PubMed Health⌕ Search

Biomedical subjects

A Jokstad

Publications and source records attributed to A Jokstad.

At least 19 recordsLinked to original sources
PubMed2006

Amalgam waste management.

Dental amalgam has been extensively used as a tooth filling material for many decades and has beyond doubt saved millions of teeth that otherwise would have needed to be extracted. The release of amalgam particles into dental office wastewater is a matter of particular concern as amalgam particles could then be discharged into the environment. Amalgam waste discharges contribute to mercury in the environment through direct wastewater discharge, incineration, land-filling and sewage sludge incineration, although the discharge from dentistry is probably responsible for less than 1% of the total mercury discharged annually into the environment as a result of human activities. Nevertheless, dentists, by being producers of amalgam waste, have a responsibility and a duty of care for the proper management of this waste within their practices. Appropriate measures should be taken to minimise the amount of waste where possible or take action to ensure that all generated waste is disposed of in accordance with environmental legislation.

American Dental Association↗
PubMed2005

Wear of teeth due to occupational exposure to airborne olivine dust.

OBJECTIVES: To clarify whether high tooth wear of employees in a mining industry that extracts the mineral olivine could be associated with airborne dust exposure in their working environment. METHOD: The cumulative exposure to airborne mineral dust for the workers in the company was calculated on the basis of their period of employment multiplied by the airborne olivine-dust concentrations, which have been monitored continuously during the past 20 years for all divisions of the company. After invitation, 85% of the employees (n = 191) were examined clinically and their dentitions were photographed and duplicated in plaster casts. Four clinicians, working independently, examined the sets of casts/photographs for tooth wear and ranked these from most to least. Two groups of employees were compared with regard to tooth wear, i.e. the 30% with the highest (case) and the lowest (control) estimated dust exposure levels. Tooth wear in the case and control groups was compared using a non-parametric test based on rankings (Mann-Whitney test). RESULTS: Tooth wear differed significantly between the workers in the low and the high mineral dust exposure groups (p < 0.001). The differences were also apparent within three age subsets, although statistical significance was reached only in the 34-44 years subset (p = 0.002). Considerable individual variation was noted within the three exposure groups. CONCLUSION: Workers with high exposure to airborne olivine dust may contract considerable tooth wear.

Adolescent↗
PubMed2003

Interventions for replacing missing teeth: surgical techniques for placing dental implants.

BACKGROUND: Many variations in the surgical technique for the placement of dental implants have been developed since the introduction of implant surgery into clinical practice. These include variations in the timing of implant placement in relation to the tooth removal, and variations in the way the recipient bone site is prepared, amongst others. OBJECTIVES: To test the null hypothesis of no difference in the success, function, morbidity, patient satisfaction and cost-effectiveness of different surgical techniques for placing dental implants, against the alternative hypothesis of a difference. SEARCH STRATEGY: The Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched. In addition, the bibliographies of review articles were checked for studies outside the handsearched journals and personal references were searched. 55 implant companies were also contacted. SELECTION CRITERIA: Randomised controlled clinical trials (RCTs) of implant surgical techniques. DATA COLLECTION AND ANALYSIS: Authors were contacted for details of randomisation and data and quality assessment was carried out (ME, PC). Data were independently extracted, in duplicate, by two reviewers (HW, PC). The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Four RCTs (six publications) were suitable for inclusion in this review of the nine RCTs (11 publications) identified. Two different aspects of implant surgical technique were reported in these RCTs. These were, two versus four implants to support a mandibular overdenture and crestal versus vestibular incision for implant placement. At the patient level there were no statistically significant differences for any of these alternative techniques with respect to implant failures, marginal bone levels, morbidity or patient satisfaction. REVIEWER'S CONCLUSIONS: This review included studies evaluating the surgical techniques of two versus four implants to support a mandibular overdenture and crestal versus vestibular incision for implant placement. Based on the available results of RCTs, there is no strong evidence supporting superior success with one or other of the alternative techniques for either of these two aspects of surgical technique. These conclusions are based on a few RCTs for each aspect of surgical technique and some with relatively short follow-up periods and few patients.

Dental Implantation, Endosseous↗
PubMed2003

Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment.

BACKGROUND: Dental implants require sufficient bone to adequately stabilise. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for use in bone augmentation. OBJECTIVES: To test the null hypothesis of no difference in the success, function, morbidity and patient satisfaction between different bone augmentation techniques for dental implant treatment. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. Implant manufacturing companies were also contacted. SELECTION CRITERIA: Randomised controlled trials (RCTs) of different techniques and materials for augmenting bone for implant treatment. DATA COLLECTION AND ANALYSIS: Quality assessment was carried out and authors were contacted for any missing information. Data were independently extracted in duplicate. MAIN RESULTS: Four RCTs (n = 95) were suitable for inclusion in this review, assessing three different aspects of bone augmentation techniques: onlay grafting with and without a barrier membrane, grafting with a resorbable and non-resorbable membrane, and membranes for guided bone regeneration (GBR). Trials reported on augmentation procedures up to abutment connection only. At the patient level there were no statistically significant differences for the alternative techniques for onlay grafting with respect to the degree of bone graft resorption and wound dehiscence. One trial showed statistically significantly more infections in the non-resorbable group compared to the resorbable group, relative risk 0.05 (95% confidence interval (CI): 0.00 to 0.74). One study of GBR with a resorbable versus non-resorbable membrane indicated no statistically significant difference in early implant failure, reduction in bone defect or wound dehiscence. The other GBR study compared a non-resorbable membrane with no membrane and reported no statistically significant difference in wound infection or dehiscence but a significant increase in per cent bone gain for the test group compared to control, mean difference = 70 (95% CI: 36 to 104, p = 0.002). REVIEWER'S CONCLUSIONS: There is no evidence from available RCTs supporting superior success with one or other of the alternative techniques examined. There was weak evidence that a non-resorbable membrane was better than no membrane for permitting bone growth about dental implants, and that a resorbable membrane over a bone graft may allow healing with fewer infections than a non-resorbable membrane.

Animals↗
PubMed2002

Interventions for replacing missing teeth: maintaining and re-establishing healthy tissues around dental implants.

BACKGROUND: To maintain healthy tissues around oral implants it is important to institute an effective preventive regimen (supportive therapy) and when a pathologic condition of the tissue around implants is diagnosed, an intervention should be initiated as soon as possible. Different maintenance regimens and treatment strategies for failing implants have been suggested, however it is unclear which are the most effective. OBJECTIVES: To test the null hypothesis of no difference between different interventions for maintaining or re-establishing healthy tissues around dental implants. SEARCH STRATEGY: The Cochrane Oral Health Group Specialised Register, The Cochrane Controlled Trials Register, MEDLINE and EMBASE were searched. Hand searching included several dental journals. In addition, authors of all identified trials, fifty-five oral implant manufacturers and two extensive personal libraries (ME and AJ) were consulted. SELECTION CRITERIA: All randomised controlled trials of oral implants comparing agents or interventions for maintaining or re-establishing healthy tissues around dental implants. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers (ME & HW). Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Nine RCTs were identified. Five of these trials, which reported results from a total of 127 patients, were suitable for inclusion in the review. REVIEWER'S CONCLUSIONS: There is only a little reliable evidence for which are the most effective interventions for maintaining health around peri-implant tissues. There was no evidence that the use of powered or sonic toothbrushes was superior to manual toothbrushing. There is a weak evidence that Listerine mouthwash, used twice a day for 30 seconds, as adjunct to routine oral hygiene is effective in reducing plaque formation and marginal bleeding around implants. There was no evidence that phosphoric etching gel offered any clinical advantage over mechanical debridement. These findings are based on RCTs having short follow-up periods and few subjects. There is not any reliable evidence for the most effective regimens for long-term maintenance. For the treatment of failing implants (peri-implantitis) there is not any reliable evidence for preferring one therapeutic regimen over another. More RCTs should be conducted in this area. In particular, there is a definite need for trials investigating which is the most effective approach for the treatment of peri-implantitis and for trials with longer follow-up for maintenance. Such trials should be reported according the CONSORT guidelines (http://www.consort-statement.org/).

Dental Implants↗
PubMed2002

Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants.

BACKGROUND: Dental implants offer one way to replace missing teeth and associated tissues. Patients who have undergone radiotherapy and those that have also undergone surgery for cancer may benefit particularly from reconstruction with implants. Hyperbaric oxygen therapy (HBO) has been advocated to improve the success of implant treatment in patients who have undergone radiotherapy but this remains a controversial issue. OBJECTIVES: This review aims to compare success, morbidity, patient satisfaction and cost effectiveness of dental implant treatment carried out with and without HBO in irradiated patients. SEARCH STRATEGY: The Cochrane Oral Health Group Specialised Register, the Cochrane Controlled Trials Register, MEDLINE and EMBASE were searched. In addition, the bibliographies of review articles were checked for studies outside the handsearched journals and personal references were searched. We also wrote to implant manufacturers and experts in the field. SELECTION CRITERIA: Randomised controlled trials of HBO therapy for irradiated patients requiring dental implants. DATA COLLECTION AND ANALYSIS: No randomised trials were identified. MAIN RESULTS: No data were available. REVIEWER'S CONCLUSIONS: Clinicians ought to make patients aware of the lack of reliable clinical evidence for or against the clinical effectiveness of HBO in irradiated patients requiring dental implants. There is a definite need for RCTs to ascertain the effectiveness of HBO in irradiated patients requiring dental implants. These trials ought to be of a high quality and reported as recommended by the CONSORT statement (http://www.consort-statement.org/). Each clinical centre may have limited numbers of patients and it is likely that trials will need to be multi-centred.

Dental Implants↗
PubMed2002

Interventions for replacing missing teeth: preprosthetic surgery versus dental implants.

BACKGROUND: Preprosthetic surgery refers to the surgical procedures that can modify the oral anatomy to facilitate the retention of conventional dentures. Osseointegrated implants offer an alternative treatment to improve denture retention. A denture may be connected by special attachments to implants placed into the jaw. OBJECTIVES: To test the null hypothesis of no difference in the success (patient satisfaction and morbidity) and cost effectiveness between conventional prostheses that require preprosthetic surgery (PPS) and implant retained prostheses (IRO) that do not require preprosthetic surgery, against the alternative hypothesis of a difference. SEARCH STRATEGY: The Cochrane Oral Health Group (OHG) Specialised Register (May 2002), the Cochrane Controlled Trials Register (Issue 2, 2002), MEDLINE and EMBASE (May 2002) were searched. In addition, 55 implant companies were contacted and the bibliographies of review articles were checked for studies outside the hand searched journals and personal references were searched. SELECTION CRITERIA: Randomised controlled trials comparing preprosthetic surgery and implant retained dentures for improving denture retention. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers (HW, PC). Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out (ME, PC). The Cochrane OHG's statistical guidelines were followed. MAIN RESULTS: One study, containing 60 participants, reported in four articles was identified for inclusion in this review. No studies were excluded. There was a statistically significant difference between mean patient satisfaction scores with patients in the IRO group being more satisfied in general at both year one (WMD = -0.66(95% CI; -1.28 to -0.04)) and five years (WMD = -0.90(95%CI; -1.74 to -0.06). Altered sensation of the lower lip and chin was measured at one year and five years. There was no statistically significant difference at either time point and no patients had altered sensation at five years. REVIEWER'S CONCLUSIONS: There is weak evidence from the results of one randomised controlled trial including 60 subjects that patients are generally less satisfied with preprosthetic surgery and a conventional denture than with an implant retained denture. There is a need for more well designed trials comparing the success and cost-effectiveness of preprosthetic surgery and implant supported dentures. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/). However, since preprosthetic surgery is considered to be an obsolete treatment nowadays, almost completely replaced by dental implants, it may be that new RCTs on this topic will not be designed.

Dental Implantation↗
PubMed2002

Interventions for replacing missing teeth: different types of dental implants.

BACKGROUND: Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performances. OBJECTIVES: To test the null hypothesis of no difference in clinical performance between various root-formed osseointegrated implant types. SEARCH STRATEGY: The Cochrane Oral Health Group Specialised Trials Register, The Cochrane Controlled Trials Register, MEDLINE and EMBASE were searched. Hand searching included several dental journals. Bibliographies of relevant clinical trials and review articles were checked for studies outside the handsearched journals. In addition, authors of all identified trials and fifty-five oral implant manufacturers were contacted to find unpublished or ongoing RCTs. Two extensive personal libraries (ME and AJ) were consulted. The last electronic search was conducted 8th May 2002. SELECTION CRITERIA: All randomised controlled trials of oral implants comparing implants with different materials, shapes and surface properties having a follow-up of at least one year. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers (ME & HW). Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Thirty publications, representing 13 different RCTs, were identified. Five of these RCTs (seven publications), which reported results from a total of 326 patients, were suitable for inclusion in the review. Six implant systems were compared: Astra, Branemark, IMZ, ITI, Steri-Oss and Southern with a follow-up ranging from one to three years. All implants were made in commercially pure titanium and had different shapes and surface preparations. On a patient rather than per implant basis there were no statistically significant differences for failures and marginal bone level changes on intra-oral radiographs between various implant systems. REVIEWER'S CONCLUSIONS: There was no evidence that any of the implant systems evaluated was superior to the other. However, these findings are based on a few RCTs all having short follow-up periods and few participants. More RCTs should be conducted, with follow-up of at least five years and including a sufficient number of patients, to detect a true difference if any exists. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/).

Dental Implantation, Endosseous↗
PubMed1999

Clinical trial of gingival retraction cords.

STATEMENT OF PROBLEM: A wide spectrum of different gingival retraction cords is used, while the relative clinical efficacy of these cords remains undocumented. PURPOSE: This study aimed to determine whether clinicians were able to identify differences in clinical performance among 3 types of gingival retraction cords. METHODS AND MATERIAL: Dental students and faculty members ranked pairs or series of cords according to 6 criteria for clinical performance, with a blind experimental study design. Cords differed in consistency (knitted or twined) and impregnation (8% dl-epinephrine HCl, 0.5 mg/in or 25% aluminum sulfate, 0.5 mg/in). RESULTS: Knitted cords were ranked better than twined cords (P =.03). Cords containing epinephrine performed no better clinically than aluminum sulfate cords (P >.05). CONCLUSION: Clinicians were unable to detect any clinical advantages of using epinephrine impregnated gingival retraction cords compared with aluminum sulfate cords.

Alum Compounds↗
PubMed1998

Determinants of quality in operative dentistry.

The definition of quality in operative dentistry has often, at least in part, been related to how well a cut preparation compares with an ideal preparation. The ideal preparation follows well-defined design principles. These design principles have their roots in empirical dentistry and scientific evaluations, the latter often being conducted in vitro. Because of the complexity of following these design principles practically, a large portion of dental education consists of perfecting cavity preparations. By focusing on how to cut these cavity preparations as closely as possible to the ideal preparation, dentists with high psycho-motor skills have been able to provide the public with restorative procedures of high standards over the years. However, because of the tendency of relating quality in operative dentistry to the ideal preparation, we found it justifiable to review the literature dealing with the cavity design principles of the Class II amalgam preparation. What triggered this review was a request from the International Dental Federation (FDI) to start a process leading to a scientifically based quality definition of dental restorations, a definition that determines how different factors, including cavity design principles, affect the longevity of both tooth and restoration. From our review, we conclude that patient response and restoration performance over time, rather than how closely a cavity preparation compares with the ideal preparation, will be of more significance in determining the longevity of a Class II amalgam restoration.

Dental Amalgam↗
PubMed1998

Somatic complaints, psychologic distress, and treatment outcome in two groups of TMD patients, one previously subjected to whiplash injury.

The aim of this study was to compare somatic complaints and psychologic distress in a group of whiplash patients with temporomandibular disorders (TMD) and a group of patients with TMD only, and to assess the outcome after conservative TMD treatment consisting of counseling, muscle exercises, and a stabilization splint. Each group consisted of 16 patients (12 women and 4 men) with a mean age of 42 years. The duration of the symptoms was from 1 to 3 years. In addition to a functional clinical examination and a recording of headache frequency and intensity, the patients answered three questionnaires: a Somatic Complaints Questionnaire (SCQ); the trait portion of Spielberger's State-Trait Anxiety Inventory; and the Symptom Checklist-90-Revised (SCL-90-R). The whiplash patients had higher scores than the TMD patients on the SCQ muscle score and on the following subscores of SCL-90-R: obsession, somatization, depression, and anger/hostility. The treatment outcome as assessed by the change of self-reported frequency of headache, number of tender muscles upon palpation, and change of values on a visual analogue scale for headache intensity showed that the whiplash patients obtained only a decrease in the proportion of tender muscles, while those in the TMD only group showed improvement on all treatment criteria.

Adult↗
PubMed1997

Assessment of the periapical and clinical status of crowned teeth over 25 years.

OBJECTIVES: The purpose of this study was to examine radiographically changes in the periapical status and compare the clinical status of teeth with a vital pulp and root-filled teeth restored with crowns and bridge retainers during 25 years. METHODS: During 1967/68, 114 patients received prosthodontic treatment by senior dental students at the Oslo Dental Faculty. In all, 291 teeth with a vital pulp and 106 root-filled teeth were restored with 158 prostheses. All root-filled teeth were restored with a cast dowel and core. The casts were made in a type-3 gold alloy, and cemented with zinc phosphate cement. Forty-six teeth were restored with crowns and 351 teeth with bridge retainers. Radiographs were taken preoperatively, immediately after cementation, and every fifth year. Two independent observers assessed the periapical status on the radiographs according to the PAI-index. At the 25 years examination, 32 patients (28%) with 101 restored teeth (24%) remained in the study. Survival rates of the prostheses and of the restored teeth were estimated using Kaplan-Meyer non-parametric statistics. RESULTS: The PAI-score of the periapical status deteriorated in 13 vital and four root-filled teeth. The survival rates of the fixed prostheses were not influenced by the pulp vitality of the restored tooth at the baseline. The survival rates of the restored teeth with a vital pulp and of the root-filled teeth were similar. Clinical failures were recorded on approximately one-third of the restored teeth. The main reason for tooth failure was caries (12%), and for the teeth with a vital pulp also pulpal deterioration (10%). Estimates of the proportions of crowned teeth with a vital pulp that will remain free from signs and symptoms of pulpal deterioration were 98% after five years, 92% after 10 years, 87% after 20 years and 83% after 25 years. CONCLUSIONS: The incidence of periapical lesions on radiographs of crowned teeth was low during 25 years observation. Crowned, root-filled teeth with a high quality endodontic treatment and an optimal morphology of the dowel and core have a similar survival rate as crowned teeth with a vital pulp. A high proportion of crowned teeth with a vital pulp will remain free from signs and symptoms of pulpal deterioration over 25 years.

Adult↗
PubMed1996

Ten years' clinical evaluation of three luting cements.

OBJECTIVE: The aim of the present clinical longitudinal study was to observe, over 10 years, the prognosis of abutment teeth restored with fixed prostheses retained by glass ionomer luting cements and one conventional zinc phosphate cement. METHODS: Three dentists prepared 135 abutment teeth in 61 patients to retain 81 fixed prostheses. The prostheses were retained by two glass ionomer luting cements (Ketac-Cem, Fuji Ionomer), or a conventional zinc phosphate cement (De Trey Zinc Zement Improved). The patients were examined yearly for 10 years. RESULTS: Post-operative hypersensitivity occurred in five teeth restored with glass ionomer luting cement. The prevailing reason for abutment tooth failure was secondary caries (n = 21) and pulp necrosis (n = 5). Non-parametric survival estimates indicated that 80-85% of the abutment teeth remained intact after 5 years and 71-81% after 10 years. CONCLUSIONS: The 10-year results indicate that the prognosis of abutment teeth restored with fixed prostheses is good, regardless of whether a glass ionomer or a zinc phosphate luting cement is used.

Dental Abutments↗
PubMed1996

The teaching of all-ceramic restorations in Scandinavian dental schools: a survey.

The study was designed to survey the curricular requirements, types of clinical experience, and materials/ techniques used in teaching programs for all-ceramic restorations in Scandinavian dental schools. All 13 dental schools responded. Ten offered some clinical experience to pre-doctoral students, but only one required one all-ceramic restoration. The departments of fixed prosthodontics had the main teaching responsibility. All-ceramic crowns were taught at 9, veneers at 7, and inlays/onlays at 10 dental schools. A wide range of different teaching concepts, materials, and views on indications and contraindications was reported. It appears as if all-ceramic restorations are regarded as experimental by the teaching institutions, although the dental industry and some practitioners strongly recommend these types of restorations.

Ceramics↗
PubMed1996

Oral health in institutionalized elderly people in 1993 compared with in 1980.

The dental and periodontal status, oral hygiene, and dental visit habits of 250 residents in long-term care (LTC) facilities for the elderly in a suburban community in Norway were recorded. The findings were compared with the data from an identical examination of the residents in the same LTC facilities in 1980. In 1993 the mean number of remaining teeth per person was 11.7 (CI = 10.3-13.1). The mean number of filled teeth was 5.1 (CI = 4.1-6.0), and the mean number of decayed teeth was 1.8 (CI = 1.4-2.2). The mean number of residual roots per person was 0.8 (CI = 0.5-1.1). Periodontal pockets exceeding 4 mm was recorded on 5% of all teeth. In general, the oral hygiene was poor. Edentulousness had decreased from 80% in 1980 to 54% in 1993, and more remaining and filled teeth and fewer residual roots per person were observed in the 1993 population. The findings show that the objective need for resources to prevent periodontal disease and caries among elderly patients in LTC facilities today is higher than previously.

Aged↗