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Biomedical subjects

O Fejerskov

Publications and source records attributed to O Fejerskov.

At least 19 recordsLinked to original sources
PubMed1992

Putative periodontopathogens in "diseased" and "non-diseased" persons exhibiting poor oral hygiene.

The aim of the study was to assess the occurrence of some putative periodonto-pathogens in "test" and "control" sites in "diseased" and "non-diseased" persons, respectively, from an adult rural Kenyan population exhibiting poor oral hygiene and widespread loss of attachment (LA). 14 persons (less than 35 years) were assigned to a "diseased" category on the basis of at least 4 sites with LA greater than or equal to 4 mm; at least 5 mm LA and a pocket greater than or equal to 4 mm interproximally in a lower incisor ("test" site): and less than 2 mm LA and no pocket greater than or equal to 4 mm distal to a lower canine or mesial to a lower first premolar ("control" site). Age-matched "non-diseased" persons were identified on the basis of no sites with LA greater than 2 mm and no pockets greater than or equal to 4 mm associated with LA. Paperpoint samples from test and control sites as well as a scraping sample from the dorsum of tongue were examined for presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides intermedius, B. melaninogenicus group, Capnocytophaga, Selenomonas spp., and Wolinella recta. P. gingivalis was found in 79% of test sites and 36% of control sites in "diseased" persons, and in 18% and 35% of test and control sites, respectively, in "non-diseased" persons. "No other bacterial group discriminated significantly between test and control sites or between diseased and non-diseased subjects. The surprisingly high occurrence of P. gingivalis in non-diseased subjects, both subgingivally and on tongue, indicates that deep periodontal pockets are not prerequisite ecological environments for P. gingivalis establishment.

Adult↗
PubMed1992

Use of palladium touch microelectrodes under field conditions for in vivo assessment of dental plaque pH in children.

The aim of this study was to assess the applicability of palladium touch microelectrodes, connected to battery-run pH meters, for in vivo plaque pH measurements in children. The pH was assessed in 20 7-year-old and in 19 14-year-old caries-active and caries-inactive rural Kenyan children. The resting pH was measured at non-carious interproximal and occlusal sites and in open dentine cavities. Independent repeated measurements were performed at given sites at intervals of 15 s and 5 min and on different days. The resting plaque pH varied widely among the children, and there was no significant difference between caries-active and caries-inactive groups. The most striking feature was the considerable erratic fluctuations of pH at a given site with time, both in resting and in sucrose-challenged plaque. These fluctuations were sensitively recorded by palladium touch microelectrodes. After a sucrose rinse, not all sites in the same mouth behaved in a similar fashion, and thus the classical 'Stephan curve' was not always apparent. In conclusion, the palladium touch microelectrodes are highly applicable for plaque pH measurements in children, even under extreme field conditions.

Adolescent↗
PubMed1992

Validity of diagnosis of questionable caries lesions in occlusal surfaces of extracted third molars.

This study was to evaluate the accuracy of visual inspection, conventional radiography, and digital radiographic methods for the detection of occlusal carious lesions in third molars from a present-day adolescent population. Seventy-eight third molars, considered clinically to be without occlusal cavities, were extracted from young soldiers. Before extraction, an intra-oral radiograph was obtained. After extraction, the teeth were examined visually as per the criteria: 0 = no caries, 1 = chalky/stained fissure indicative of enamel caries, 2 = chalky and dark-stained fissure considered indicative of a dentinal lesion, and 3 = as per criterion 2, but with small surface defects (microcavities). The radiographs were digitised, and image enhancement with contrast stretch and a filtering procedure was performed, respectively. The three types of radiographic image were assessed as per the criteria: 1 = no caries/caries confined to enamel, 2 = caries involving the outermost dentine, and 3 = deep dentinal caries extending half-way or more to the pulp. Ground sections (500-600 microns in thickness) served as validation for lesion depth. The digital radiographic method with contrast stretch performed overall best of the four methods (greater than 70% detection rate) while visual inspection (53% detection rate) performed better than conventional radiography (48% detection rate). When results from visual inspection and conventional radiography were combined, an increase in the detection rate of 11% was obtained with a 7% increase in false-positive scorings. When digitally contrast-manipulated radiographs were combined with visual inspection, a gain of 33% was obtained with an 11% increase in false positives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Effect of sugarcane chewing on plaque pH in rural Kenyan children.

In 5 rural Kenyan children, the effect of sugarcane chewing on plaque pH was compared with the effect of a mouthrinse with 10% sucrose at various intraoral sites. They all had poor oral hygiene and at least two carious cavities in occlusal surfaces of molars. pH measurements were conducted under field conditions using paladium touch microelectrodes connected to a battery-operated pH meter. There was a marked difference in pH response of non-carious approximal sites between maxilla and mandible, with the lowest values in the maxilla. However, the pH recovery following the instantaneous drop occurred in parallel even if most pH values had not returned to baseline values 30 min after the sucrose rinse. Following the sugarcane chewing, the pH fall was less pronounced on all sites, and within 5-10 min the values had returned to resting pH and even exceeded this. In carious cavities, a similar pattern was observed, although the acidity in these sites was more pronounced, also reflected in a lower resting mean pH. The main conclusion from this study is that sugarcane chewing yields a less pronounced pH drop and a quicker pH recovery in dental plaque than is seen following a mouthrinse with 10% sucrose. This difference probably results from stimulation of salivary flow associated with the chewing.

Adolescent↗
PubMed1992

Fluoride concentrations in unerupted fluorotic human enamel.

Unerupted fluorotic human enamel was obtained from teeth surgically removed from patients with dental fluorosis. Fluoride was measured in samples produced by serial acid etching from the surface to the interior of blocks of buccal and lingual enamel. The severity of fluorosis, according to the TF index, was determined from the macroscopic and microradiographic appearance of the specimens. The shape of the fluoride profiles was not affected by the degree of severity of fluorosis, but the fluoride concentrations increased with increasing severity of lesions. Fluoride concentrations were similar to those previously recorded in erupted fluorotic enamel and were not related to the length of time the teeth had been present in the jaws. It was concluded that the fluoride content of erupted fluorotic enamel represents fluoride acquired during tooth formation and that further uptake prior to eruption may be negligible.

Acid Etching, Dental↗
PubMed1992

The effect of sucrose on plaque pH in the primary and permanent dentition of caries-inactive and -active Kenyan children.

The hypothesis that the Stephan pH responses of dental plaque would be different in caries-active and -inactive individuals was tested in 20 seven-year-old and 19 14-year-old Kenyan children. In each age group, half the children had greater than or equal to 2 dentin cavities; the other half had no such lesions. With a palladium-touch microelectrode, interdental plaque pH was monitored between m1/m2 in each quadrant in the primary dentition and in the four molar/premolar regions in the permanent dentition. pH was also monitored in caries cavities in the occlusal surfaces of lower first molars and on the tongue. pH was measured before and up to 60 min after the children rinsed with 10 mL of 10% sucrose. Caries status of the individual was unrelated to plaque pH in comparable non-carious sites in both of the age groups. The pH minimum in the maxilla was about 0.5 pH units lower than that in the mandible. Active occlusal caries lesions had a resting pH value of about 5.5, about 1 pH unit lower than that of sound surfaces. The pH dropped to about 4.5 in caries lesions and recovered slowly. In sound occlusal sites, a pH drop to about 6.0 was followed by a relatively rapid return to the resting value. Thus, when the mean values were considered, the classic Stephan curve response was evident. However, when the pH changes at single sites were considered at various time intervals, a substantial, erratic fluctuation was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

A random effects model for some epidemiological features of dental caries.

We describe a random effects model for caries lesion development and progression based on considering the effects of the pH fluctuations over time in microbial dental plaque as a Wiener process with a single absorptive barrier. The model predicts that the period of greatest risk to developing caries occurs shortly after eruption, but thereafter the longer a surface survives without developing a lesion, the less likely will it be that a lesion will subsequently develop. The model is able to anticipate why the effect of water fluoridation on caries prevalence is most pronounced when caries is diagnosed at cavity level. This model offers one way in which the variability which characterizes the complex ecosystem associated with dental caries may be considered a subject of interest for enhancing our understanding of its pathogenesis and epidemiology.

Absorption↗
PubMed1991

Detection of occlusal caries without cavitation by visual inspection, film radiographs, xeroradiographs, and digitized radiographs.

The study compared visual inspection, conventional film radiographs, xeroradiographs, and digitized radiographs for the detection of caries in occlusal surfaces without cavitation. 166 extracted premolars and permanent molars without macroscopic cavitation were included. Eight observers assessed five grades of occlusal caries by visual inspection and by the three imaging techniques. Histologic sections (700-1,000 microns) served as validating criterion for the presence and depth of carious lesions, 82 teeth being found carious (27 with deep dentinal involvement) and 84 being scored as sound. Approximately 20% of the dentinal carious lesions were detected by visual inspection and 40% by conventional film radiography (both with a minimal number of false-positive observations). By xero- and digital radiography, an increasing number of false-positive scorings was seen. By digital radiography the true-positive detection rate was similarly increased to 60%. The predictive values of a positive test were, on average, 0.85 for visual inspection, 0.89 for film, 0.78 for xero-, and 0.82 for digital radiography and for a negative test 0.56, 0.61, 0.61, and 0.69, respectively. However, digital radiography was able to detect over 70% of deep dentinal lesions in contrast to 45% by the other two imaging methods, without an increase in false-positive diagnoses of truly caries free teeth, compared with the other techniques.

Bicuspid↗
PubMed1991

Active and inactive root surface caries lesions in a selected group of 60- to 80-year-old Danes.

In 90, 60- to 80-year-old patients with teeth retained in both jaws (mean 20.4 +/- 4.3), a total of 1,092 root surface lesions were recorded. Of these 156 were diagnosed as active caries lesions, whereas 509 were considered inactive, and 427 were filled. About 60% of the elderly had one or more active lesions and 79% had fillings. Seventy percent had more than 8 filled or carious (active or inactive) surfaces. The percentage of carious and filled root surfaces in relation to surfaces at risk demonstrated that the buccal surfaces of lower molars and premolars and upper canines were the most severely affected (RCI = 70%) with fillings predominating on easily accessible surfaces. A constant relationship between active and inactive lesions was found on all other surfaces but third molars and upper incisors. The data suggest that active and inactive root caries lesions must be diagnosed as separate entities if the dynamic nature of root surface caries is to be explored in epidemiological studies and clinical trials.

Aged↗
PubMed1991

A quantitative analysis of mineral loss and shrinkage of in vitro demineralized human root surfaces.

Demineralization of dentin specimens proceeds at a faster rate than that of enamel. Although this is generally accepted, a quantification of the rate of formation of root lesions is hampered by the shrinkage of the lesions when these are dried prior to microradiographic analysis. This leads to a significant underestimation of the lesion depth and total mineral loss. The aim of this paper was to quantitate the rate of mineral loss during root lesion formation in vitro and to determine the shrinkage of root specimens as a result of drying. Unerupted roots of human teeth were subjected to a demineralizing system of 0.1 mol/L lactate buffer (pH = 4.8) with 0.2 mmol/L methanehydroxydiphosphonate during four, 11, 22, and 44 days. The root lesions were assessed by quantitative microradiography. The demineralizing solutions were analyzed to determine the amounts of root tissue dissolved. A comparison of these two sets of data showed that, with the demineralizing system used, root lesions may shrink up to 62%. Fixation of the specimens in fixative did not affect this shrinkage. Chemical analysis showed that mineral loss proceeded linearly with time. From the data-sets of this study, a model was developed to compensate for the shrinkage in the dentin specimens. In this way, it was possible to calculate the lesion depth at four demineralization times as being 130, 220, 320, and 530 microns, respectively. These values were in agreement with a microscopic determination of the lesion depth.

Decalcification Technique↗
PubMed1991

Posteruptive changes in human dental fluorosis--a histological and ultrastructural study.

The aim of the present study was to describe the structural features characterizing the severe grades of human fluorotic enamel (TF scores 5-9) with particular emphasis on the posteruptive changes in severely fluorosed teeth. Dental fluorosis is a subsurface hypomineralized lesion deep to a well-mineralized outer enamel surface, which in severe cases breaks apart shortly after eruption. Early signs of posteruptive changes comprise small defects corresponding to the opening of striae of Retzius. The enamel pits which develop after eruption in more severe cases exhibit an increase in mineral content at their base which correspond to the exposed subsurface hypomineralized lesions. Likewise, the extensive removal of surface enamel in the most severe cases of human fluorosis results in a highly varying uptake of mineral into the exposed subsurface hypomineralized lesions. The uptake varies greatly within apparently similar degrees of hypomineralized lesions. In approximal abrasion facets, however, where the subsurface lesions are also exposed, no evidence of mineral uptake was found. At the ultrastructural level, the well-mineralized surface zone consists of large hexagonal enamel crystals separated by rather large intercrystalline spaces in which numerous irregular small crystals are observed. Moreover, the large crystals may exhibit central and peripheral dissolution. In addition, mineral appeared to be deposited into such defects as well as along the side of the crystals, often with the lattices being continuous from the original crystal into the apparently posteruptive formed crystal material. It is concluded that a substantial mineral uptake can take place in exposed porous hypomineralized fluorotic enamel after eruption, but is most likely to be associated with the presence of microbial deposits, the metabolic activity of which may play a keyrole in mineral exchange.

Crystallography↗
PubMed1990

Effects of single doses of 1-hydroxyethylidene-1,1-bisphosphonate on the mineralizing front of rat incisor enamel: a microradiographic and scanning electron microscopic study.

The effects of a single dose of HEBP were examined by injecting rats subcutaneously with various doses (0.5, 1, 2.5, 5 and 10 mg P/kg body wt) and killing them either 2 or 9 days after injection. The maxillary incisors were processed for microradiography and the mandibular incisors for scanning electron microscopy after enzymatic digestion of the enamel organ remains. All doses resulted in a hypomineralized incremental band corresponding to the position of the mineralizing front at the time of injection. At 5 and 10 mg P/kg body wt, a hypomineralized lesion was found throughout the whole thickness of the enamel in an area which corresponded to the stage of late enamel secretion at the time of injection. The surface layer covering this lesion was elevated or disrupted. By scanning electron microscopy, there were three different types of lesions along the enamel surface: a "demarcation groove" corresponding to the initial enamel formation at the time of injection; an "area containing mineral globules" and a "bright band" corresponding to the stages of late secretory and final enamel formation, respectively, at the time of injection. A single injection of HEBP thus interferes with different stages of enamel formation. The findings may be explained as of the physico-chemical effects of HEBP on the mineral phase alone, but a direct effect of the drug on ameloblast function cannot be excluded.

Amelogenesis↗
PubMed1990

Effect of cigarette smoking on the transition dynamics in experimental gingivitis.

This paper reports the findings of an experimental gingivitis study conducted in smokers and non-smokers. 33 volunteers were examined and underwent prophylaxis during a period of 4 weeks. 28 subjects who showed a plaque index less than 0.20 on all prophylaxis occasions were permitted to continue in the study. Subjects then had their gingival status recorded, had their teeth polished and were requested to abstain from all oral hygiene measures for the following 21 days. After 5 days, 10 days and 21 days, plaque and gingival status were recorded using the criteria of the plaque index and gingival index. After the examination on day 21, the teeth were polished and oral hygiene was re-instituted. Following 2 weeks of supervised oral hygiene, recordings of plaque and gingival status were performed. At the initial examination, there was no difference between the clinical assessment of plaque and gingival status in smokers and non-smokers. Similar amounts of plaque accumulated in the 2 groups during the period of no oral hygiene, but smokers exhibited less gingival inflammation assessed clinically than non-smokers. This difference occurred as a result of an apparently lowered incidence rate and a markedly higher recovery rate in smokers compared to non-smokers. These findings may indicate that smokers for reasons yet unknown have a reduced capacity to mount and maintain an effective defense reaction to a given plaque challenge.

Adult↗
PubMed1990

A new approach to investigating associations in periodontal disease data.

This paper presents a method for the analysis of data originating from studies of destructive periodontal disease. The proposed method is an extension of the Mantel-Haenszel technique for the analysis of case-control studies and allows for expression of the site-specificity of destructive periodontal disease while maintaining the individual as the unit of analysis. Using data originating from a cross-sectional study of periodontal breakdown and oral hygiene parameters in a random sample of adult rural Kenyans, the proposed method is illustrated and the results compared with results obtained when two alternative analytical methods are used. The results demonstrate that the choice of analytical strategy may have profound implications for the conclusions to be drawn. Depending on the strategy chosen, one may draw conclusions which are qualitatively different and the present study indicates that the direction of these differences is not predictable.

Adolescent↗
PubMed1990

Depth of occlusal caries assessed clinically, by conventional film radiographs, and by digitized, processed radiographs.

Occlusal caries depth was assessed in 47 extracted premolars and permanent molars by 4 observers on a rank scale by eye inspection, by film radiographs, and by 2 of the observers also by digitized radiographs after filtering and contrast enhancement of the image. Quantitative estimates of caries depth were obtained from the digitized radiographs. Accuracy of scorings was determined with the histologic section as validating criterion. Occlusal caries was present in a spectrum from incipient fissure decalcification to large cavity formation. Clinical as well as radiographic scorings most frequently under-estimated lesion depth. Accuracy of radiographic assessments increased substantially by digital processing of the radiographic image. Quantitative measures of caries depth on digitized radiographs were strongly correlated to the histologic measures (r = 0.91). Interobserver agreement was fair to moderate according to kappa coefficients for the clinical and the radiographic scorings. The agreement was highest for the scorings of the digitally enhanced images. The study suggests that digital processing of radiographic images constitutes a diagnostic aid that may give a more accurate estimate of occlusal caries depth.

Analog-Digital Conversion↗
PubMed1990

An ultrastructural study of bacterial invasion and tissue breakdown in human experimental root-surface caries.

This study describes the structural features of the interface between microbial deposits and root cementum in actively progressing root-surface caries lesions developed experimentally in six elderly individuals. A total of 18 specimens was examined by microradiography, and a further 18 by light and transmission electron microscopy after intra-oral periods of one, two, and three months. All specimens showed various degrees of subsurface dissolution of mineral and bacterial invasion of the cementum. Although the microradiographic pattern of mineral loss was subsurface in nature, transmission electron microscopy showed dissolution of crystals in the outermost layers of the cementum, with a distinct gradient inward. Bacterial invasion occurred along the borders between bundles of relatively well-mineralized extrinsic collagen fibers in which the characteristic cross-banding remained intact. The pattern of bacterial invasion was influenced by the incremental lines and the cemento-dentinal junction. The invading bacteria were almost exclusively Gram-positive, of various shapes, and possessed thick, moderately electron-dense cell walls and electron-lucent "vacuoles" in the cytoplasm. It is concluded that because of pronounced mineral loss of the outermost cementum, accompanied by bacterial invasion, the surface of an active cementum caries lesion, as observed by transmission electron microscopy, is not identical to that seen in microradiograms.

Aged↗
PubMed1990

The nature and mechanisms of dental fluorosis in man.

Any use of fluorides, whether systemic or topical, in caries prevention and treatment in children results in ingestion and absorption of fluoride into the blood circulation. The mineralization of teeth under formation may be affected so that dental fluorosis may occur. Dental fluorosis reflects an increasing porosity of the surface and subsurface enamel, causing the enamel to appear opaque. The clinical features represent a continuum of changes ranging from fine white opaque lines running across the tooth on all parts of the enamel to entirely chalky white teeth. In the latter cases, the enamel may be so porous (or hypomineralized) that the outer enamel breaks apart posteruptively and the exposed porous subsurface enamel becomes discolored. These changes can be classified clinically by the TF index to reflect, in an ordinal scale, the histopathological changes associated with dental fluorosis. Compared with Dean's and the TSIF index, we consider the TF index to be more precise. Recent studies on human enamel representing the entire spectrum of dental fluorosis have demonstrated a clear association between increasing TF score and increasing fluoride content of the enamel. So far, no useful data on dose (expressed in mg fluoride/kg b.w.)-response (dental fluorosis) relationships are available. In this paper, we have, therefore, re-evaluated the original data by Dean et al. (1941, 1942), Richards et al. (1967), and Butler et al. (1985) from the USA, by applying the equation of Galagan and Vermillion (1957) which permits the calculation of water intake as a function of temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Enamel↗