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Biomedical subjects

S Lavstedt

Publications and source records attributed to S Lavstedt.

At least 19 recordsLinked to original sources

Relationship between oral health and mortality in cardiovascular diseases.

BACKGROUND, AIMS: The purpose of the study was to investigate the relationship between periodontal health and fatal cardiovascular diseases (CVD). METHODS: The investigation was conducted on a sample of 1393 individuals in the County of Stockholm. The subjects were examined in an epidemiological study in 1970 with respect to dental health. At a follow-up in 1997, the mortality rate of the sample during the years 1970-1996 was registered as well as cause of death according to the death certificate. Stepwise logistic regression analysis was performed in order to evaluate the influence of the investigated variables on the incidence of death from CVD. RESULTS: The interactional effect between plaque and oral health score (a sum of scores for number of missing teeth, apical lesions, caries lesions and marginal bone loss), adjusted for age, gender, smoking and CVD at baseline, was significantly correlated to fatal coronary events. For individuals younger than 45 years of age, the age-adjusted incidence odds ratio of death due to CVD was 2.7 (p=0.04) if subjects with mean marginal bone loss of >10% were compared with subjects with mean marginal bone loss < or =10 %. If the stratum of individuals <45 years of age is confined to smokers, the odds ratio was found to be 3.4 (p=0.03). CONCLUSION: Dental health was found to be a risk indicator of death due to CVD, especially in combination with another risk factor, smoking habits.

Adult↗

Intravenous hydroxyethylrutosides combined with long-term oral anticoagulation in atherosclerotic nonreconstructable critical leg ischemia: a retrospective study.

OBJECTIVE: To evaluate in a group of seriously diseased patients with nonreconstructable chronic critical leg ischemia (CLI), treated by a combination of i.v. hydroxyethylrutosides (HR)* and oral anticoagulation (AC) by warfarin, the short-term effects on the cutaneous microvascular blood perfusion of the soles of feet and especially the long-term clinical outcome in terms of amputation and death. DESIGN: A retrospective comparison between two groups of patients, HR + AC and a comparable reference group, fulfilling the same inclusion and exclusion criteria corresponding to the definition of CLI according to the Second European Consensus Document (1991). Clinical follow-up in both groups was made after 1, 3, 6, 12, and 24 months. SETTING: Patients were examined at university departments of clinical physiology with special interest in peripheral vascular disease, in cooperation with colleagues at university departments of surgery, internal medicine and dermatology of Karolinska Hospital, Södersjukhuset and Huddinge Hospital. PATIENTS: A total of seventy patients with CLI according to the definition of the Second European Consensus Document, 1991, ie, besides severe rest pain or ischemic lesions also a toe blood pressure < 30 mg Hg. Group with HR + anticoagulation (AC): 42 patients (19 diabetics, 23 nondiabetics). Reference group: 28 patients (18 diabetics, 10 nondiabetics). For distribution of age and toe blood pressure at baseline, see Table I. INTERVENTIONS: Therapy group: besides ordinary standard therapy, daily HR infusions for a mean period of 3.6 weeks + oral anticoagulation continued to the end of the study at 24 months. A comparable reference group on the same basic therapy but without the combination HR + AC. PARAMETERS IN EVALUATION: Short-term parameters: clinical data, skin temperature, and fluorescein imaging. Long-term outcome: amputation or death. RESULTS: Short-term and long-term results with HR + AC indicated that patients with severe CLI and very poor prognosis benefited in terms of survival and limb salvage from initial therapy with HR infusion combined with long-term oral anticoagulation. Results of this combined treatment seem at least comparable with those with i.v. prostacyclin analogies.

Administration, Oral↗

The effect of changed smoking habits on marginal alveolar bone loss. A longitudinal study.

Tobacco smoking is a factor claimed to be of influence on alveolar bone loss. The purpose of the present study was to investigate whether the effect of changed smoking habits is associated with the progress of proximal marginal alveolar bone loss as measured on intraoral radiographs. The study comprised 349 individuals with twenty or more remaining teeth examined in 1970 and 1980. The bone loss in the period was measured as the difference in the ratios "bone height/root length" at proximal tooth sides between the two examinations. It was found that the marginal bone loss in "Non smokers in 1970 and 1980" was as a mean 3.9 per cent of the root length. The corresponding value among "Smokers 1970 and 1980" was 6.0 per cent. The difference is statistically significant (p = 0.001). In individuals who had given up smoking during the 10-year period (bone loss: 4.4 per cent) as compared with those who had smoked regularly, the progression of bone loss was significantly (p < 0.05) retarded. The result is in agreement with the hypothesis that giving up smoking produces favourable effects also with regard to the attachment of the teeth in the jaw-bone.

Adult↗

Quality of intraoral radiographs sent by private dental practitioners for therapy evaluation by the Social Insurance Office.

Nearly all Swedish private dentists are affiliated with the Dental Care Insurance. Proposed treatment plans, including radiographs, are submitted to the Social Insurance Office for prior approval. In this study the quality of a sample of intraoral radiographs submitted by 404 private dental practitioners was analysed. Forty-four per cent of 3,708 periapical radiographs, simultaneously evaluated by two examiners, were satisfactory. The most frequent errors were excessive vertical angulation (18 per cent), missing apex (12 per cent), film positioning error (11 per cent) and underexposure (10 per cent). Fifty-five per cent of 294 bitewing radiographs were satisfactory; the major error was missing bone margin (33 per cent). The radiographs of 15 per cent of the 2,844 teeth proposed for therapy had insufficient radiographic documentation, six per cent because of missing radiograph and nine per cent because of missing apex on the radiograph. These errors applied to every second dentist. Compared to a similar study ten years ago, the present results do not indicate that the quality of intraoral radiographs has improved.

Chi-Square Distribution↗

A computerized system to measure interproximal alveolar bone levels in epidemiologic, radiographic investigations. I. Methodologic study.

The aims of the study were to adapt a computerized system to epidemiologic conditions, for rapid full-mouth measurements of alveolar bone levels from X5-magnified periapical radiographs and to analyze the variations in measurement due to different system components. Full-mouth measurements of interproximal alveolar bone height in percentage of root and tooth lengths were completed within an average time of 15 min per set of radiographs. An analysis of variance showed that the examiner variation in measurement of a linear scale distance was 0.02 mm. The measurement accuracy was different for different distances; each distance (d) measured with this system should therefore be calibrated with the equation Y = -0.007-0.014 (log3d-1.50), where Y is the estimate of measurement accuracy. The present computerized system enabled rapid recordings and demonstrated good measurement precision and accuracy; these are valuable features in epidemiologic investigations.

Alveolar Process↗

A computerized system to measure interproximal alveolar bone levels in epidemiologic, radiographic investigations. II. Intra- and inter-examiner variation study.

The study was aimed at analyzing intra- and inter-examiner variations in computerized measurement and in non-measurability of alveolar bone level in a cross-sectional, epidemiologic material. At each interproximal tooth surface, alveolar bone height in percentage of root length (B/R) and tooth length (B/T) were determined twice by one examiner and once by a second examiner from x5-magnified periapical radiographs. The overall intra- and inter-examiner variations in measurement were 2.85% and 3.84% of root length and 1.97% and 2.82% of tooth length, respectively. The variations were different for different tooth groups and for different degrees of severity of marginal periodontitis. The overall proportions of non-measurable tooth surfaces varied with examiner from 32% to 39% and from 43% to 48% of the available interproximal tooth surfaces for B/R and B/T, respectively. With regard to the level of reliability, the computerized method reported is appropriate to cross-sectional, epidemiologic investigations from radiographs.

Adult↗

Radiographic study of alveolar bone height related to tooth and root length.

In radiographs from 76 randomly selected periodontally healthy subjects, aged 18-22 yr, at the School of Dentistry in Stockholm, the alveolar bone height was evaluated and correlated to the root length as well as to the entire tooth length. The root lengths were also related to the entire tooth lengths. The mean tooth length was found to be 24.9 mm and the mean root length 65.7% of the mean tooth length. The correlation of alveolar bone height to the root length varied between 91.5% and 96.3% and the correlation to the entire tooth length between 54.0 and 65.7%.

Adolescent↗

Proximal alveolar bone loss in a longitudinal radiographic investigation. II. A 10-year follow-up study of an epidemiologic material.

Four hundred and six individuals from an unselected sample from the County of Stockholm aged 18-65 years in 1970 were examined radiographically in 1970 and 1980. The differences in proximal alveolar bone height were recorded, attention being paid to the divergences in projection between the two investigations. The mean of the alveolar bone difference was 5.5% of the mean root length, which corresponds to an average annual bone loss of 0.09 mm. Ninety per cent of the individuals had a difference in alveolar bone height of less than 10% of the root length--that is, an average bone loss of 1.6 mm or less during 10 years. By linear regression analysis it was shown that the difference in alveolar bone height is a function of the initial bone loss; that is, the greater the initial bone loss, the greater the alveolar bone loss during the 10-year period. The result of the regression analysis may facilitate predictions of alveolar bone loss.

Adolescent↗

Proximal alveolar bone loss in a longitudinal radiographic investigation. III. Some predictors with a possible influence on the progress in an unselected material.

The difference in proximal alveolar bone height between 1970 and 1980, the 'ABD index', has been measured longitudinally in radiographs from an unselected material. The group constitutes 406 individuals born in 1904-1952 in the county of Stockholm. Thirteen of 18 predictors determined in 1970 were significantly related to the ABD index in the simple correlation analyses. The predictor 'the alveolar bone loss 1970' ('ABL index 1970') had the strongest correlation to the ABD index. In the stepwise multiple regression analysis the predictor ABL index 1970 and three other predictors reached significant levels. These were age, number of lost teeth, and Russell's Periodontal Index.

Adolescent↗

Proximal alveolar bone loss in a longitudinal radiographic investigation. IV. Smoking and some other factors influencing the progress in individuals with at least 20 remaining teeth.

In Sweden people in all age groups now have more remaining teeth than previously. An investigation has been made to identify some predictors of alveolar bone loss in a 10-year period in subjects with at least 20 remaining teeth. The material consisted of 349 individuals, examined radiographically, clinically, and by interview in 1970 and in 1980. These subjects, born in 1904-1952, constituted a subgroup, with regard to remaining teeth, of an unselected sample of the population of the old county of Stockholm. In the unselected sample statistically significant predictors of alveolar bone loss found in a stepwise multiple regression analysis were alveolar bone loss in 1970, age, number of lost teeth, and Russell's Periodontal Index (PI). In the subgroup the predictors were in the order Russell's PI and smoking. The prediction values (R2) of further variables were marginal. The analyses showed that there was an interaction between PI and smoking, implying that the effect of smoking on alveolar bone loss was increased in individuals with high PI values. Furthermore, a tendency was found for a dose-response effect of tobacco consumption. This tendency almost disappeared when controlling for PI.

Adolescent↗

Proximal alveolar bone loss in a longitudinal radiographic investigation. I. Methods of measurement and partial recording.

A longitudinal radiographic investigation was made of the progression of the proximal alveolar bone loss over a 10-year period (1970-1980). The material was unselected and consisted of 669 individuals in the county of Stockholm. Sixty-one individuals were randomly selected for evaluation of a recording system using alternative methods of measurement, and 90% of the measurement sites could then be assessed. The correlations between some of the methods were high, such as between measurement of alveolar bone height and root length and between alveolar bone height and tooth length. To reduce the number of measurements, a partial recording was made, giving a high correlation coefficient between the partial recording and total recording. When five measurement sites (12 m, 11 m, 33 d, 31 d, 41 m) were were used, the correlation coefficient was 0.96, and a slight increase of the coefficient was obtained when using additional sites.

Adult↗

Changes in tooth length on radiographs after crown therapy.

Altogether 155 crowned teeth--incisors, canines, premolars and molars in both jaws--have been studied by means of radiographs regarding tooth length before and after crown therapy. The results show that the correlation in tooth length is good. The mean differences, however, vary between -0.52 mm for the upper molars and 0.44 mm for the upper incisors. The best correlation in tooth length was found for the upper premolars and the lower incisors.

Crowns↗

Plaque and gingivitis in a group of Swedish schoolchildren with special reference to toothbrushing habits.

The plaque and gingival condition in 232 Swedish schoolchildren aged 13-14 years has been related to the following predictors; plaque, toothbrushing frequency and technique, bristle stiffness of the toothbrush, smoking habits, use of snuff, social class and sex. Multiple regression analyses have been performed in order to explain the variation of plaque index and of gingival index employing these predictors. Significant predictors of plaque index were toothbrushing frequency, sex (boys), number of cigarettes and social class. The predictors which significantly aggravated gingival inflammation were: plaque, use of snuff and the toothbrushing method "modified Bass". The slight gingival inflammation due to toothbrushing with the modified Bass' method was not due to inferior plaque removal.

Adolescent↗

The relationship between marginal bone loss and serum zinc levels.

Serum was analyzed for zinc in 51 patients of varying age and with varying degrees of alveolar bone loss as recorded on roentgenograms. There was a reversed correlation between marginal alveolar bone loss and serum zinc levels. The observations are discussed in relation to the physiological functions of zinc.

Adult↗

Relation between tobacco consumption and oral health in Swedish schoolchildren.

A group of 232 schoolchildren aged 13-14 years in the Municipality of Huddinge, on the outskirts of Stockholm, were examined in order to study the effects of smoking and oral use of snuff in relation to oral health. Of the schoolchildren 21.5% smoked regularly. Snuff was taken regularly by 11% of the boys, but none of the girls. Snuff was present in the oral cavity for an average of 3.5 hours every day. The variable "number of cigarettes" was found to be a significant (p less than 0.01) predictor to the dependent variable "plaque" after controlling for the predictors "frequency of tooth-brushing" and "sex". Snuff usage showed a strongly significant correlation to gingival index after controlling for plaque. The result showed that use of snuff may influence on the gingival tissue directly whereas smoking affects plaque accumulation.

Adolescent↗

An epidemiologic approach to toothbrushing and dental abrasion.

Abrasion lesions were recorded in 818 individuals representing the adult population of 430,000 residents of the Stockholm region, Sweden. The subjects were asked about toothbrushing habits, toothbrush quality and dentifrice usage; these factors were related to abrasion criteria. Abrasion was prevalent in 30% and wedge-like or deep depressions were observed in 12%. The relationship between abrasion and toothbrushing was evident, the prevalence and severity of abrasion being correlated to toothbrushing consumption. The importance of the toothbrushing technique for the development of abrasion lesions was elucidated. Horizontal brushing technique was strongly correlated to abrasion. It was demonstrated by treating the data with the statistical AID analysis that toothbrushing factors related to the individual (brushing frequency and brushing technique) exert a greater influence than material-oriented toothbrushing factor such as dentifrice abrasivity and bristle stiffness.

Adolescent↗