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Biomedical subjects

Asbjørn Jokstad

Publications and source records attributed to Asbjørn Jokstad.

10 recordsLinked to original sources
PubMed2006

Implant retained or conventional dentures, which give more patients satisfaction?

DESIGN: This was a randomised controlled trial (RCT) set in a dental hospital. INTERVENTION: The implant group (IG) had two implants placed in the interforaminal region of the lower jaw followed (after healing) by a denture fixed to the implants by a ball attachment mechanism. In the conventional dentures group (CG), dentures were constructed using conventional replacement denture techniques. Patients in the IG had conventional upper dentures made in the same fashion. OUTCOME MEASURE: The performance of the dentures was evaluated using an oral health impact profile (OHIP) and a denture satisfaction scale before treatment and 3 months post-treatment. RESULTS: Analysis was conducted on an intention-to-treat basis. Substantial improvements in oral-health-related quality of life and denture satisfaction were reported by both groups. There were, however, no significant differences post-treatment between the groups. Patients randomised to the IG who declined implants had significantly lower pretreatment OHIP scores and there were significantly greater pre-/ post-treatment change-scores for individuals who had implants compared with the change-scores of people who declined. CONCLUSIONS: There were no significant post-treatment differences between the groups, but a treatment effect may be masked by the intention-to-treat analysis. The pre-/ post-treatment OHIP change-scores were significantly greater for people receiving implants than for those who refused.

Comment↗
PubMed2005

Fluoride tablet programs in healthy elderly subjects: distribution of fluoride in saliva and plaque with tablets in different sites.

Based on root caries data and oral sugar clearance pattern, vestibular surfaces of upper incisors and lower molars may be regarded as risk areas along with the proximal surfaces. The aim of the present study was to use this information in improving fluoride tablet programs for the elderly. Six healthy elderly males with full dental arches took part. Flavored and unflavored tablets dissolved passively either under the tongue or in the vestibule close to the root caries risk areas. Salivary fluoride was determined at five to six intra-oral sites with a micro-sampling technique at intervals up to 10 min tablet use. Plaque samples were collected from single tooth surfaces before and after tablet use, and analyzed for total fluoride and total protein by micro-techniques. Salivary fluoride exposure to root caries risk areas was strongly increased when fluoride tablets were placed in the vestibule in these areas. The unflavored tablet gave higher fluoride retention in saliva than did the flavored brand. Plaque fluoride levels tended to be above baseline in the first couple of hours after tablet use, and then to decline. In the caries risk areas, at vestibular surfaces of lower posterior and upper incisor teeth, most of the fluoride taken up in plaque had been lost after 5 h and a bread meal, whereas in the non-risk areas it was largely retained. The study demonstrated that fluoride exposures to the vestibular caries risk areas can be strongly increased by placing fluoride tablets close to them. An unflavored tablet seemed to give higher exposures than a flavored one. The rapid loss of fluoride from plaque in slow clearance risk areas indicates that more than one daily treatment would be required for elderly caries risk subjects.

Administration, Oral↗
PubMed2003

Quality of dental implants.

BACKGROUND: Clinicians need quality research data to decide which dental implant should be selected for patient treatment. AIM(S)/OBJECTIVE(S): To present the scientific evidence for claims of relationship between characteristics of dental implants and clinical performance. STUDY DESIGN: Systematic search of promotional material and Internet sites to find claims of implant superiority related to specific characteristics of the implant, and of the dental research literature to find scientific support for the claims. MAIN OUTCOME MEASURES: Critical appraisal of the research documentation to establish the scientific external and internal validity as a basis for the likelihood of reported treatment outcomes as a function of implant characteristics. RESULTS: More than 220 implant brands have been identified, produced by about 80 manufacturers. The implants are made from different materials, undergo different surface treatments and come in different shapes, lengths, widths and forms. The dentist can in theory choose among more than 2,000 implants in a given patient treatment situation. Implants made from titanium and titanium alloys appear to perform well clinically in properly surgically prepared bone, regardless of small variations of shapes and forms. Various surface treatments are currently being developed to improve the capacity of a more rapid anchorage of the implant into bone. A substantial number of claims made by different manufacturers on alleged superiority due to design characteristics are not based on sound and long-term clinical scientific research. Implants are, in some parts of the world, manufactured and sold with no demonstration of adherence to any international standards. CONCLUSIONS: The scientific literature does not provide any clear directives to claims of alleged benefits of specific morphological characteristics of dental implants.

Clinical Trials as Topic↗
PubMedDate not supplied

Oral prosthetics from a Nordic perspective.

PURPOSE: The purpose of this study was to describe oral prosthetics in a context intended for other, primarily Nordic, health professionals and health authorities. MATERIALS AND METHODS: An article describing oral prosthetics for the general public was formulated on the basis of recent data and publications in prosthodontics from Scandinavian authors. A draft was presented to the educational committee of the Scandinavian Society for Prosthetic Dentistry for verification and consensus. Following modifications and amendments by representatives from the 11 dental schools in the Nordic countries, the educational committee has approved the present article. RESULTS: The report consists of four sections describing oral prosthetics, prosthetic therapy, undergraduate teaching in oral prosthetics, and advanced oral prosthetics, from a Nordic perspective. The report appraises the various factors in context with demographic, cultural, and professional circumstances and suggests strategies for improvement of present conditions. CONCLUSION: The relationship between the undergraduate curriculum in oral prosthetics and the public need for advanced oral prosthetics must continuously be monitored so that patients can obtain optimal care from the profession.

Clinical Competence↗
PubMedDate not supplied

The reporting of randomized controlled trials in prosthodontics.

PURPOSE: This article evaluates the reporting of randomized controlled trials (RCT) in prosthodontics, excluding endosseous implant-based prosthetics. MATERIALS AND METHODS: Reports of RCTs published to the end of 2000 in any language were identified using a multilayered search strategy. The Cochrane Oral Health Group specialized register, Medline, and personal libraries were searched. Three researchers appraised the articles independently using guidelines following Jadad and CONSORT, complemented with an evaluation of the appropriateness of the reported statistics. RESULTS: Ninety-two reports of RCTs were evaluated, covering a wide spectrum of study hypotheses, topics, and issues within various prosthodontic domains. The interrater agreements on appraisal criteria were relatively high, with median kappa values ranging between 0.65 and 0.79. The reports were in general of poor methodologic quality. Randomization and procedures for concealment allocation were not described in 70% of the articles. The methods used to generate the random allocation sequence were not mentioned in 82%. The methods used to implement the random allocation sequence, clarifying whether it was concealed until all interventions were assigned, was not mentioned in 94%. Reporting who generated allocation sequence, who enrolled patients, and who assigned participants to groups was not reported in 7%. Reasons for withdrawals were not given in 23% of the reports. No attempt at blinding was reported in 72%. Statistical analysis was not described in 6% of the papers, while these analyses were assessed as appropriate for 75%, unclear in 12%, and inappropriate in 7%. CONCLUSION: Few RCTs in prosthodontics are reported in accordance with contemporary guidelines for adequate reporting of trials.

Adhesives↗
PubMedDate not supplied

A survey of the use of mandibular implant overdentures in 10 countries.

PURPOSE: This preliminary international survey compared provision of implant-retained overdentures to fixed implant-supported prostheses for edentulous mandibles. MATERIALS AND METHODS: Questionnaires based on a 2001 Swedish study were sent to prosthodontists and specialist clinics in nine additional countries. RESULTS: Response rate varied from 53% to 100% in 10 national surveys and should allow careful comparison of results. The relationship between implant overdentures and fixed implant-supported prostheses in treatment of edentulous mandibles varied much; in Sweden, the proportion of overdentures was 12%, whereas it was 93% in The Netherlands. In all countries, the most common reason for choice of the overdenture was reduced cost. In all but two countries, the majority of respondents thought that patients with implant overdentures were equally or more satisfied with overdentures as those with fixed implant-supported prostheses. CONCLUSION: There were great differences among the 10 countries in choice of implant treatment of the edentulous mandible. The relative proportion of mandibular overdentures to fixed prostheses was low in Sweden and Greece and varied from one to two thirds in the other countries, except The Netherlands.

Canada↗
PubMedDate not supplied

A split-mouth randomized clinical trial of single crowns retained with resin-modified glass-ionomer and zinc phosphate luting cements.

PURPOSE: This study compared the influence of two luting cements on the clinical performance of single crowns. MATERIALS AND METHODS: Twenty patients received 39 pairs of metal-ceramic and Procera crowns cemented with zinc phosphate and resin-modified glass-ionomer luting cement (Vitremer) in a split-mouth randomized pattern blinded to the recipient. The crowns were examined immediately after cementation, after 2 weeks, after 6 months, and then yearly. Clinical performance was scored according to CDA criteria, Silness and Loe criteria, patient satisfaction, and operator-appraised general clinical criteria. Three clinicians in private general practice carried out all procedures. RESULTS: During the observation period, which varied between 80 and 104 months, seven clinical events were recorded. Two abutments fractured vertically, two underwent retrograde endodontic surgery, and one developed pulp necrosis. Two crowns were recemented. Estimated survival, defined as no negative events observed, was 89% at 102 months (85% for crowns cemented with zinc phosphate and 93% for crowns cemented with resin-modified glass-ionomer). Estimated survival, defined as no recementation or loss of pulp vitality, was 96% at 102 months (95% with zinc phosphate and 97% with resin-modified glass-ionomer). The differences between cements were not statistically significant. CONCLUSION: A resin-modified glass-ionomer luting cement was at least as good as zinc phosphate cement to retain single crowns over a 102-month observation period.

Cariostatic Agents↗
PubMedDate not supplied

A systematic review of the scientific documentation of fixed partial dentures made from fiber-reinforced polymer to replace missing teeth.

PURPOSE: Many restorative systems have become commercially available that are based on fiber-reinforced polymers (FRP) for production of fixed partial dentures. However, the clinical documentation of their use has not been systematically reviewed and critically appraised. This systematic review aimed to identify the scientific documentation of all commercially available products within this material group. MATERIALS AND METHODS: MEDLINE was searched for all clinical and laboratory studies on FRP, and papers were browsed to identify product names. Moreover, the Internet was searched to find manufacturers of FRP products. Also, several large trade exhibitions were visited to identify products and manufacturers. All papers that included any data from a clinical setting of an identifiable product were critically appraised. Each product was categorized according to the scientific clinical documentation of their intended clinical use. RESULTS: Eleven commercial products were identified. The scientific clinical documentation of these products varied markedly, but was generally poor. No randomized controlled trials have been carried out on FRPs versus, eg, conventional treatments, nor are any long-term cohort studies available. None of the products demonstrate good evidence for usage as a technical solution to permanently replace lost teeth. CONCLUSION: The use of FRP for fixed partial dentures must still be regarded as experimental.

Composite Resins↗