PubMed HealthSearch

Biomedical subjects

L Lysell

Publications and source records attributed to L Lysell.

At least 19 recordsLinked to original sources

Rating the preventive indication for mandibular third-molar surgery. The appropriateness of the visual analogue scale.

The aim was to determine whether a visual analogue scale (VAS) is an appropriate way for general dental practitioners and oral surgeons to rate their judgement of the indication for therapy of asymptomatic mandibular third molars. Thirty general dental practitioners and 10 oral surgeons had to judge the need for removal of 36 third molars. They were also asked to estimate the strength of the indication for extraction on a VAS. To assess the reliability of the judgment, the 36 cases were duplicated. For each participant, two mean indication indices with 95% confidence limits were calculated, one index for molars proposed to be extracted and one index for molars proposed not to be extracted. Pearson's correlation coefficient was used to estimate the intra-examiner reliability and the correlation between the number of molars proposed for extraction and the mean indication index. The correlation between the number of molars proposed to be extracted and the mean indication index was high (p < 0.001). The intra-examiner reliability was also high, with a mean correlation coefficient of 0.72 for the general practitioners and 0.84 for the oral surgeons. No single judge presented any overlap for the 95% confidence limits for the mean indication index of teeth proposed to be extracted versus teeth proposed not to be extracted. These results indicate that the VAS seems to be an appropriate method for analyzing the judgements on a therapeutic strategy like extraction versus no intervention for asymptomatic mandibular third molars.

Adult

Judgement on removal of asymptomatic mandibular third molars: influence of the perceived likelihood of pathology.

Thirty general dental practitioners and 10 oral surgeons were asked to judge the need for removal of 36 asymptomatic impacted third molars. To estimate the reliability of the judgement, the 36 cases were duplicated. The participants had to estimate the strength of the indication for extraction and, if the teeth were not extracted, the probability of development of pathology in general and of six specific complications on a Visual Analogue Scale. Multiple linear regression analysis was used to describe their judgement. There was a high correlation between the indication index for extraction and the perceived likelihood of the development of pathology, although there was considerable individual variation. The general dental practitioners rated cyst development as the most, and pericoronitis as the second most, influential factors in their decision to extract the third molar. The oral surgeons rated pericoronitis the highest and the development of a cyst or caries in the second molar as the second highest factors influencing their judgement. Tumour formation and root resorption received low weightings. Intraexaminer reliability was high. The study confirms that the judgement to extract asymptomatic impacted third molars is not made solely on the basis of cognitive factors.

Adult

Asymptomatic mandibular third molars: oral surgeons' judgment of the need for extraction.

Ten oral surgeons were asked to judge the need for extraction of asymptomatic mandibular third molars. Thirty-six mandibular third molars with equal distribution of angular position, impaction status, and patient's sex and age were selected. To estimate the consistency of judgment, the 36 cases were duplicated so that, in all, 72 cases were judged. The judgment of the oral surgeons was compared with that of 30 general dental practitioners (GDPs). The number of mandibular third molars the oral surgeons proposed to extract varied from 3 to 21 of 36 teeth. The mean number of molars proposed for extraction was 12 for the oral surgeons and 13 for the GDPs. There was no third molar that all the observers in the two groups agreed should be extracted. About three times as many observers in both groups proposed extraction of molars partially covered by soft tissue. The oral surgeons were unanimous in their judgment not to extract 11 molars, and the GDPs were also unanimous in judgment not to extract two of these. The mean intraobserver agreement within the two groups was comparable, 94% for the oral surgeons and 92% for the GDPs. We conclude that there is a great variation among oral surgeons in their judgment on the need for removal of asymptomatic mandibular third molars. A similar variation in judgment also was observed among GDPs.

Adolescent

General dental practitioners' evaluation of the need for extraction of asymptomatic mandibular third molars.

Thirty general dental practitioners were asked to evaluate the need for extraction of asymptomatic mandibular third molars. Thirty-six mandibular third molars with equal distribution of angular positions, impaction status, males and females and age groups were selected. To estimate the consistency of the evaluation, the 36 cases were duplicated so that, in all, 72 teeth were evaluated. The number of molars proposed to be extracted by the observers varied from 0 to 26. There was no third molar which all observers agreed should be extracted. The two molars which most observers, 25 and 23 of altogether 30 observers, proposed to be extracted were partially covered by soft tissue. The decision not to extract two molars was unanimous. Both of these were completely covered by bone tissue and positioned vertically. The mean overall intra-observer agreement for the therapeutical decision was 92%, with a range of 69-100%. The length of professional experience of the observer did not influence the evaluation whether or not to extract. We conclude that there is a great variation among general dental practitioners regarding their evaluation on the need for removal of asymptomatic mandibular third molars.

Adult

Pain control after third molar surgery--a comparative study of ibuprofen (Ibumetin) and a paracetamol/codeine combination (Citodon).

Two analgesics commonly used in oral surgery, ibuprofen (Ibumetin) and a paracetamol/codeine combination (Citodon) have been compared in a single-blind multi-centre trial after third molar surgery. The study comprised 120 patients, 60 in each treatment group. The profiles of postoperative pain in the two groups were similar from the first postoperative day, but Ibumetin was better pain reliever on the day of surgery. The profiles of postoperative swelling and trismus had the same general course, but patients taking Ibumetin reported lower scores for these variables during the whole postoperative period. Citodon induced significantly more side-effects than Ibumetin.

Acetaminophen

Postoperative status after partial removal of the mandibular third molar.

The aim of the study was to examine the postoperative status one year after partial removal of the third mandibular molar. Thirty-three third molars were selected because of the proximity of the apices to the mandibular canal and/or complicated root anatomy. At a follow-up examination one year postoperatively, clinical and radiological findings were recorded. A definition based on both clinical and radiological findings for healing and unsatisfactory healing, respectively, is suggested. Twenty-seven root fragments migrated between 1 and 7 mm coronally in the length axis of the tooth. Nine patients had subjective symptoms or objective findings. Three of these patients had dysesthesia. The findings indicated healing around 24 root fragments (73%) and unsatisfactory healing around 9 root fragments (27%). This findings of healing around most of the root fragments indicates that partial removal might be considered as an alternative method in certain cases of complicated root anatomy.

Adult

Prevalence of impacted third molars in dental students.

To study the prevalence of third molar impaction in dental students, the radiographs of 113 female and 144 male students in the age groups 20-39 years were investigated. Half of the individuals had all four third molars, whereas 10% of the individuals lacked all third molars. A radiologic definition of impaction, which is illustrated, is suggested. One or more impacted third molars were found in 33% of the individuals. The difference between the sexes regarding impacted third molars was not significant. Calculated by number of teeth, one fourth of all third molars were impacted and were then mostly in a vertical or mesioangular position. The frequency of impacted third molars was higher in the lower jaw compared to the upper jaw.

Adult

A study of indications used for removal of the mandibular third molar.

To study the indications used for removal of the mandibular third molar, questionnaires were sent to 35 Oral Surgery Clinics in Sweden, out of which 29 clinics participated. In each clinic, the questionnaires were to be recorded for 30 patients. The indications for removal were classified into 15 groups. There were also questions about symptoms as well as eruption status for the molar being removed. The results were based on data from 870 individuals with a mean age of 27 years. More than half of the removed third molars (54%) presented no subjective symptoms. Such symptoms were more frequent in association with fully or partially erupted molars than molars completely covered by soft or bone tissue. The indication for removal was classified as prophylactic in 27% and as orthodontic in 14%. Earlier episodes of pericoronitis consisted of 1/4 of the indications and caries or pulpitis of the third molar made up 13%. Pathologic entities like cysts, tumours and root resorption were registered in less than 3% each, and were more frequent among patients 40 years of age or older.

Adolescent

Initial Tc-99m diphosphonate uptake in mineralized and demineralized bone implants in rats.

Radionuclide imaging has been suggested as a means to assess healing and viability of bone grafts and implants. This study deals with the in vivo uptake of 99mTc-MDP in the initial postoperative period in rats. Isogeneic or xenogeneic bone was implanted in subcutaneous pouches. The isogeneic grafts and implants were treated with saline or freeze-treated or demineralized. The xenogeneic implants consisted of Kiel bone or collagen sponge. One day after surgery, the accumulation of 99mTc after an intraperitoneal injection of 99mTc-MDP was seen in all grafts and implants containing bone mineral independent of prior treatment of the graft and implant. In implants composed of only the organic part of bone, no accumulation was observed. One prerequisite for accumulation of 99mTc-MDP is the presence of the inorganic phase. Thus, the interpretation of the initial postoperative scan is based on whether or not the graft or implant initially contained mineral.

Animals

Surgical treatment of juxtaradicular periodontitis.

A retrospective study was performed on surgically treated localized juxtaradicular periodontitis. 23 teeth were operated on during the years 1971-1976. The majority of these (79%) were incisors or cuspids. The most common etiological factor was iatrogenic root perforation. The postoperative healing process was completely successful in 57% of the cases.

Adult

Ameloblastic fibroma: report of two cases.

Two cases of ameloblastic fibroma are described. One case was a seven-year-old girl, the other a 13-year-old boy. In both cases the tumour was located in the posterior part of the maxilla. Both neoplasms were associated with failure of tooth eruption, in one case a primary molar, in the other case a permanent molar. Local excision was performed in both cases, with a recurrence observed in one case ten months after surgery.

Adolescent