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Biomedical subjects

E Budtz-Jörgensen

Publications and source records attributed to E Budtz-Jörgensen.

At least 19 recordsLinked to original sources
PubMed1996

Restoration of the partially edentulous mouth--a comparison of overdentures, removable partial dentures, fixed partial dentures and implant treatment.

OBJECTIVES: Loss of posterior teeth may result in the loss of neuromuscular stability of the mandible, reduced masticatory efficiency, loss of vertical dimension of occlusion and poor aesthetics. Prosthetic rehabilitation should aim at restoring the vertical dimension and increasing the occlusal contact area in the premolar/molar region. Overdentures are particularly indicated in patients with a severe loss of periodontal attachment, uncertain periodontal prognosis and complicated functional or aesthetic conditions. Removable partial dentures are particularly indicated in Kennedy Class I cases when there is need for a simple and economic solution. Placement of a removable partial denture with occlusal overlays is a simple way to restore occlusal face height. Cross-arch cantilevered fixed partial dentures are primarily indicated for stabilization of periodontally weakened abutments. Short unilateral or bilateral bridges are a solution in patients who refuse removable appliances and who cannot afford more extensive rehabilitation with fixed prosthodontics. Rehabilitation with a fixed partial denture supported by means of osseointegrated implants is the optimal solution in Kennedy Class II cases provided that the bone conditions are appropriate. For any prosthetic treatment, a definite recall system should be established depending on the patient's degree of cooperation, caries susceptibility, periodontal status and the rate of residual ridge resorption. This is essential in order to obtain a satisfactory prognosis. In a patient with poor oral hygiene, the best solution, with regard to the prognosis of the remaining teeth, is to abstain from any prosthetic treatment. METHODS: This manuscript reviews the current literature to identify treatment options for the Kennedy Class I and II partially edentulous patient.

Bicuspid↗
PubMed1996

Examiner agreement on periodontal indices during dental surveys of elders.

Indices used to evaluate periodontal health have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of periodontal indices applied on elders. 19 elderly subjects, 73-years-old on average, were examined at a 1st appointment by 2 independent examiners. They were re-examined 2 weeks later during a 2nd session. The examinations were performed in a dental chair with good illumination. Periodontal health was evaluated using the community periodontal index of treatment need, and tooth mobility was evaluated using 2 different indices. Inter and intra-examiner agreements were evaluated using kappa statistics. Taken as an overall measurement, the CPITN was a reliable assessment of periodontal treatment need in elders. Disagreement occurred mainly on the evaluation of bleeding and shallow pockets. The detection of fairly mobile teeth was reliable; however, the performance of the more sensitive scale was deceptive. it seems that, in the case of tooth mobility, a choice has to be made between sensitivity or reproducibility. It can be concluded that examiners should be trained carefully since the reliability of the CPITN and tooth mobility evaluation were good but close to a critical level for which an agreement is classified as poor.

Aged↗
PubMed1996

Non-insulin-dependent diabetes mellitus as a risk factor for denture stomatitis.

The prevalence of denture stomatitis as well as the frequency of isolation of Candida species and their density on the palatal mucosa have been compared in 70 acrylic denture-wearers suffering from non-insulin-dependent diabetes mellitus (NIDDM) versus 58 acrylic denture-wearers with normal glucose metabolism. The adherence of C. albicans to palatal epithelial cells in vitro was also assessed in both groups. The patients with NIDDM had a significantly higher prevalence of denture stomatitis compared with the controls. The frequency of Candida colonization was increased in diabetics, but not significantly. According to the imprint culture technique, the density of Candida species was significantly higher in patients with NIDDM compared with the controls. The adherence of C. albicans to palatal epithelial cells from patients with NIDDM showed a significant increase compared with that observed in cells collected from the controls. This study supports the view that NIDDM predisposes to Candida-associated denture stomatitis.

Acrylic Resins↗
PubMed1995

Prognosis of overdenture abutments in elderly patients with controlled oral hygiene. A 5 year study.

The effect of controlled oral hygiene was studied in 31 elderly overdenture patients involving 72 abutments over a period of 5 years. Intensive instruction and motivation in oral hygiene care were carried out prior to prosthodontic treatment and two to four times yearly during the study period. The initial dental and periodontal conditions were very poor, with a mean loss of proximal bone adjacent to the abutments of 61%. During the study period, it was possible to maintain mean plaque index scores of 0.45-0.73 and mean gingival index scores of 0.89-0.95 adjacent to the abutments. There was no relationship between the patients' initial plaque index score and the oral and denture hygiene observed during the study. There was spontaneous regression of 4-5 mm periodontal pockets, whereas deeper pockets persisted. Seven abutments were extracted due to periodontal complications. Caries was a minor problem which could be controlled by hygienic measures, topical fluoride or fillings. The present study has shown that it was possible to maintain teeth as overdenture abutments to a large extent in elderly patients initially having a poor dental and periodontal status.

Aged↗
PubMed1995

Examiner agreement on caries detection and plaque accumulation during dental surveys of elders.

Indices used to evaluate plaque accumulation and coronal caries have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of clinical criteria used in coronal and root caries diagnosis and oral hygiene evaluation as applied in elders. Nineteen elderly subjects, 73 years old on average, were examined at a first appointment by two independent examiners. They were re-examined two weeks later. Plaque accumulation was evaluated using the Plaque Index (PI) and coronal and root caries were detected according to the WHO criteria and Fejerskov et al. (1991), respectively. Recurrent caries was recorded as recommended by WHO and by probing at the interface tooth-restoration. Inter- and intra-examiner agreement was evaluated using kappa statistics. The PI score showed good reliability except for examiner b, for whom a simplification of the 4-point scale in 3-point scale improved significantly the reliability. The prevalence of coronal caries was very low and intra- and inter-examiner agreement was poor. Most of the root caries lesions were covered by plaque and the kappa values indicated only poor agreement. Recurrent caries were found with good agreement using WHO criteria but the detection with the probe was not reliable. In conclusion, it seems that examiners should be trained carefully to maximise their reliability and that plaque should be removed to obtain reliable diagnoses of caries. Retraining and calibration may be necessary for surveys continuing over a long period.

Aged↗
PubMed1994

Effects of denture-wearing habits on periodontal health of abutment teeth in patients with overdentures.

The effect of denture-wearing habits was studied in 31 overdenture wearers (17 day-and-night wearers, 14 day wearers) during a period of 5 years with controlled oral hygiene. Prior to prosthetic treatment, intensive instruction and motivation in oral hygiene were carried out and the patients were recalled 2-4 x yearly during the study period. Before treatment, mean plaque index (PlI) and gingival index (GI) were 1.5 and 1.6, respectively, in both groups of patients. During the study period, mean PlI and GI were 0.3-0.6 and 0.6-0.8, respectively, in the group of day wearers and 0.5-1.0 and 1.0-1.2, respectively, in the group of day-and-night wearers. With regard to the GI, this difference was statistically significant. Furthermore, during the study period, 20% of the abutment tooth surfaces showed attachment loss (1-4 mm) in the group of day-and-night wearers against 8% of the tooth surfaces in the group of day wearers. This difference was statistically significant. During the 5 years, 40 carious lesions developed in the group of day-and-night wearers against 3 in the group of day wearers. The results of this study have shown that day-and-night wearing of dentures is a major periodontitis and caries risk factor in complete overdenture wearers with controlled oral hygiene.

Aged↗
PubMed1993

Langerhans cells: structure, function and role in oral pathological conditions.

Langerhans cells (LCs) are dendritic bone marrow derived cells situated suprabasally in most stratified squamous epithelia, such as the epidermis and the epithelium of oral mucosa, including the gingiva. Langerhans cells are thought to act as antigen-presenting cells (APC) during induction of immune responses. The exact role of Langerhans cells in the oral mucosa is not fully understood although several investigations suggest that these cells are involved in reactions to antigen challenge under both normal and pathological situations. In this paper the structure, phenotypic markers and derivation of Langerhans cells are reviewed. In view of recent findings, the immunological characteristics and the implications of Langerhans cells in pathologic oral reactions are discussed.

Antigens, Surface↗
PubMed1993

Treatment of denture-induced stomatitis: a review.

Denture-induced stomatitis is the term used in the literature to indicate an inflammatory state of the denture-bearing mucosa. A large number of denture-wearing patients are affected by this lesion, particularly elderly people. Denture stomatitis is a multifactorial disease precipitated by several predisposing and aetiological factors. A number of different regimens are currently employed in treatment of this lesion. The management of denture stomatitis, with particular reference to recent findings, is reviewed. Mechanical plaque control and appropriate denture-wearing habits are the most important measures in prevention and treatment of the disease.

Anti-Infective Agents↗
PubMed1992

Prognosis of overdenture abutments in the aged: effect of denture wearing habits.

The effect of denture wearing habits was studied in 35 overdenture wearers (20 day-and-night wearers, 15 day-wearers) during a period of 3 yr with controlled oral hygiene. Prior to prosthetic treatment intensive instruction and motivation in oral hygiene were carried out and the patients were recalled 2-4 times yearly during the study period. Before treatment mean Plaque Index (PlI) and Gingival Index (GI) were 1.5 and 1.6, respectively, in both groups of patients. At day 0, 1 yr, 2 yr and 3 yr mean PlI and GI were 0.3-0.5 and 0.6-0.8, respectively, in the group of day-wearers and 0.5-1.0 and 1.0-1.2, respectively, in the group of day-and-night wearers. This difference was statistically significant. Furthermore, during the study period 16% of the abutment tooth surfaces showed attachment loss (1-4 mm) in the group of day-and-night wearers against 7% of the tooth surfaces in the group of day-wearers. This difference was statistically significant. During the 3 yr 36 carious lesions developed in the group of day-and-night wearers, but none in the group of day-wearers. The results of this study have shown that day-and-night wearing of dentures is a major periodontitis and caries risk factor in complete overdenture wearers with controlled oral hygiene.

Aged↗
PubMed1990

Histopathology, immunology, and serology of oral yeast infections. Diagnosis of oral candidosis.

For diagnostic purposes it is normally not important to obtain a biopsy specimen, since an oral smear from the lesion will yield blastospores and pseudohyphae in abundance. However, in lesions that respond poorly to antimycotic treatment a biopsy should be carried out to detect possible malignant changes in the epithelium. Assessment of cell-mediated immunity against Candida albicans and other antigens may be important in patients with severe chronic candidosis to assess the degree of immunocompetence and prognosis. Usually, patients with oral candidosis show only moderately elevated antibody titers in serum and saliva against C. albicans, and serologic tests are normally not a diagnostic tool for oral candidosis. However, such tests may be a prognostic instrument in patients with severe oral candidosis who respond poorly to antimycotic therapy.

Antibodies, Fungal↗
PubMed1990

Etiology, pathogenesis, therapy, and prophylaxis of oral yeast infections.

Etiologic factors in oral candidosis are immature antimicrobial host defenses, acquired suppression of immune defense mechanisms (AIDS, immunosuppressive or radiation therapy), or changes of the environmental conditions of the oral cavity (antibiotics, dentures, epithelial changes). After colonization and adhesion of Candida to the epithelial surface the subsequent mucosal lesion is due to tissue destruction by potent proteolytic enzymes or toxins and an inflammatory response to Candida antigens. Topical antimycotic treatment with nystatin, amphotericin B, or miconazole is important especially to prevent spread of the infection. Chronic Candida infections require long-term antifungal therapy, and patient compliance may be difficult to obtain. In denture stomatitis colonization of the fitting denture surface by Candida should be controlled by, for example, using a chlorhexidine solution as a denture disinfectant. However, recurrences are frequent if the local or the systemic predisposing conditions are not corrected. Fluconazole, a new bis-triazole, may be important for long-term treatment of immunocompromised patients.

Antifungal Agents↗
PubMed1989

A method for preparing and staining histological sections containing titanium implants for light microscopy.

An improved method for preparing and staining ground tissue-implant sections for light microscopy is presented. Undecalcified tissue blocks with titanium implants were dehydrated in an ascending series of ethanol and stained in toto with basic fuchsin. Specimens were infiltrated and embedded in methyl methacrylate and sections were prepared using a cutting-grinding-system. The polished surface was counterstained with light green or anilin blue. Light polymerizing resin was used as slide mounting medium and for mounting the coverglass. The sections obtained were 10-15 microns thick with tissue architecture which clearly differentiated structures at the tissue-implant interface. The method was very useful for computer assisted morphometric analysis.

Animals↗
PubMed1988

Influence of pontic material on alveolar mucosal conditions.

The purpose of the present study was to investigate plaque accumulation and inflammatory changes in the mucosa beneath fixed bridge pontics of various materials, in patients cleaning the infrapontic space daily. Fixed bridges with a tight but non-compressive contact to the mucosa in the pontic area and with interchangeable test specimens placed in the pontic base were constructed for five patients. During 4-wk periods the following materials were tested: alloys with a high or a low gold content, silver-palladium, cobalt-chromium, nickel-chromium and also a dental porcelain or a composite restorative resin. Between the test periods a "sanitary pontic" was used to enable recovery of the alveolar mucosa. Clinical examinations including exudate measurements demonstrated that the alveolar mucosa remained healthy irrespective of the material used when the dental floss was used regularly. The amount of plaque on the test specimens of the seven dental materials showed no consistent differences. The composition of the bacterial deposits showed no regular pattern. This investigation has demonstrated that patients maintaining a high standard of oral hygiene are able to prevent the development of inflammatory changes in the alveolar mucosa in contact with fixed bridge pontics irrespective of the pontic material used.

Aged↗
PubMed1987

Influence of oral hygiene on the mucosal conditions beneath bridge pontics.

The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index. Daily use of dental floss resulted in a significantly lower number of microorganisms per mm2 compared with the other hygienic measures. Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inflammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a part of the oral hygiene regimen in patients wearing fixed bridges.

Adult↗
PubMed1986

Clinical effects of glazing denture acrylic resin bases using an ultraviolet curing method.

Control of denture plaque accumulation is essential to obtain and maintain a healthy oral mucosa in denture wearers. The present study was designed to study the effect on denture plaque accumulation and denture stomatitis of coating the fitting denture surface by a glaze. Twenty-one subjects wearing complete dentures participated in the study. Glazing of the denture surface was performed using a Perma Cure System. Plaque accumulation was studied clinically and using a semiquantitative microbiologic technique. Plaque accumulation on the glazed and the non-glazed halves of the fitting denture surface was compared after 1 wk. There was significantly less plaque on the glazed half of the denture (P less than 0.001), and the calculated number of CFU of bacteria/cm2 was significantly lower from the test area of the glazed half than from the test area of the non-glazed half of the denture (P less than 0.001). When the patients were re-examined 1 month after the entire fitting denture surface had been glazed plaque scores, yeast scores and number of CFU of bacteria/cm2 were not significantly different from those observed before glazing. There was a reduction of the erythema of the palatal mucosa in 14/19 patients with denture-induced stomatitis. The study indicates that coating of the fitting denture surface by a glaze may be a means to improve denture cleanliness; however, the present glazing system should be further developed to produce a more uniform glazing.

Acrylic Resins↗
PubMed1983

Quantitative relationship between yeast and bacteria in denture-induced stomatitis.

Quantitative cultural studies of yeasts and bacteria were made from 7-day-old denture plaque accumulate on pieces of self-adhesive tape stuck on the fitting surface of the maxillary denture in 17 edentulous subjects with healthy oral mucosa and in 27 patients affected with denture-induced stomatitis. Significantly higher numbers of yeasts and bacteria were cultured in the stomatitis patients than in the controls. This indicates that the rate of plaque formation is increased in patients with denture-induced stomatitis. Yeasts usually constituted less than 1% of the anaerobic bacterial counts, but the percentage of yeasts was significantly higher in the stomatitis patients than in the controls. There was a significant correlation between initially higher yeast counts and improvement of the clinical condition of the palatal mucosa following antimycotic treatment. In some patients only bacteria were grown and antimycotic treatment had no effect. The study supported the contention that yeast antigens and toxins of denture plaque are significant factors in initiation and maintenance of denture-induced stomatitis. However, bacteria may also be involved as pathogens.

Aged↗
PubMed1983

Regional variations in viable bacterial and yeast counts of 1-week-old denture plaque in denture-induced stomatitis.

Quantitative cultural studies of yeasts and bacteria were made from 1-week-old denture plaque accumulated on pieces of self-adhesive tape stuck on the fitting surface of the maxillary denture in four well-defined locations. A tape piece was also stuck on the buccal denture flange. The cultural examinations were made in 15 patients with denture-induced stomatitis which affected most of the denture-bearing mucosa. There was no significant difference of the bacterial counts from the different sampling areas although the variations between patients was significant. The yeast counts from the test area located on the buccal denture flange were significantly lower than those originating from the fitting denture surface. On the other hand, there was no significant variation of the yeast counts when comparing the test areas of the fitting denture surface. In 12/15 of the patients yeast counts of greater than or equal to 10(3)/cm2 were obtained from the fitting denture surface. The results indicate that the environmental conditions beneath a denture base predispose for yeast colonization and are different from those present on the buccal flange.

Bacteria↗