PubMed Health⌕ Search

Biomedical subjects

Gunnar E Carlsson

Publications and source records attributed to Gunnar E Carlsson.

At least 19 recordsLinked to original sources
PubMed2006

Changes in reported orofacial symptoms over a ten-year period as reflected in two cohorts of fifty-year-old subjects.

OBJECTIVE: The study presents changes in reported orofacial symptoms over the course of a 10-year period. It was hypothesized that there was an increase of temporomandibular disorder (TMD) and orofacial pain symptoms during the period concurrent with social and demographic changes. MATERIAL AND METHODS: All 50-year-old subjects living in two Swedish counties were asked to answer a mail questionnaire in 1992 and 2002. In the two cohorts, 6,343 and 5,798, respectively, responded (response rate 71.3% and 70.2%). RESULTS: Striking differences in demographic, occupational, general, and oral health conditions were found. General health was reported to be less good, utilization of dental care decreased, whereas number of teeth increased. The prevalence of a number of intra-oral symptoms and orofacial symptoms increased significantly between 1992 and 2002. Reported bruxism increased from 18% in 1992 to 28% in 2002. CONCLUSION: The observed increase in reported orofacial pain symptoms during the 10-year period, concurrent with changes in society, deserves further attention by society and the dental community.

Bruxism↗
PubMed2006

Trends in prosthodontics.

Prosthodontics is concerned with the impact of tooth or tissue damage and partial or complete loss of teeth on oral function in its broadest sense. It deals with this largely through prosthetic replacement. The discipline occupies a major portion of a dental school curriculum, and dental practitioners usually devote much of their practice to prosthodontic services. With the rapid improvement in oral health and the reduction of edentulism in many countries, increasing numbers of people are retaining more teeth later in life.Gradually,the main focus in prosthodontics has shifted from removable dentures to fixed prostheses, while implant-supported restorations have attracted intense interest in the dental community. Another factor increasingly influencing prosthodontic practice is patients' awareness of newer technologies in aesthetic dentistry. Because prosthodontic interventions as well as maintenance and repair are by nature costly, the global development in the field manifests fundamental inequalities in the levels of service that patients can access. Diminishing resources for health care in general challenges educators and practitioners of prosthodontics alike. This review is an attempt to describe the recent developments in prosthodontics and its therapeutic areas, and the impact such developments may have on the theory and practice of the discipline.

Health Education↗
PubMed2006

Facts and fallacies: an evidence base for complete dentures.

UNLABELLED: The rate of edentulism is falling but many edentulous people still need complete dentures. There is poor correlation between the quality of dentures and patient satisfaction. There is no evidence that a more complex fabrication technique including face-bow registration results in a better clinical outcome. Balanced occlusion/articulation is not necessary for successful complete denture function. Variations in materials and techniques appear to have only minor influence, if any, on the clinical end result. Psychosocial factors, especially a good relationship between dentist and patient, are more important than prosthodontic factors for a positive outcome. CLINICAL RELEVANCE: Creating a good relationship between the dentist and the patient is extremely important for a successful outcome of a complete denture treatment.

Dental Impression Technique↗
PubMed2005

A prospective long-term study of signs and symptoms of temporomandibular disorders in patients who received orthodontic treatment in childhood.

This investigation analyzed the influence of orthodontic treatment performed in childhood on the long-term development of signs and symptoms of temporomandibular disorders (TMDs). The original sample consisted of 50 consecutive patients (27 girls and 23 boys) with different morphological malocclusions, who were to receive orthodontic treatment. Their mean age at start of treatment was 12.9 years. Seventeen (range 15-18) years after completion of orthodontic treatment, 40 former patients (89% of the traced subjects) completed and returned a questionnaire, and 31 subjects (69% of the traced subjects) were also examined clinically. A great majority of the participants were pleased with the result of the orthodontic treatment. Relapses of morphological malocclusions were very uncommon. The prevalence of signs and symptoms of TMD was low both before and after the active phase of orthodontic treatment, as well as at the long-term follow-up after 15 to 18 years. The incidence per year of manifest TMD requiring treatment was approximately 1%. The result of the present investigation supports the opinion that orthodontic treatment in childhood does not entail an increased risk to develop either signs or symptoms of TMD later in life.

Case-Control Studies↗
PubMed2005

A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary.

The aim of this summary of a longitudinal investigation on temporomandibular disorders (TMD) was to present the prevalence figures of signs and symptoms of TMD and certain other examined variables, and the correlations between these variables, over a 20-year period. Originally, 402 randomly selected 7-, 11-, and 15-year-olds were examined clinically and by means of a questionnaire. The same examination procedure was repeated three times: after 4-5 years and after 10 and 20 years, respectively. Signs and symptoms of TMD were mainly mild, but common already in childhood. They increased up to young adulthood, after which they leveled out. Progression to severe pain and dysfunction was rare, and spontaneous recovery from more pronounced symptoms was also rare. Significant correlations between reported bruxism and TMD symptoms were found, and a baseline report of tooth-grinding was a predictor of TMD treatment during the 20 years covered by the investigation. Occlusal factors were only weakly associated with TMD signs and symptoms. However, a lateral forced bite between the retruded contact position (RCP) and the intercuspal contact position (ICP) and a unilateral crossbite deserve further consideration as possible local risk factors for development of TMD. In conclusion, a substantial fluctuation of TMD signs and symptoms was observed in this sample of Swedish subjects followed for 20 years from childhood to adult. The demand for TMD treatment was low at all examinations, while the estimated treatment need was larger. One-third of subjects who had some kind of orthodontic treatment did not run a higher risk of developing TMD later in life.

Adolescent↗
PubMed2005

Changes in the prosthodontic literature 1966 to 2042.

PURPOSE: To describe the growth and content of the prosthodontic literature over the last 4 decades, to make a prognosis on its probable development in the coming 4 decades and to discuss changes in the content of the International Journal of Prosthodontics (IJP) from its start in 1988 to 2004. METHODS: MEDLINE was searched for articles on prosthodontics published between 1966 and April 2004. All volumes of IJP were examined with respect to type, subject area and geographic origin of articles. RESULTS: Using the term "prosthodontics," the MEDLINE search produced 66,600 hits. The proportion of clinical studies increased from 1% during the first 10-year period to 13% since 2001. Articles on removable dentures decreased during the period reviewed, whereas those on implant prosthodontics increased. Randomized controlled trials were rare and often of inadequate quality. Literature reviews have become popular, but many do not follow current guidelines for systematic reviews. A marked change in geographic origin of articles in IJP has occurred, with a decrease in material from North America and an increase in that from Europe and Asia. The Internet and open-access publishing will probably have a great impact on the future development of the prosthodontic literature. CONCLUSIONS: Substantial changes have occurred in the prosthodontic literature between 1966 and 2004, and they can be expected to continue with the rapid development of information technology and increased use of the Internet.

Bibliometrics↗
PubMed2004

Responses of jawbone to pressure.

OBJECTIVE: To provide a literature review of bone resorption of edentulous jaws focusing on responses to pressure. BACKGROUND: After the extraction of all teeth in a jaw there is a continuous reduction of the residual ridge. The individual variation of bone resorption is great, and the aetiology is complex and not yet well understood. MATERIALS AND METHODS: A search of the literature published up to May 2003 on bone resorption and pressure was performed using PubMed/Medline. RESULTS: Animal studies have demonstrated that excessive and constant pressure induces bone resorption. Recent experimental research has indicated that bone resorption is a pressure-regulated phenomenon with a lower threshold for continuous than for intermittent pressure. Clinical studies have suggested that residual ridge resorption is due more to the effects of denture wearing than to disuse atrophy. However, the results of leaving out dentures at night are not conclusive. Nor does the literature offer any strong evidence for the so-called combination syndrome, which has been described as a result of unfavourable loading. Clinical studies using multivariate analyses indicate that female gender and systemic factors may be of greater importance than oral and denture factors. Implant-supported prostheses have a bone preserving effect rather than the continuing resorption under complete dentures. CONCLUSIONS: The best way to reduce bone resorption is to avoid total extraction, preserve a few teeth and fabricate overdentures. In edentulous jaws, placement of implant-supported prostheses will lead to less bone loss and may even promote bone growth. To increase our knowledge of residual ridge resorption extended experimental, clinical and statistical methods will be needed, preferably including collaboration between dental and medical researchers.

Aged↗
PubMed2003

The combination syndrome: a literature review.

Although combination syndrome is recognized by many clinicians, documented observations seem to be rare. The aim of this article was to critically review the literature regarding combination syndrome to evaluate the evidence for this concept. A search of the dental literature with Medline/PubMed through July 2002, focusing on the combination syndrome and related features, was undertaken and combined with a hand search of older references and textbooks on removable prosthodontics.

Alveolar Bone Loss↗
PubMed2003

A 20-year follow-up of signs and symptoms of temporomandibular disorders and malocclusions in subjects with and without orthodontic treatment in childhood.

This investigation analyzes the influence of orthodontic treatment on signs and symptoms of temporomandibular disorders (TMDs) and different malocclusions during a 20-year period. Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire for signs and symptoms of TMDs. The examination was repeated after five and ten years. After 20 years, 320 subjects (85% of the traced subjects) completed the questionnaire. The oldest age group,now 35 years of age, was invited to a clinical examination, and 100 subjects (81% of the traced subjects) were examined. The correlations between signs and symptoms of TMD and different malocclusions were mainly weak, although sometimes statistically significant. Lateral forced bite and unilateral crossbite were correlated with TMD signs and symptoms at the 10- and 20-year follow-ups (r = 0.38, P < .05 and r = 0.34, P < .01, respectively). Subjects with malocclusion over a long period of time tended to report more symptoms of TMD and to show a higher dysfunction index, compared with subjects with no malocclusion at all. There were no statistically significant differences in the prevalence of TMD signs and symptoms between subjects with or without previous experience of orthodontic treatment. This 20-year follow-up supports the opinion that no single occlusal factor is of major importance for the development of TMD, but a lateral forced bite between retruded contact position (RCP) and intercuspal position (ICP), as well as unilateral crossbite, may be a potential risk factor in this respect. Furthermore, subjects with a history of orthodontic treatment do not run a higher risk of developing TMD later in life, compared with subjects with no such experience.

Adolescent↗
PubMed2003

Gender difference in symptoms related to temporomandibular disorders in a population of 50-year-old subjects.

AIMS: To investigate, by means of a mail questionnaire, the prevalence of symptoms related to temporomandibular disorders (TMD) in 50-year-old subjects living in the counties of Orebro and Ostergötland, Sweden. METHODS: The total population comprised 8,888 individuals, and the overall response rate was 71%. A clinical evaluation of the masticatory system was performed in subgroups to validate the responses to the questionnaire. There was satisfactory correspondence between self-reports and well-defined clinical conditions. RESULTS: Women reported, more often than men, pain from the temporomandibular joints (TMJs), TMJ sounds, bruxism, sensitive teeth, and burning mouth symptoms. The prevalences of difficulties in jaw opening, loss of anterior teeth due to trauma, and masticatory problems were greater in men than in women. No gender difference was found in the number of remaining teeth. Logistic regression analysis with pain from the TMJ as the dependent variable identified bruxism, impaired chewing efficiency, and gender (women) as the most significant risk factors. With reduced chewing ability as the dependent variable, several missing teeth constituted the highest risk, followed by pain from the TMJ, bruxism, gender (men), and loss of anterior teeth due to trauma. CONCLUSION: There were significant gender differences in reported TMD-related symptoms in 50-year-old Swedes. Bruxism was a significant risk factor for pain from the TMJ. Reduced number of teeth and pain from the TMJ were significant risk factors for impaired chewing ability.

Bruxism↗
PubMed2003

Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period.

AIMS: To analyze predictors of bruxism, other oral parafunctions, and tooth wear in a group of subjects who had been examined 20 years earlier. METHODS: Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire. Twenty years after the first examination, 94% of the original group could be traced, and 320 (85%) completed and returned the questionnaire. Of the oldest group, 100 (81%) also underwent a clinical examination focusing on occlusal factors and function and dysfunction of the masticatory system. For analyses of predictors of some oral parafunctions and tooth wear registered at the 20-year follow-up, logistic regression was used with recordings at the first examination as independent variables. RESULTS: Subjective reports in childhood of bruxism (defined as tooth clenching during daytime and/or tooth grinding at night), clenching only, grinding at night only, nail biting, and/or other parafunctions were predictors of the same oral parafunctions 20 years later. There were different predictors of the 2 components of bruxism, daytime tooth clenching and tooth grinding at night. Postnormal occlusion (Angle Class II malocclusion) and tooth wear in childhood predicted increased tooth wear in adulthood. Subjects with nonworking-side interference had less anterior tooth wear than those without such interference. CONCLUSION: Oral parafunctions in childhood may be a persistent trait in many subjects. Postnormal occlusion and tooth wear in childhood predicted increased anterior tooth wear 20 years later, whereas nonworking-side interference reduced the risk for such wear in 35-year-old subjects.

Adolescent↗
PubMed2003

Use of mandibular implant overdentures: treatment policy in prosthodontic specialist clinics in Sweden.

The aim was to examine the use of mandibular implant overdentures in Swedish prosthodontic specialist clinics. Questionnaires related to treatment with mandibular implant overdentures during 2001 were sent to the heads of the 30 prosthodontic specialist clinics of the Public Dental Health Service in Sweden. Completed questionnaires were received from 28 (93%). The number of treatments with mandibular implant overdentures varied much among the clinics (0 to 22). Seven clinics had not performed any such treatment, and the median number was 2. The number of fixed implant-supported prostheses was much higher (median value 17, range 4 to 100). The correlation between the number of implant overdentures and fixed implant-supported prostheses in edentulous mandibles was weak (r = 0.33; P = 0.10). The most common anchorage system was ball attachments on two unsplinted implants. The most common reason for the choice of the overdenture treatment was the reduced cost, whereas the patient's main wish to improve denture retention came next. The question whether the demand for implant overdentures had increased during the last few years, was answered with "no" by 19, with "yes" by 5 and with "don't know" by 4 clinics. All but one responded that their attitude to implant overdentures had not changed after the introduction of free pricing in Swedish dentistry. It can be concluded that compared to the rapidly increasing international use of mandibular implant overdentures, this treatment of edentulous patients is rare in Sweden, where fixed implant-supported prostheses still are predominant.

Dental Clinics↗
PubMed2002

Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood.

The aim of this study was to find possible predictors of signs and symptoms of temporomandibular disorders (TMD) in a long-term perspective. Baseline questionnaire and clinical examinations focusing on function and dysfunction of the masticatory system were performed in a sample of 402 subjects 7, 11, and 15 years old. After 20 years, 320 subjects (80% of the original sample) completed a similar questionnaire as at baseline. From the oldest age group, now aged 35 years, 100 subjects (74% of the original sample) also attended a clinical examination. Three variables from the 20-year follow-up were chosen as dependent variables in logistic regression analyses, with independent variables selected from the baseline examinations. Three variables at baseline were significant predictors for reported TMJ clicking at the 20-year follow-up, tooth wear index being the strongest (odds ratio = 4.3). Reported TMJ clicking at the start was the only significant predictor for TMD symptoms without clicking 20 years later (odds ratio = 2.3). The third logistic regression model, using the Helkimo Clinical Dysfunction Score as dependent variable, resulted in four significant predictors from the baseline examinations (bruxism, oral parafunctions, TMJ clicking, and deep bite). The results indicated that some signs and symptoms might predict TMD signs and symptoms in a long-term perspective. However, it cannot be concluded from this study whether these symptoms recorded in childhood--oral parafunction, tooth wear, TMJ clicking, and deep bite--can be used for predicting manifest TMD in adult age.

Adolescent↗
PubMed2002

Treatment received, treatment demand, and treatment need for temporomandibular disorders in 35-year-old subjects.

An epidemiological sample of 114 subjects was followed longitudinally from the age of 15 to 35 years with regard to treatment received, treatment demand, and treatment need for temporomandibular disorders (TMD). Some kind of TMD treatment had been provided to 18% of the subjects during the 20-year follow-up period. Eighty-five percent of those who had received previous TMD treatment reported that the treatment had had a positive effect on their symptoms. The estimated present need for treatment was 11%, but, in line with several other investigations, the active demand for such treatment was much less (3%). From age 15 to 25 years, a small but gradual increase of clinical signs of dysfunction was found. From the age of 25 to 35 years, however, a significant reduction of such signs was noted. One explanation for this reduction of clinical signs and symptoms of TMD might be the stomatognathic treatment received. It was concluded that 18% of the subjects had received some TMD treatment during the 20-year follow-up period. Only 3% still had a demand for such treatment at age 35.

Adult↗
PubMedDate not supplied

A long-term retrospective and clinical follow-up study of In-Ceram Alumina FPDs.

PURPOSE: The purpose of this study was to evaluate the long-term outcome of In-Ceram Alumina fixed partial dentures (FPD) performed in a general dental practice from 1992 to 1996. MATERIALS AND METHODS: The study was conducted as a retrospective assessment of up to 9 years of patient records and a clinical follow-up examination of patients treated with In-Ceram Alumina FPDs. In 37 patients, 42 FPDs had been inserted during the selected period. After randomized selection, 16 patients with 18 FPDs were examined clinically. The most common restorations comprised two and three units. Cantilever extensions were present on 64% of the FPDs. Sixty-two percent of the FPDs extended into the posterior region. RESULTS: The mean time in function for the 42 FPDs was 76 months (range 2 to 110 months), with 86% being followed for > 5 years. No adverse effects to either periodontal or pulpal tissues were recorded. The technical quality was very good, and patient satisfaction very high. Five FPDs fractured during the observation period, resulting in a total failure rate of 12%. Two of these FPDs fractured as a consequence of external trauma. Excluding these, the total survival rate during the observation period was 93%. Cumulative survival rate according to life table analysis was 93% after 5 years and 83% after 10 years. CONCLUSION: The results suggest that the In-Ceram Alumina short-span FPD is a viable prosthetic alternative.

Adult↗