health and Quality of Life Outcomes, E-ISSN 1477-7525, Vol. 10, artikel-id 135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The Orofacial Esthetic Scale (OES) is an eight-item instrument to assess how patients perceive their dental and facial esthetics. In this cross-sectional study we investigated dimensionality, reliability, and validity of OES scores in the adult general population in Sweden. METHODS: In a random sample of the adult Swedish population (response rate: 39%, N=1159 subjects, 58% female, mean age (standard deviation): 49.2 (17.4) years), dimensionality of OES was investigated using factor analytic methods to determine how many scores are needed to characterize the construct. Reliability of scores was calculated using Cronbach's alpha. Score validity was determined by correlating the OES summary score with a global indicator of orofacial esthetics (OE). RESULTS: Factor analyses provided support that a single score can sufficiently characterize OE. A Cronbach's alpha of 0.93 indicated excellent reliability. A validity coefficient of r=0.89 (95% confidence interval: 0.87-0.90) indicated that OES summary scores correlated highly with a global OE assessment. CONCLUSIONS: The OES is a promising instrument to measure the construct OE. Factor analyses supported that this construct can be assessed with one score, offering a feasible and acceptable standardized assessment of OE. The present study extends the OES use to the general population, an important target population for assessment of orofacial esthetics

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  • 26. Korduner, Eva-Karin
    et al.
    Nordenram, Gunilla
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Är korta tandbågar förenligt med god oral funktion hos äldre2003Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 95, nr 8, s. 44-49Artikel, forskningsöversikt (Övrigt vetenskapligt)
    Abstract [sv]

    Eftersom tandhälsan förbättras och dagens äldre kan förväntas få behålla fler tänder kommer det att ställas större krav på äldretandvården i framtiden. Samtidigt kommer tandvården att ha en begränsad tillgång på tandläkare som förväntas balansera samhällets allt mer restriktiva ekonomiska ersättning till tandvården mot patientens och de anhörigas ökade och därmed kostsammare krav på god funktionell tandvård. Mot denna bakgrund genomfördes en litteraturgenomgång i syfte att närmare kunna presentera sda-konceptet (”The shortened dental archkonceptet”) och dess möjliga kliniska applikation inom äldretandvården. En försiktig extrapolering som baserats på resultat från studier som rör patienter i yngre åldrar visar att ”the shortened dental arch-konceptet” även är tillämpbart inom tandvården för äldre.

  • 27.
    Korduner, Eva-Karin
    et al.
    Malmö högskola, Odontologiska fakulteten (OD). Prosthodontic Clinic, Public Dental Health Service, SE-222 21 Lund, St. Laurentiigatan 10, Sweden.
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Kronström, Mats
    Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Attitudes toward the shortened dental arch concept among Swedish general dental practitioners2006Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 19, nr 2, s. 171-176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The purpose of this investigation was to obtain the opinions and assess the attitudes of Swedish general dental practitioners in private practice versus a public health care setting regarding management of patients with a shortened dental arch (SDA). MATERIALS AND METHODS: A questionnaire containing different statements regarding the SDA concept was sent to a random sample of 189 clinicians. Differences between male and female practitioners and between private practitioners (PPs) and those employed by the Public Dental Health Service (PDHS) were tested for statistical significance by the Student t test. RESULTS: The response rate was 54% (102 clinicians). Among the respondents, 62% were men and 38% were women. Fifty-six percent were PPs and 44% were employed by the PDHS. The results showed small differences in attitudes between various groups of practitioners but large individual variations. In general, Swedish general practitioners had a positive attitude toward the SDA concept with respect to oral function and oral comfort. They recognized few risks with a dentition lacking molar support, although female clinicians were more risk conscious. PPs expressed fewer advantages in using the SDA concept than PDHS practitioners with respect to the reduced risk for overtreatment, better patient economy, and the ability for older patients to keep their teeth. CONCLUSION: The results from this questionnaire study indicate that, overall, Swedish general practitioners have an affirmative opinion toward the SDA concept.

  • 28. Korduner, Eva-Karin
    et al.
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Kronström, Mats
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Decision making among Swedish general dental practitioners concerning prosthodontic treatment planning in a shortened dental arch2010Ingår i: European Journal of Prosthodontics and Restorative Dentistry, ISSN 0965-7452, Vol. 18, nr 1, s. 43-47Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purposes of this study were to describe how dentists evaluated the importance of various patient-related items when planning for a treatment in a shortened dental arch, to analyse common dimensions of the decision-making in comparison to other decision situations, and to identify explanatory factors behind these dimensions. A questionnaire containing different statements regarding the shortened dental arch concept was sent to a random sample of Swedish general dentists (n=189), with a response rate of 54%. The dentists were asked to evaluate items to be considered when planning for a prosthetic treatment in a shortened dental arch. Differences between individuals were great as well as between groups of dentists. Especially delivery system but also place of dental education and attitudinal factors were related to the shortened dental arch decision making process.

  • 29.
    Larsson, Christel
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Vult von Steyern, Per
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    A prospective study of implant-supported full-arch yttria-stabilized tetragonal zirconia polycrystal mandibular fixed dental prostheses: three-year results2010Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 23, nr 4, s. 364-369Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The development of high-strength oxide ceramic materials has led to increased interest in all-ceramic fixed dental prostheses (FDPs). Success rates reported in clinical studies for all-ceramic FDPs based on high-strength oxide ceramic materials reportedly approach those of porcelain-fused-to-metal FDPs. These reconstructions, however, are still of limited size and have mainly concerned FDPs supported by natural teeth. The purpose of this study was to evaluate the clinical performance of multiunit all-ceramic FDPs supported by dental implants. MATERIALS AND METHODS: Ten patients received mandibular yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) FDPs manufactured according to the Cercon technique and supported by four Astra Tech implants. Nine patients received 10-unit FDPs and one patient received a 9-unit FDP. The FDPs were cemented with Panavia F 2.0 onto individually prepared titanium abutments. The FDPs were evaluated at baseline and after 12, 24, and 36 months. RESULTS: At the 3-year follow-up, all FDPs were in use, and all patients were fully satisfied with their treatment. None of the reconstructions had fractured. Superficial chip-off fractures of the veneering porcelain were, however, observed in nine patients (34 of 99 units, 34%). CONCLUSION: Results from this 3-year study suggest that implant-supported full-arch Y-TZP FDPs manufactured according to the Cercon technique should be viewed as a treatment alternative cautiously. A better understanding of the factors resulting in chip-off fractures is needed, together with longer follow-up studies involving larger numbers of patients, before the material and technique can be recommended for general use.

  • 30.
    Larsson, Christel
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Vult von Steyern, Per
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    All-ceramic multi-unit implant-supported fixed dental prostheses: A prospective clinical study2009Ingår i: IADR Abstract book;Abstract #242, IADR , 2009Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    The development of high-strength oxide ceramic materials has led to increased interest in all-ceramic fixed dental prostheses (FDPs). Success rates reported in clinical studies on such reconstructions are close to those of porcelain fused to metal (PFM) FDPs. These reconstructions however, are still of limited size and have so far only concerned FDPs supported by natural teeth. Objectives: The purpose of this study was to evaluate the clinical performance of mutli-unit all-ceramic FDPs supported by dental implants. Methods: Ten patients received all-ceramic FDPs designed according to the Cercon® technique and supported by four AstraTech implants in the lower jaw. Nine patients received ten-unit prostheses and one patient received a nine-unit FDP. The FDPs were cemented with Panavia F2.0 onto preparable titanium abutments. The FDPs were evaluated at baseline, twelve, twenty-four and thirty-six months. The surface and marginal integrity were rated according to the California Dental Association (CDA) quality assessment system. Results: At the three-year follow up all FDPs were in use and all patients reported that they were fully satisfied with the treatment. None of the reconstructions had fractured. Superficial cohesive, chip-off, fractures of the veneering porcelain were, however, observed in nine patients. A total of 34 of 99 units (34%) showed such chip-off fractures. Corresponding results for the twelve-month and twenty-four month follow-ups were 14% and 19% respectively. Most patients were unaware of the fractures, some fractures were adjusted by polishing but no FDPs were in need of replacement. Conclusion: Results from this three-year study suggest that multi-unit all-ceramic implant-supported FDPs designed according to the Cercon® technique may be considered a treatment alternative. Better understanding of the factors behind chip-off fractures is necessary togehter with long-term follow-up studies before the material and technique can be recommended for general use.

  • 31.
    Larsson, Christel
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Vult von Steyern, Per
    Malmö högskola, Odontologiska fakulteten (OD).
    Sunzel, Bo
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    All-ceramic two- to five-unit implant-supported reconstructions. A randomized, prospective clinical trial2006Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 30, nr 2, s. 45-53Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Syftet med denna studie var att kliniskt utvärdera helkeramiska två- till femleds rekonstruktioner på implantat, samt att jämföra två olika keramiska system, Denzir® (DZ) och In-Ceram Zirconia® (InZ). Arton patienter behandlades med totalt 25 två- till femleds rekonstruktioner på implantat. Nio patienter fick rekonstruktioner utförda i DZ och nio patienter fick rekonstruktioner utförda i InZ. Rekonstruktionerna cementerades med zinkfosfatcement på preparerbara titandistanser. Rekonstruktionerna utvärderades efter 6- och 12 månader. Vid uppföljning efter 12 månader var alla 25 rekonstruktioner i funktion, inga hade frakturerat. Ytliga kohesiva, sk. chip-off, frakturer noterades däremot hos 6 av 18 patienter (8 av 25 rekonstruktioner). Nio led i DZ-gruppen (7 av 13 rekonstruktioner) och ett led i InZ-gruppen (1 av 12 rekonstruktioner) uppvisade chip-off frakturer. Skillnaden mellan de båda grupperna var statisktiskt signifikant (p< 0.01). Kantanslutningen bedömdes som utmärkt vid 34 stöd (56%) och acceptabel vid 27 stöd (44%). Resultat från denna 12 månaders uppföljning indikerar att helkeramiska två- till femleds rekonstruktioner på implantat kan övervägas som behandlingsalternativ. Vid jämförelse mellan de båda keramiska systemen är slutsatsen att DZ-systemet uppvisar oacceptabelt många frakturer i ytporslinet och därför inte kan rekommenderas för den typ av behandling som utvärderats här. Fortsatta studier och långtidsuppföljningar är nödvändiga innan ovan nämda material och teknik kan rekommenderas för allmänt bruk.

  • 32.
    Larsson, Pernilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    John, Mike
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Bondemark, Lars
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Development Of An Orofacial Aesthetic Scale In Prosthodontic Patients2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: Despite the interest and need to assess orofacial aesthetics in prosthodontic patients, few self-report instruments are available to measure this construct and none describes how prosthodontic patients perceive the appearance of patients' face, mouth, teeth, and dentures. We report development of the Orofacial Aesthetic Scale (OAS), in particular its conceptual framework, how questionnaire items were generated, and the scale's measurement model. Methods: After test conceptualization, we solicited aesthetic concerns in 17 prosthodontic patients who were asked to evaluate their photographs. A focus group of 8 dental professionals reduced the initial number of concerns/items and decided on an item response format. Pilot testing in 9 subjects generated the final instrument, the OAS. We performed exploratory factor analysis to investigate OAS dimensionality and item analysis to investigate item difficulty and discrimination in 119 subjects. Results: Prosthodontic patients generated an initial 28 aesthetic concerns. These items were reduced to 8 preliminary representative items that were subsequently confirmed in pilot testing. Item analysis supported these 8 items assessing appearance: Face, Profile, Mouth, Tooth alignment, Tooth shape, Tooth color, Gums, as well as Overall impression measured on an 11-point numeric rating scale (0 ”Very dissatisfied”, 10 ”Very satisfied” with appearance). Exploratory factor analysis found only 1 factor and high positive loadings for all items (.73 to .94) on the first factor, supporting OAS' unidimensionality. Conclusion: The Orofacial Aesthetic Scale, developed especially for prosthodontic patients, is a brief questionnaire that assesses orofacial aesthetic impacts with freely available Swedish and English versions.

  • 33.
    Larsson, Pernilla
    et al.
    Ctr Oral Rehab, SE-58185 Linköping, Sweden.
    John, Mike
    Univ Minnesota, Dept Diagnost & Biol Sci, Minneapolis, MN USA; Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Bondemark, Lars
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Development of an Orofacial Esthetic Scale in prosthodontic patients2010Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 23, nr 3, s. 249-256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Despite the interest and need to assess orofacial esthetics in prosthodontic patients, few self-reporting instruments are available to measure this construct, and none describe how prosthodontic patients perceive the appearance of their face, mouth, teeth, and dentures. The development of the Orofacial Esthetic Scale (OES) is reported in this article, in particular its conceptual framework, how questionnaire items were generated, and the scale's measurement model. MATERIALS AND METHODS: After test conceptualization, the authors solicited esthetic concerns from 17 prosthodontic patients by asking them to evaluate their own photographs. A focus group of 8 dental professionals reduced the initial number of concerns/items and decided on an item response format. Pilot testing in 9 subjects generated the final instrument, the OES. Exploratory factor analysis was performed to investigate OES dimensionality and item analysis to investigate item difficulty and discrimination in 119 subjects. RESULTS: Prosthodontic patients generated an initial 28 esthetic concerns. These items were reduced to 8 preliminary representative items that were subsequently confirmed during pilot testing. Analysis supported 8 items assessing appearance: face, profile, mouth, tooth alignment, tooth shape, tooth color, gums, and overall impression, measured on an 11-point numeric rating scale (0 = very dissatisfied, 10 = very satisfied). Exploratory factor analysis found only 1 factor and high positive loadings for all items (.73 to .94) on the first factor, supporting the unidimensionality of the OES. CONCLUSIONS: The OES, developed especially for prosthodontic patients, is a brief questionnaire that assesses orofacial esthetic impacts.

  • 34.
    Larsson, Pernilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    John, Mike
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Reliability And Validity Of The Orofacial Aesthetic Scale2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: This study evaluated reliability and validity of the Orofacial Aesthetic Scale (OAS)—an instrument assessing self-reported orofacial aesthetics in prosthodontic patients. Methods: The OAS has 7 items addressing direct aesthetical impacts in the orofacial region and an 8th global assessment item. Response format is a 0 to 10 numeric rating scale (”Very dissatisfied” to ”Very satisfied” with appearance). OAS summary scores range from 0 (worst score) to 70 (best score). Test-retest reliability (n=27) and internal consistency (n=119) were assessed. Content validation (asking patients about their satisfaction with the questionnaire content, n=119) and discriminative validation (comparing OAS scores between patients and healthy controls, n=119) were performed. Convergent validity was assessed by correlating patients' own OAS scores (n=29) with ratings from a consensus expert group (n=4) and with the Oral Health Impact Profile (OHIP) aesthetic-item summary score (n=119). Results: Test-retest reliability was excellent for the OAS scores (intraclass correlation coefficient = .96). Internal consistency was satisfactory for aesthetically impaired patients (n=27, Cronbach's alpha=.86). Patients rated their satisfaction with the questionnaire content as 7.8±1.3 units on a 0 to 10 numeric rating scale (0=very dissatisfied, 10=very satisfied). OAS scores discriminated aesthetically impaired patients (31.4 units) from healthy controls (45.9 units, P<0.001). OAS scores correlated well with other measures of the same construct (r=.43 for patients' own assessment with an assessment by experts using OAS, r=-.72 for a correlation with OHIP's 3 aesthetic-related items). Conclusion: The Orofacial Aesthetic Scale, developed especially for prosthodontic patients, exhibited good score reliability and validity.

  • 35.
    Larsson, Pernilla
    et al.
    Ctr Oral Rehab, SE-58185 Linköping, Sweden.
    John, Mike
    Univ Minnesota, Dept Diagnost & Biol Sci, Minneapolis, MN USA; Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Reliability and validity of the Orofacial Esthetic Scale in prosthodontic patients2010Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 23, nr 3, s. 257-262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study evaluated the reliability and validity of the Orofacial Esthetic Scale (OES)-an instrument assessing self-reported orofacial esthetics in prosthodontic patients. MATERIALS AND METHODS: The OES has seven items addressing direct esthetic impacts in the orofacial region, as well as an eighth global assessment item. The response format was a 0 to 10 numeric rating scale (very dissatisfied to very satisfied with appearance, respectively). OES summary scores ranged from 0 (worst score) to 70 (best score). Test-retest reliability (n = 27) and internal consistency (n = 119) were assessed. Content validation (asking patients about their satisfaction with the questionnaire content, n = 119) and discriminative validation (comparing OES scores between patients and healthy controls, n = 119) were performed. Convergent validity was assessed by correlating patients' own OES scores (n = 29) with ratings from a consensus expert group (n = 4) and with the Oral Health Impact Profile (OHIP) esthetic-item summary score (n = 119). RESULTS: Test-retest reliability was excellent for the OES scores (intraclass correlation coefficient = .96). Internal consistency was satisfactory for esthetically impaired patients (n = 27, Cronbach alpha = .86). Patients rated their satisfaction with the questionnaire content as 7.8 +/- 1.3 units on a 0 to 10 numeric rating scale (0 = very dissatisfied, 10 = very satisfied). OES scores discriminated esthetically impaired patients (31.4 units) from healthy controls (45.9 units, P < .001). OES scores correlated well with other measures of the same construct (r = .43 for patients' own assessment with an assessment by experts using the OES, r = -.72 for a correlation with the OHIP's three esthetic-related items). CONCLUSIONS: The OES, developed especially for prosthodontic patients, exhibited good score reliability and validity.

  • 36.
    Larsson, Pernilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    John, MT
    Hakeberg, M
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    General population norms of the Swedish short forms of oral health impact profile2014Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 41, nr 4, s. 275-281Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We reported the development and psychometric evaluation of a Swedish 14-item and a five-item short form of the Oral Health Impact Profile. The 14-item version was derived from the English-language short form developed by Slade in1997. The five-item version was derived from the German-language short form developed by John et al. in 2006. Validity, reliability and normative values for the two short form summary scores were determined in a random sample of the adult Swedish population (response rate: 46%, N = 1366 subjects). Subjects with sufficient OHRQoL information to calculate a summary score (N = 1309) were on average 50·1 ± 17.4 years old, and 54% were women. Short form summary scores correlated highly with the 49-item OHIP-S (r ≥ 0.97 for OHIP-S14, r ≥ 0.92 for OHIP-S5) and with self-report of oral health (r ≥ 0.41). Reliability, measured with Cronbach's alpha (0.91 for OHIP-S14, 0.77 for OHIP-S5), was sufficient. In the general population, 50% of the subjects had ≥2 OHIP-S14 score points and 10% had ≥11 points, respectively. Among subjects with their own teeth only and/or fixed dental prostheses and with partial removable dental prostheses, 50% of the population had ≥2 OHIP-S14 score points, and 10% had ≥11 points. For subjects with complete dentures, the corresponding figures were 3 and 24 points. OHIP-S5 medians for subjects in the three population groups were 1, 1 and 2 points. Swedish 14-item and 5-item short forms of the OHIP have sufficient psychometric properties and provide a detailed overview about impaired OHRQoL in Sweden. The norms will serve as reference values for future studies

  • 37.
    Larsson, Pernilla
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    John, MT
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Normative values for the Oro-facial Esthetic Scale in Sweden2014Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 41, nr 2, s. 148-154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study reports the findings and challenges of the assessment of oro-facial aesthetics in the Swedish general population and the development of normative values for the self-reporting Orofacial Esthetic Scale (OES). In a Swedish national sample of 1406 adult subjects (response rate: 47%), OES decile norms were established. The influence of sociodemographics (gender, age, and education), oral health status and general health status on OES scores was analysed. Mean ± standard deviation of OES scores was 50.3 ± 15.6 units (0, worst score; 70, best score); <1% of the subjects had the minimum score of 0, and 11% had the maximum score of 70 OES units. Orofacial Esthetic Scale score differences were (i) substantial (>5 OES units) for subjects with excellent/very good versus good to poor oral or general health status; ii) small (2 units), but statistically significant for gender (P = 0.01) and two age groups (P = 0.02), and (iii) absent for subjects with college versus no college education (P = 0.31) or with and without dentures (P = 0.90). To estimate normative values for a self-reporting health status, instrument is considered an important step in standardisation, and the developed norms provide a frame of reference in the general population to interpret the Orofacial Esthetic Scale scores

  • 38.
    Nilner, Krister
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Bergkvist, G
    Sahlholm, S
    Karlsson, U
    Direktbelastning av implantat i tandlösa överkäkar: en 32 månaders klinisk och radiologisk studie2006Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 39. Nordenram, Gunilla
    et al.
    Davidson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Norlund, Anders
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Sunnegårdh-Grönberg, Karin
    Tranæus, Sofia
    Malmö högskola, Odontologiska fakulteten (OD).
    Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: A systematic review with meta-synthesis2013Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, nr 3-4, s. 937-951Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.

  • 40.
    Rohlin, Madeleine
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Davidson, Thomas
    Gynther, Göran
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nordenram, Gunilla
    Norlund, Anders
    Sunnegårdh-Grönberg, Karin
    Tranaeus, Sofia
    Treatment of adult patients with edentulous arches: a systematic review2012Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, s. 553-567Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. MATERIALS AND METHODS: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). RESULTS: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. CONCLUSIONS: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism.

  • 41. Rosendahl, K.
    et al.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Dahlberg, G.
    Kisch, J.
    Implant periapical lesion2006Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    One complication in implant dentistry is the implant periapical lesion. This case report describes a 30-year-old man who after an injury was treated with a single implant that caused a fistula that appeared four months after the implant installation. Proper pharmaceutical intervention was not successful. The fistula did not disappear until the apical part of the implant together with granulomatous tissue was surgically removed. It is concluded that an extended period of pain after implant installation might be an early indication that the treatment is not uneventful, that a fistula always should lead up to a fistulography, and that the condition can be successfully treated with surgery.

  • 42.
    Rosendahl, Kerstin
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Dahlberg, Gunnar
    Univ Hosp, Dept Oral & Maxillofacial Surg, Lund, Sweden.
    Kisch, Jenö
    Clin Prosthet Dent, Malmo, Sweden.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Implant periapical lesion. A case series report2009Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 33, nr 33, s. 49-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One complication in implant dentistry is the implant periapical lesion-IPL--which is a lesion around the apex of a stable implant diagnosed radiographically as a radioluscency in the bone at the apical part of an implant.The IPL can perform with or without clinical symptoms such as tenderness, swelling, suppuration and fistulation. This report describes 4 cases of IPL which were treated surgically with sectioning and removal of the affected portion of a stable implant and thorough debridement of the granulomatous tissue around it. This treatment was, up to 4 years after treatment, successful in all 4 cases. It can also from this report be concluded that IPL is a rather rare condition and that it can occur at any stage of implant treatment, in these cases from 4 months up to 11 years after implant installation. Finally there is a discussion about the aetiology of IPL and a comparison to findings in other reports on IPL and it is concluded that it is difficult to claim that there is a single cause to IPL. Rather it is evident that the condition might be a sequel of the summation of many possible causes.This summation exceeds the local biological threshold for the individual patient.

  • 43.
    Sjödin, Torgny
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Sparre, Birgitta
    Active Biotech AB, Lund, Sweden.
    Bernet, Catarina
    Kineticon AB, Uppsala, Sweden.
    Åström, Mikael
    StatCons, Malmö, Sweden.
    A clinical and microbiological study on the enantiomers of delmopinol2016Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, nr 5, s. 355-361Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective The clinical part of this study aimed to investigate whether the racemate of delmopinol [(+/-)-delmopinol] is equivalent to its two enantiomers [(+)-delmopinol and (-)-delmopinol] with respect to efficiency and to determine and compare their pharmacokinetic properties. The purpose of the pre-clinical part was to elucidate possible differences in antimicrobial efficiency. Materials and methods The compounds were tested clinically in a double-blind, randomized, cross-over study comprising three treatment periods of 4 days each. The antimicrobial efficacy of the enantiomers was compared in vitro with respect to planktonic and biofilm bacteria of different species. Results No statistically significant differences in prevention of plaque formation were observed. Except for a somewhat higher systemic exposure in terms of AUC and C-max indicated for (-)-delmopinol compared to (+)-delmopinol, the pharmacokinetic properties were similar. The most common adverse event was a transient anaesthetic feeling in the mouth. This event was reported with the same frequency for all three test solutions. The enantiomers showed similar antimicrobial effects on planktonic bacteria and their biofilms. Conclusions The enantiomers were found to be equally effective with respect to inhibition of plaque development and only minor differences were observed with respect to their pharmacokinetic properties. No differences could be observed in the adverse events reports. There is, therefore, no reason to use one of the enantiomers of delmopinol instead of the racemate. This was further supported by the antimicrobial tests. It is suggested that the combined action of cationic and neutral delmopinol is important for its effect on biofilms.

  • 44. Sunnegårdh-Grönberg, Karin
    et al.
    Davidson, Thomas
    Gynther, Göran
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Nordenram, Gunilla
    Norlund, Anders
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Tranaeus, Sofia
    Hultin, Margareta
    Treatment of adult patients with partial edentulism: a systematic review.2012Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 25, nr 6, s. 568-581Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    PURPOSE: The purpose of this systematic review was to identify and critically appraise published studies of treatment methods used in general practice to rehabilitate adult patients with single tooth loss or partial edentulism, with special emphasis on outcomes reported after at least 5 years of follow-up. MATERIALS AND METHODS: Three databases were searched using specified indexing terms. Publications were included if the study design, research questions, and sample size satisfied pre-established criteria. Reference lists of relevant publications and systematic reviews were also searched. The quality of evidence was classified according to the GRADE system as high, moderate, low, or very low. RESULTS: The search yielded 7,675 titles, of which 1,130 were read in full text. A final total of 15 publications were deemed eligible for inclusion: 5 of moderate quality and 10 of low quality. The five studies of moderate quality were all related to implant-based treatment. The 5-year survival rates for implant-supported single crowns and prostheses were 91% and 94.7%, respectively (implant survival rates: 98.5% and 94.9%, respectively). The underlying scientific evidence was low in quality. No relevant publications were identified regarding the economic aspects of treatment. CONCLUSION: Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss or partial edentulism.

  • 45.
    Vult von Steyern, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    al-Ansari, A
    White, K
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Dérand, T
    Fracture strength of In-Ceram all-ceramic bridges in relation to cervical shape and try-in procedure. An in-vitro study.2000Ingår i: European Journal of Prosthodontics and Restorative Dentistry, ISSN 0965-7452, Vol. 8, nr 4, s. 153-158Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Investigations were performed on the strength of dental porcelain depending on whether it was exposed to saliva before or after the final firing. Forty porcelain specimens were fabricated and subjected to different treatments. A three-point flexural test was performed. In a second study investigations were performed to compare how the cervical shape of the preparation influenced the fracture strength of fixed partial dentures made of glass-infiltrated aluminium oxide. It was concluded that short-term exposure to saliva could have a negative effect on the strength of porcelain and that all-ceramic bridges luted with non-adhesive luting techniques should be supported by abutments with shoulder preparations.

  • 46.
    Vult von Steyern, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Carlsson, P
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    All-ceramic Fixed Partial Dentures Designed According to the DC-Zirkon Technique. A 2-year Clinical Study2005Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 32, nr 3, s. 180-187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present in-vitro study was to compare the fracture strength of all-ceramic Fixed Partial Dentures supported by tooth-analogues and periodontal membrane with the same supported by dental implants. As ceramics are highly brittle, they cannot withstand deformations of more than 0.1% without fracturing. Hence, when planning an all-ceramic FPD, it is essential to evaluate abutment sup-port, as the fracture strength of all-ceramic constructions depends on the stability of the support to reduce strain in the beam of the prosthe-sis. The support provided by implants differs, however, from the sup-port provided by natural teeth as the implants are anchored directly in the bone with no intermediate tissue. One question that arises is whether strain and stress in the prosthesis are lower when the prosthe-sis is loaded on implants compared to natural teeth and hence if all-ceramic FPDs benefit from implant support. Twenty-four three-unit all-ceramic FPDs-12 supported by two dental implants and 12 by two tooth-analogues serving as end abutments-were made. All FPDs were subjected to preloading in a preloading procedure and subsequently subjected to load until fracture occurred. Load at fracture were regis-tered and comparisons between the two groups were made. The loads at fracture were statistically significant higher in the group supported by implants compared to the group supported by tooth-analogues (p = 0.003). Within the limitations of this in-vitro study, the following con-clusions can be drawn: All-ceramic fixed partial dentures can be used in combination with dental implants. The solid support gained from implants might thus be beneficial for the outcome of such treatment due to decreased strain and stress levels in the prosthesis when loaded on implants compared to when loaded on natural teeth. Clinical stud-ies are, however, needed to confirm these findings as there are more factors that influence the final clinical outcome.

  • 47.
    Vult von Steyern, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ebbesson, S
    Holmgren, J
    Haag, Per
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Fracture strength of two oxide ceramic crown systems after cyclic pre-loading and thermocycling2006Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 33, nr 9, s. 682-689Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to investigate the fracture resistance of zirconia crowns and to compare the results with crowns made of a material with known clinical performance (alumina) in away that reflects clinical aspects. Sixty crowns were made, 30 identical crowns of alumina and 30 of zirconia. Each group of 30 was randomly divided into three groups of 10 crowns that were to undergo different treatments: (i) water storage only, (ii) pre-loading (10 000 cycles, 30-300 N, 1 Hz), (iii) thermocycling (5-55 degrees , 5000 cycles) + pre-loading (10 000 cycles, 30-300 N, 1 Hz). Subsequently, all 60 crowns were subjected to load until fracture occurred. There were two types of fracture: total fracture and partial fracture. Fracture strengths (N) were: group 1, alumina 905/zirconia 975 (P = 0.38); group 2, alumina 904/zirconia 1108 (P < 0.007) and group 3, alumina 917/zirconia 910 (P > 0.05). Total fractures were more frequent in the alumina group (P < 0.01). Within the limitations of this in vitro study, it can be concluded that there is no difference in fracture strength between crowns made with zirconia cores compared with those made of alumina if they are subjected to load without any cyclic pre-load or thermocycling. There is, however, a significant difference (P = 0.01) in the fracture mode, suggesting that the zirconia core is stronger than the alumina core. Crowns made with zirconia cores have significantly higher fracture strengths after pre-loading.

  • 48.
    Vult von Steyern, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Jönsson, Ola
    Private Practice in Prosthodontics, Lund, Sweden.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Five-year evaluation of posterior all-ceramic three-unit (In-Ceram) FPDs2001Ingår i: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 14, nr 4, s. 379-384Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this study was to investigate whether the properties of the In-Ceram material are adequate for use in posterior three-unit fixed partial dentures (FPD) and to evaluate the clinical method regarding preparation technique, design, and choice of cement. Materials and Methods: Eighteen patients were treated with a total of 20 posterior three-unit FPDs according to the In-Ceram technique. The FPDs were constructed with bilateral support and one pontic and were all replacing one premolar or a molar (11 replacing premolars and 9 replacing molars). They were evaluated 6 months after delivery and then once yearly. Results: Eighteen of the 20 FPDs (90%) showed no defects at any of the follow-up examinations and were functioning well after 5 years. No caries or signs of gingivitis or periodontitis exceeding those found in the rest of the dentition were registered. Conclusion: The In-Ceram technique is, in a 5-year perspective and adopted for three-unit FPDs, an acceptable treatment alternative. Further studies must, however, be performed before the material can be recommended for more extensive restorations than the FPDs included in this study.

  • 49.
    Vult von Steyern, Per
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Kokubo, Yuji
    Dental Medicine, Tsurumi University, Tsurumi, Japan.
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Use of Abutment-teeth vs. Dental Implants to Support All-ceramic Fixed Partial Dentures: An In-vitro Study on Fracture Strength2005Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, nr 2, s. 53-60Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    The aim of the present in-vitro study was to compare the fracture strength of all-ceramic Fixed Partial Dentures supported by tooth-analogues and periodontal membrane with the same supported by dental implants. As ceramics are highly brittle, they cannot withstand deformations of more than 0.1% without fracturing. Hence, when planning an all-ceramic FPD, it is essential to evaluate abutment sup-port, as the fracture strength of all-ceramic constructions depends on the stability of the support to reduce strain in the beam of the prosthe-sis. The support provided by implants differs, however, from the sup-port provided by natural teeth as the implants are anchored directly in the bone with no intermediate tissue. One question that arises is whether strain and stress in the prosthesis are lower when the prosthe-sis is loaded on implants compared to natural teeth and hence if all-ceramic FPDs benefit from implant support. Twenty-four three-unit all-ceramic FPDs-12 supported by two dental implants and 12 by two tooth-analogues serving as end abutments-were made. All FPDs were subjected to preloading in a preloading procedure and subsequently subjected to load until fracture occurred. Load at fracture were regis-tered and comparisons between the two groups were made. The loads at fracture were statistically significant higher in the group supported by implants compared to the group supported by tooth-analogues (p = 0.003). Within the limitations of this in-vitro study, the following con-clusions can be drawn: All-ceramic fixed partial dentures can be used in combination with dental implants. The solid support gained from implants might thus be beneficial for the outcome of such treatment due to decreased strain and stress levels in the prosthesis when loaded on implants compared to when loaded on natural teeth. Clinical stud-ies are, however, needed to confirm these findings as there are more factors that influence the final clinical outcome.

  • 50. Öwall, Bengt
    et al.
    Carlsson, Gunnar E
    Glimstedt, Björn
    Hermerén, Göran
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Scholander, Sven
    Estetisk och kosmetisk tandvård: nytt och unikt eller gamla metoder som vidareutvecklats?2005Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 97, nr 5, s. 46-52Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Intresset för estetisk/kosmetisk tandvård är stort och ökar snabbt. Det stora intresset skulle kunna vara positivt för tandvården men har i stället resulterat i olika reaktioner bland tandläkare. Den snabba utvecklingen inom området har ökat den kunnige tandläkarens möjligheter att förbättra patienternas dentala estetik. Men det har även visat sig att tandläkares och patienters uppfattningar om vad som är vackert, estetiskt acceptabelt och fult skiljer sig åt. Detta behöver studeras ytterligare. Den odontologiska litteraturen innehåller en mängd artiklar och böcker i ämnet men det finns förhållandevis få vetenskapliga studier. Det är också svårt att hitta artiklar som ifrågasätter området. Grundinställningen är att det är positivt att försöka förbättra tändernas utseende. De flesta material och metoder inom estetisk tandvård tycks vara relativt ofarliga att använda, åtminstone på kort sikt. Kunskaperna om resultat och risker på längre sikt är dock begränsade. Det är även brist på långtidsstudier som jämför kostnader för olika material och metoder. Tandläkare bör därför vara försiktiga med att använda nyheter som marknadsförs okritiskt, utan relevanta kliniska studier.

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