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Biomedical subjects

P Hörsted-Bindslev

Publications and source records attributed to P Hörsted-Bindslev.

At least 19 recordsLinked to original sources

Longitudinal study of periapical and endodontic status in a Danish population.

AIM: To describe and discuss changes in periapical and endodontic status in a general Danish population. METHODOLOGY: In 1997, 616 randomly selected individuals had a full-mouth radiographic survey taken. In 2003, 77% of the participants attended for a new full-mouth radiographic examination. Information on endodontic treatment and periapical status was obtained. The periapical index (PAI) was used to assess apical periodontitis (AP). RESULTS: More participants had root filling(s) and AP in 2003 than in 1997. More teeth had AP and/or root fillings in 2003. Fewer of the root-filled teeth (RFT) had AP in 2003. Less than 3% of the teeth without root fillings (NRFT) that in 1997 had no AP, developed AP and/or received a root filling. Of the NRFT which in 1997 had AP, more than 35% still had AP and no root filling in 2003. Approximately, 30% of the NRFT with AP in 1997 received a root filling. Of the teeth that received a root filling, 40% had healed, whereas 60% had not. Approximately, 25% of the NRFT that in 1997 had AP had been extracted. In 1997 there were 618 RFT, 314 of the RFT had no AP in 1997. Almost 20% of the RFT that in 1997 were periapically sound, developed AP. Of the 304 RFT with AP in 1997, approximately 30% had healed, in 60% AP persisted, and 10% were extracted. CONCLUSIONS: The present study indicates that caution must be exercised when statements on the outcome of root canal treatment are made based on the cross-sectional studies.

Adult↗

Tunnel or saucer-shaped restorations: a survival analysis.

The aim of the present effectiveness trial was to compare the survival of restorations placed in saucer-shaped cavities to that of restorations placed in tunnel preparations. Ten operators placed a total of 85 tunnel and 97 saucer-shaped restorations. The dentinal part of the tunnel was restored by resin-modified glass ionomer cement. The remaining part of the tunnel was restored by composite resin using an adhesive technique. Composite resin was used to restore the saucer-shaped cavities. The restorations were assessed clinically and radiographically for up to 79 months, with a mean observation time of 28.8 months for tunnel, and 30.3 months for saucer-shaped restorations. The survival proportion of the tunnel restorations was 46%, and the survival proportion for the saucer-shaped restorations was 76%. A main reason for failure of the tunnel restorations was fracture of the marginal ridge (24% after 24 months). Caries development in relation to the restoration was significantly higher for tunnel restorations compared with saucer-shaped restorations (41 and 19%, respectively, after 24 months). There was no difference between the two types of restoration in marginal deterioration and caries progression in the neighboring tooth (40% after 24 months). Based on findings from the present study, it is suggested that saucer-shaped restorations should be preferred for tunnel restorations in small- and mid-sized cavities.

Adolescent↗

Frequency and distribution of endodontically treated teeth and apical periodontitis in an urban Danish population.

AIM: The aim of this study was to investigate the prevalence of endodontically treated teeth and apical periodontitis (AP) in a Danish population. METHODOLOGY: From Aarhus County 614 individuals were radiographically examined, and the frequency of endodontic treatment and periapical status of all teeth were assessed. The year of birth of the subjects ranged from 1935 to 1975. The chi-squared test was used to determine the significance of differences between males and females and amongst age and tooth groups for the following parameters: AP, the number of endodontically treated teeth, and the number of endodontically treated teeth with AP. RESULTS: A total of 15 984 teeth were examined; of these 538 (3.4%) had AP and 773 (4.8%) had been endodontically treated. Of the endodontically treated teeth, 404 (52.2%) had AP. Females had more endodontically treated teeth than males; otherwise, no effect of gender was observed. Significantly more molars (P < 0.01) had been endodontically treated (8.1%) compared to premolars (5.4%) and anterior teeth (2.5%). The prevalence of AP in connection with molars was significantly (P < 0.01) higher (7.0%) than premolars (2.8%) and anterior teeth (1.5%). The prevalence of endodontically treated teeth and of teeth with AP gradually increased with age. CONCLUSIONS: The average number of teeth, the number of teeth with AP and the number of teeth with endodontic treatment in Danish adults were comparable to findings in other European countries. The frequency of endodontically treated teeth with AP was found to be high compared to that demonstrated in other epidemiological studies.

Adult↗

A comparison of the quality of root canal treatment in two Danish subpopulations examined 1974-75 and 1997-98.

AIM: The aim of this study was to compare the quality of root canal treatment in two Danish subpopulations. METHODOLOGY: Group 1 (358 patients) was examined 1974-75 and group 2 (244 patients) 1997-98. All patients were more than 20 years old. All had undergone a full-mouth radiographic survey. In root-filled teeth the following parameters were assessed: the quality of the coronal restoration or crown, the lateral seal of the root filling, the length of the root filling, and the periapical status. Chi-squared tests were used for the evaluation of differences between the groups. RESULTS: In group 1 there were 975 endodontically treated teeth, in group 2 there were 753. In group 1 the majority of root-filled teeth were premolars, in group 2 the majority were molars (P < 0.001). The quality of coronal restorations (P = 0.35) and crowns (P = 0.68) did not differ significantly between the groups. In group 2 more teeth had adequately sealed root canals (P < 0.001) and adequate length of root filling (P < 0.001). More root-filled molar teeth had apical periodontitis (AP) than root-filled premolar and anterior teeth (P < 0.001). CONCLUSIONS: Whilst the technical quality of endodontic treatment had improved during the last 24 years, basic differences between the populations prevented assessment of the impact of this change on disease frequencies. The study indicates that great care should be taken when comparing different patient populations, in particular more emphasis should be placed on the selection and description of study groups.

Adult↗

Abrasiveness of an air-powder polishing system on root surfaces in vitro.

OBJECTIVE: The purpose of this study was to evaluate the abrasiveness of a new air polisher on root surfaces. METHOD AND MATERIALS: Fifty extracted human teeth were air polished for 5 seconds. RESULTS: All root surfaces showed a circular defect visible with the naked eye. Scanning electron microscope examination showed smooth crater walls and a few open dentin tubules, but most seemed to be obliterated. Laser profilometry of the exposed areas revealed defects with an average depth of 484 microns, whereas the unexposed root surfaces showed irregularities with an average depth of 323 microns. The depths of the abraded areas were evaluated in relation to the values for the unexposed surfaces, and an average depth of 161 microns was found. The difference between the exposed and unexposed surfaces was statistically significant. CONCLUSION: The present study indicates that the air polisher has a strong abrading effect on exposed root surfaces and should therefore be used with caution on patients with gingival retractions.

Air Abrasion, Dental↗

A 5-year clinical study of indirect and direct resin composite and ceramic inlays.

OBJECTIVE: The aim of this investigation was to evaluate the clinical performance of 4 types of tooth-colored inlays. METHOD AND MATERIALS: Fifteen direct ceramic inlays (Cerec Cos 2.0), 15 direct resin composite inlays (Brilliant Direct Inlay), 14 indirect ceramic inlays (Vita Dur N), and 14 indirect resin composite inlays (Estilux) were made in 37 patients, according to the manufacturers' instructions. The inlays were evaluated 1 week (baseline) and 6, 12, 36, 48, and 60 months after cementation (modified CDA Quality Evaluation System). RESULTS: Two Vita Dur N inlays fractured after 1 and 4 years in function, and one Cerec inlay fractured after 4.5 years. Two Brilliant DI inlays needed replacement because of secondary caries (after 1 and 5 years), and one inlay (Estilux) needed replacement due to persisting hypersensitivity. Three inlays (1 Estilux and 2 Brilliant DI) were repaired due to chipping or minor fractures. During the observation period, the surface texture of Brilliant DI and Vita Dur N inlays became significantly rougher. After 5 years, the Estilux inlays had significantly lower ratings for morphology compared to baseline ratings. In general, the occlusal marginal adaptation did not show further disintegration of the luting cement after 1 year. CONCLUSION: Eighty-eight percent of the inlays were in function after 5 years. No significant differences were revealed among the survival rates of the different types of inlays.

Aluminum Oxide↗

Two-year evaluation of class II resin-modified glass ionomer cement/composite open sandwich and composite restorations.

Restorations made of a combination of resin modified glass ionomer cement (RMGIC) and composite resin (CR)--open sandwich fillings--have been recommended for use in proximal boxes of molar cavities. The aim of this study was to compare the clinical behaviour over time of RMGIC/CR sandwich restorations versus CR restorations in Class II molar cavities. During a period of 2 years, a total of 220 restorations were placed in 118 patients by one operator (VV). A random block allocation was used to allocate cavities to one of the two restorative techniques. Bitewing radiographs and photographs were taken at baseline and at annual recall appointments. At present, a total of 210 restorations have been evaluated after 1 year and 141 restorations after 2 years. All restorations were evaluated using a modification of USPHS criteria. A total of three RMGIC/CR and two CR restorations (2.8%) were rated as failures caused by endodontic complications or major fractures. Twenty-eight teeth were reported to have postoperative sensitivity at the baseline evaluation 1 week following placement. Nine RMGIC/CR (8.5%) and four CR (4.9%) restorations with minor fractures were rated Charlie but were still acceptable. Bitewing radiographs revealed progression of carious lesions in proximal surfaces of originally intact or restored teeth adjacent to five (5.9%). RMGIC/CR restorations and eight (10.9%) CR restorations. No statistically significant differences between the two types of restoration were observed with respect to marginal adaptation, discoloration and caries progression. However, a higher number of large CR filling exhibited postoperative sensitivity at baseline compared to moderate CR or extensive and moderate RMGIC/CR restorations.

Adolescent↗

A laboratory study evaluating the release of hydroxyl ions from various calcium hydroxide products in narrow root canal-like tubes.

AIM: The aim of the present study was to describe pH changes in a variety of buffering solutions within a narrow test tube containing either a gutta-percha point with incorporate calcium hydroxide, a commercial calcium hydroxide paste (Calcicur) or a freshly mixed paste of calcium hydroxide in distilled water. METHODOLOGY: The test material was placed centrally in a test tube of 2 mm inner diameter. Saline (1%) was placed at one end, whilst the buffering solutions were introduced at the other. The pH of the buffering solutions was monitored using electrodes placed at each end of the test tube. RESULTS: It was found that the pH 4.01 buffer strongly resisted pH changes at levels below 6.0, whilst saliva and bovine serum was buffered less and more evenly in the whole range up to pH 11.5. The calcium hydroxide containing gutta-percha points caused the pH to increase quickly in the sodium chloride solution to levels above 11.5. However, in bovine serum, in saliva and in the pH 4.01 buffer the pH remained below 8.5, 8.0 and 6.0, respectively, 1 mm from the point. In contrast, the release of hydroxyl ions from the two calcium hydroxide pastes brought pH above pH 11.5 irrespective of the buffering of the solutions 5 mm from the paste. CONCLUSION: It is concluded that Calcicur and the calcium hydroxide-water mixture contained substantially more available calcium hydroxide than did the calcium hydroxide containing gutta-percha points, with the result that the release of hydroxyl ions from the points was limited in comparison to that from the pastes.

Animals↗

Periapical status and quality of root fillings and coronal restorations in a Danish population.

AIM: The aim of this study was to investigate the quality of endodontic and coronal restorations and the association with periapical status in a Danish population. METHODOLOGY: A total of 614 randomly selected individuals (20-60+ years of age) from Aarhus County had a full-mouth radiographic examination. The quality of endodontic and coronal restorations and the periapical status of endodontically treated teeth were assessed by radiographic criteria. Root fillings were categorized as 'adequate' or 'inadequate' with regard to root filling length and lateral seal. Coronal restorations were categorized into 'adequate' and 'inadequate', defined by the absence or presence of radiographic signs of overhangs or open margins. Results were analysed statistically using the chi-squared test. RESULTS: The total number of endodontically treated teeth was 773, and 52.3% had apical periodontitis (AP). Root-filled teeth with an adequate lateral seal had a lower incidence of AP than teeth with an inadequate seal (44.3% vs. 57.8%), and teeth with an adequate root filling length were associated with a better periapical status than teeth with inadequate length of the root filling (42.0% vs. 67.6%). Similarly, adequate coronal restorations were associated with better periapical status than inadequate restorations (48.0% vs. 63.9%). When both root filling and coronal restoration quality were assessed, the incidence of AP ranged from 31.2% (optimal quality) to 78.3% (all parameters scored as inadequate). CONCLUSIONS: Inadequate root canal and coronal restorations were associated with an increased incidence of AP.

Adult↗

A 3-year study of inlays milled from machinable ceramic blocks representing 2 different inlay systems.

OBJECTIVE: The aim of this study was to evaluate the clinical performance of ceramic inlays made from machinable ceramic blocks. METHOD AND MATERIALS: The 2 inlay systems involved computer-aided design and computer-aided machining (Cerec Cos 2.1) or copy-milling technique (Celay). The study comprised 15 Celay inlays and 15 Cerec inlays placed in 17 patients. The inlays were evaluated clinically at baseline (1 week) as well as 1 and 3 years later (modified California Dental Association quality evaluation system). RESULTS: One Celay inlay fractured after 1 year of service, and 2 Cerec inlays were replaced, 1 after 6 months and 1 after 1 year, because of pulpal pain and persisting hypersensitivity. One Celay inlay lost retention after 2 years. At the 3-year evaluation, chipping and hairline cracks were seen in 2 Celay inlays. Progressive disintegration of the marginal luting cement was seen for both Celay and Cerec inlays. The remaining 25 inlays performed satisfactorily throughout the 3-year period. CONCLUSION: Because of their relatively high failure rate, these inlays should be reserved for esthetic indications.

Cementation↗

A milled ceramic inlay/onlay system: a report from a series of cases.

The aims of this study were to assess the handling properties of restorations produced by a milled ceramic system (Celay) and to evaluate by direct clinical means some of the characteristics of Celay restorations following placement and after one year of clinical service.

Adolescent↗

Accuracy of radiographic detection of residual caries in connection with tunnel restorations.

The aim of this study was to evaluate the diagnostic accuracy of radiographic examination for the detection of residual caries after tunnel preparation and filling with glass ionomer cement. Further, two different radiographic modalities were compared. Forty-five extracted human premolars and molars with clinical signs of approximal caries were selected for the study. The teeth were radiographed in order to identify surfaces with dentinal lesions suitable for tunnel preparation. Seventeen of the teeth had lesions that were as a minimum through the enamel and as a maximum into the outer half of the dentin (14 teeth = 1 lesion, 3 teeth = 2 lesions). Seventeen surgically removed third molars were thereafter included. These teeth were sound with respect to caries. The teeth were arranged in blocks with approximal contacts and radiographed using two image receptors: Ektaspeed Plus film (E) and the Digora (D) digital storage phosphor plate system. The 20 carious surfaces and 20 surfaces of the impacted teeth were prepared following the guidelines for the class II tunnel technique and filled with glass ionomer cement. The radiographic examination was repeated with both modalities after filling, and the approximal surfaces scored on the radiographs by 5 observers using the criteria: 0 = no filling, 1 = filling with residual caries, 2 = filling with no adjacent caries. All teeth except the unerupted third molars were sectioned, and the sections examined under the microscope. Residual caries was observed in 8 surfaces. On average, sensitivity was 0.25 for E and 0.32 for D, specificity 0.83 for E and 0.76 for D, positive predictive value 0.38 for E and 0.32 for D, and negative predictive value 0.75 for E and 0.77 for D. The differences between the two modalities were not statistically significant (p > 0.3). Based on the relatively small number of lesions in this study, it is suggested that radiography immediately after tunnel restoration cannot be recommended, as the diagnostic benefit from this examination seems to be minuscule.

Bicuspid↗

Activation of the immune system and systemic immune-complex deposits in Brown Norway rats with dental amalgam restorations.

Dental amalgam restorations are a significant source of mercury exposure in the human population, but their potential to cause systemic health effects is highly disputed. We examined effects on the immune system by giving genetically mercury-susceptible Brown Norway (BN) rats and mercury-resistant Lewis (LE) rats silver amalgam restorations in 4 molars of the upper jaw, causing a body burden similar to that described in human amalgam-bearers (from 250 to 375 mg amalgam/kg body weight). BN rats with amalgam restorations, compared with control rats given composite resinous restorations, developed a rapid activation of the immune system, with a maximum 12-fold increase of the plasma IgE concentration after 3 wks (p < 0.001; Mann-Whitney's test). LE rats receiving amalgam restorations showed no significant increase of plasma IgE (p > 0.05). After 12 wks, BN rats with amalgam restorations showed significantly increased (p < 0.05) titers of immune-complex (IC) deposits in the renal glomeruli and in the vessel walls of internal organs. These rats also showed a significant (p < 0.05), from six- to 130-fold, increase in tissue mercury concentration in the concentration order kidney > spleen > cerebrum occipital lobe > cerebellum > liver > thymus, and the tissue silver concentration was significantly (p < 0.05) increased from three- to 11-fold. Amalgam-implanted BN rats showed a significant (p < 0.05) increase in copper concentration in the kidney and spleen, and in kidney selenium concentration. We conclude that dental amalgam restorations release substantial amounts of their elements, which accumulate in the organs and which, in genetically susceptible rats, give rise to activation of the immune system and systemic IC deposits.

Analysis of Variance↗

Dentinal and pulpal uptake of mercury from lined and unlined amalgam restorations in minipigs.

The aim of the present investigation was to examine dentin and pulp in amalgam-restored teeth in minipigs with respect to presence of mercury, and to evaluate whether lining of restored cavities with a resin-modified glass ionomer cement had any effect on the penetration of mercury. Class I and V cavities were cut in 49 posterior and canine teeth of 4 minipigs. 35 cavities were restored with amalgam and 14 with composite material. 26 of the amalgam cavities were lined with a resin-modified glass ionomer cement. Following observation periods of 17-28 months, the pigs were killed and the jaws sectioned. After decalcification, the teeth were processed for light or electron microscopy examinations. Mercury was visualized by autometallography. Silver-enhanced mercury was found in all teeth with amalgam, whereas teeth with composites were devoid of mercury. Mercury could be traced in the odontoblast processes, in the body of odontoblasts, and on rare occasions in the nerve tissue of the pulp from lined and from unlined amalgam restorations. The present study thus demonstrates transport of mercury through dentinal tubules to the pulp, and that lining of cavities with a resin-modified glass ionomer cement does not prevent penetration of mercury.

Animals↗

3-year clinical evaluation of modified Gluma adhesive systems in cervical abrasion/erosion lesions.

PURPOSE: To study the clinical performance of two candidates for improvement of the original Gluma bonding system. MATERIALS AND METHODS: Eight teeth with cervical buccal abrasion/erosion lesions were identified in 40 patients. The lesions were conditioned with an oxalic acid solution followed by either a HEMA-glutaraldehyde bonding agent or a formamide-containing bonding agent. The lesions were restored with a hybrid composite. Each patient received the same number of restorations with the two different bonding formulations. All restorations were made by the same operator (JK). Evaluations were based on the USPHS system. RESULTS: No difference between the two groups as to retention, marginal adaptation and discoloration was observed after 3 years. Eight restorations were lost and a slight increase in marginal discoloration was seen during the observation period.

Adult↗

Fluoride release from alternative restorative materials.

Numerous laboratory studies have been performed to evaluate the fluoride releasing capacity of different restorative materials. The studies have comprised release of fluoride, uptake of fluoride in the dental hard tissues and the inhibitory effect on demineralization. The present paper discusses the results from and the clinical relevance of the laboratory studies especially as regards the glass ionomer materials and resin composites.

Clinical Trials as Topic↗

Comparison of marginal fit and microleakage of ceramic and composite inlays: an in vitro study.

The purpose of this in vitro study was to evaluate the marginal fit and microleakage of four types of ceramic or resin composite inlays. Sixty extracted human third molar teeth were randomly assigned into four groups. MOD cavities without bevels were prepared. The mesiogingival margin was cut in enamel, whereas the distogingival margin was placed below the amelocemental junction. The preparations and inlays were made according to the manufacturers' instructions. After acid-etching and treatment with a dentine bonding agent the inlays were cemented with dual curing CEREC resin composite luting material. After placement and polishing 10 teeth of each group were thermocycled 2500 times between 14 degrees C and 62 degrees C. Each tooth was bisectioned and from each part, one occlusal and three proximal sections of 75-100 microns thickness were cut and ground (EXAKT Cutting and Grinding system). The marginal discrepancy and the thickness of the luting cement were measured microscopically at each section and an average for each tooth was calculated. Considerable variation of marginal fit was seen, within inlays, and among different types of inlays. In general, the Vita Dur N inlays showed the best fit, e.g. the thickness of the luting cement for Vita Dur N was 114 microns occlusally and 119 microns mesiogingivally compared to 199 microns occlusally for CEREC and 219 microns mesiogingivally for Estilux. At enamel margins, a tendency of less microleakage was seen for ceramic inlays compared to composite inlays.

Aluminum Oxide↗