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Biomedical subjects

C G Crossner

Publications and source records attributed to C G Crossner.

At least 19 recordsLinked to original sources
PubMed2000

Osseointegrated implants in a patient with Papillon-Lefèvre syndrome. A 4 1/2-year follow up.

BACKGROUND: The Saudi female reported in this study was diagnosed with Papillon-Lefèvre syndrome. She had lost all her teeth, including third molars, at the age of 18 years. METHOD: She was wearing full dentures for 7 years, before 5 titanium implants were installed in the mandible. RESULTS: 4 1/2 years after the implant installation, the treatment was clinically and radiographically successful. Neither A. actinomycetemcomitans nor P. gingivalis were detected at any of the implants. This very encouraging result does not differ from what is generally reported in edentulous medically healthy patients. CONCLUSION: The use of implants could considerably enhance future therapeutic options for the severely dentally compromised patients with Papillon-Lefèvre syndrome.

Adolescent↗
PubMed1996

Saliva composition in children and young adults with Papillon-Lefèvre syndrome.

The aim of the present study was to evaluate the salivary secretion rate and composition in a group of 16 children and young adults (6-27 years) with Papillon-Lefèvre Syndrome (PLS), and to compare the findings with a group (n = 16) of healthy controls. Unstimulated and stimulated whole saliva was collected at least 2 h after meals and the secretion rate determined. The stimulated saliva was assessed for buffer capacity, total protein, peroxidase and hexosamine, while the unstimulated samples were evaluated for total protein, lysozyme, thiocyanate, lactoferrin and salivary IgA. Both the unstimulated (p < 0.01) and stimulated (p < 0.05) saliva secretion rates were significantly lower among the PLS patients compared with the controls. Furthermore salivary buffer capacity was significantly (p < 0.01) lower in the PLS patients. The total protein content in saliva was comparatively high in the study group, while the concentrations of immunoglobulins and non-immunoglobulins were within normal ranges. When calculating the output of the assessed antimicrobial factors, the mean peroxidase level in stimulated whole saliva was found to be significantly (p < 0.01) lower in the PLS patients than in the healthy controls. In conclusion, the present study indicates an impaired water secretion and a somewhat altered saliva gland function in children and young adults with PLS.

Adolescent↗
PubMed1996

Systemic retinoid medication and periodontal health in patients with Papillon-Lefèvre syndrome.

Periodontal health in relation to systemic retinoid medication was evaluated retrospectively in patients with Papillon-Lefèvre Syndrome (PLS). The material consisted of 18 children/young adults ranging from 8 to 28 years of age, all with a confirmed diagnosis of PLS. 9 participants, comprising a medication group, had been on long-term (range 1.5-9 years) retinoid medication for their cutaneous lesions. The remaining 9 served as controls. Regardless of whether or not retinoid medication was received, every patient experienced an early and devastating periodontitis, with atypical edematous and erythematous gingiva, suppuration from deep gingival pockets and premature loss of teeth. No correlation could be found between the severity of skin involvement and the severity of periodontal involvement. An improvement with age could be seen for the cutaneous lesions but not for the periodontal condition. Systemic medication with retinoids had a favorable therapeutic effect on cutaneous lesions, and no severe complication/side effect could be seen after several years of continuous use. However, from the results of this study it can be concluded that, at least in a situation with poor compliance of daily oral home-care, no positive effect on the periodontal health in patients with PLS could be seen by the retinoid medication.

Adolescent↗
PubMed1996

Accuracy of dental hygienists in diagnosing dental decay.

During recent decades, the duties and care rendered by Swedish dental hygienists have continuously expanded, and since 1991 they are licensed to practice dental hygiene independently. The aim of the present study was to investigate the accuracy of dental hygienists in examining and recording dental caries in comparison with dentists performing identical examinations. The study included two parts: A) Registration of carious lesions from radiographs of 100 extracted teeth, where the correct diagnosis could be verified, and B) clinical examination and registration of carious lesions in 213 patients. No statistically significant differences could be found between the dental hygienists' and their control dentists' accuracy to diagnose and record dental decay, with the exception of the number of initial lesions (white spot lesions) registered clinically, where the dental hygienists recorded more buccal and lingual lesions. Irrespective of the group of examiners (dental hygienists or dentists), however, the inter-examiner variation was wide. The variation decreased with the size of the lesion and increased with the age of the patient. This study suggests that no patient with a restorative treatment need would have been neglected if the dental hygienists had performed the examination, and, possibly, a more accurate non-restorative treatment need would have been addressed.

Adolescent↗
PubMed1996

A longitudinal study of dental health in a group of Swedish teenagers/young adults from the age of 14 to 25.

87 participants were followed from the ages of 14 to 25. Data concerning dental caries, gingival status, pocket depth, subgingival calculus, loss of attachment, and regularity of dental care were recorded. During the 11-yr-study-period 16% of the participants did not develop any carious lesions at all, and the average increase in DMFS-value was 0.6 per year. At age 25, about 75% of the subjects had never experienced any manifest carious lesions in incisors or cuspids or on any buccal and lingual surfaces, and 30% had never needed any proximal restorations. Over the study period, gingival inflammation changed from being merely a result of poor oral hygiene to being an indication of initial periodontal disease, and at age 25, 11% showed evidence of loss of marginal bone. The Dental Health was better in females than in males. In general, this sex differences increased in age, and at the age of 19 it had become clinically significant. The good habit of regular dental care reinforced during these 19 years of life was continued by 91% at 25, and no difference could be seen between the care rendered by the Public Dental Health Care system and by Private General Practitioners.

Adolescent↗
PubMed1991

Oral sugar clearance in children compared with adults.

The aim of the present investigation was to study oral sugar clearance of various types of foodstuffs in children of different ages in comparison with adults. Thirty children and 20 adults were selected constituting five groups, each containing 10 individuals: 3-, 7-, 15-years-olds and adults, all with normal salivary secretion rate, and adults with low salivary secretion rate (dry mouth patients). Oral sugar clearance was studied using three glucose-containing products: solution, tablet and biscuit. Repeated saliva samples were collected every other minute, between 1 and 11 min after the intake, with a convenient method suitable for very young children. For that purpose, a small circular paper disc, absorbing approximately 20 microliters of saliva, was placed under the tongue for 10 s. The glucose concentration of the samples was then analyzed enzymatically. The results showed that, in children, the oral sugar clearance became faster with increasing age. The adults and the 15-year-olds had similar patterns of clearance, while the dry mouth patients had the slowest oral clearance of all groups. The 3- and 7-year-olds showed the greatest variation in oral clearance between the various foodstuffs; the solution had faster clearance than both the biscuit and the tablet. The main conclusion from this study is that young children (3- and 7-year-olds) have both slower salivary sugar clearance and larger variation in clearance among various foodstuffs than older children and adults.

Adolescent↗
PubMed1990

Periodontitis in the primary dentition associated with Actinobacillus actinomycetemcomitans infection and leukocyte dysfunction. A 3 1/2 year follow-up.

2 siblings, aged 5 years (girl) and 7 years (boy), with periodontitis in the primary dentition were studied. Actinobacillus actinomycetemcomitans was isolated from the gingival pockets of both children. The titers of IgG antibodies against A. actinomycetemcomitans were elevated, and the polymorphonuclear leukocytes had a decreased capacity to ingest IgG-coated latex particles. Other functions of the polymorphonuclear leukocytes were normal. After antibiotic therapy and for the 7-year-old boy, debridement of the gingival pockets A. actinomycetemcomitans was no longer detectable in the gingival pockets, and the phagocytic capacity of the polymorphonuclear leukocytes was normalized. After 2 1/2 years, A. actinomycetemcomitans was found again in the gingival pockets of the boy, and once more his polymorphonuclear leukocytes had a decreased capacity to ingest IgG-coated latex particles. The antibiotic therapy was repeated and 6 months later, the number of A. actinomycetemcomitans was very low and the phagocytic capacity of the polymorphonuclear leukocytes was back to normal. This case report suggests that A. actinomycetemcomitans may be involved in the etiology of periodontitis in the primary dentition, possibly by triggering a phagocytic dysfunction of polymorphonuclear leukocytes.

Actinobacillus Infections↗
PubMed1989

A retrospective radiographic study of alveolar bone loss in the primary dentition in patients with localized juvenile periodontitis.

Lately, it has been questioned whether localized juvenile periodontitis (LJP) is restricted to the permanent dentition, or if it sometimes might have a prepubertal onset, involving the primary dentition. To clarify this question, 17 patients with LJP, together with 17 non-LJP matched controls, were retrospectively examined for radiographic signs of alveolar bone destruction in their primary dentitions. All LJP subjects but one showed localized marginal bone loss, whereas no bone loss was observed among the controls. The results suggest that at least some cases of LJP start in the primary dentition prior to the involvement of the permanent teeth.

Adolescent↗
PubMed1989

Presence of mutans streptococci and various types of lactobacilli in interdental spaces related to development of proximal carious lesions.

During a 2-yr study period samples from saliva, the tongue, and 276 interdental spaces were obtained from 23 7-yr-old children in order to (a) relate the presence of lactobacilli in various oral sites to the occurrence of lactobacilli in saliva, and (b) relate the presence of mutans streptococci and various types of lactobacilli interdentally to the development of proximal carious lesions. The results showed an increased number of interdental samples containing lactobacilli with an increasing number of salivary lactobacilli. Furthermore, lactobacilli were never found interdentally without the presence of mutans streptocci, lactobacilli proved to be the more suitable microorganism for prediction of proximal carious lesions. Neither the number nor the differentiation into different species of interdental lactobacilli seemed to be of importance, but simply whether they were present. The presence of lactobacilli probably reflects a caries-inducing environment (etiologic microflora + fermentable carbohydrates), thus explaining their high predictive ability compared to their rather limited etiologic importance in the initiation of decay.

Child↗
PubMed1988

Prediction of behavior management problems in children.

The aim of the present investigation was to study non-dental and dental background variables with a view to estimating their influence on behavior management problems by means of a structured interview and analyzing their separate and combined predictive power. The material consisted of a case group, 101 children aged 3-16 yr, referred for management problems to clinics of specialized pedodontics, and a control group, individually matched with the cases as regards age, sex, residential area, number of tooth surfaces restored, and dentist. The children or their parents were interviewed concerning background variables. Logistic regression was used for the analyses. Three non-dental variables turned out to be statistically significant as predictors (P less than 0.05): problems on visiting a medical doctor, dental fear in the mother or father, and anxiety when meeting unfamiliar people. Management problems might be expected if one of these attributes is found. Four dental variables had significant predictive power: earlier problems on seeing a dentist, dislike of the dentist, not enough time to adjust to the dental situation, and fear of injection. However, none of these dental variables was found to have predictive power in 3-6-yr-olds, and none of them improved the predictive power of the three main non-dental variables.

Adolescent↗
PubMed1987

Direct ratings of acceptance of dental treatment in Swedish children.

The aim of the present study was to bring forward data of acceptance of dental treatment for 3-16-yr-old children in a population with good dental health and annual dental care, and to evaluate the influence on acceptance of age, sex, residential area, and previous experience and present need of dental treatment. The material consisted of 2773 children. Direct ratings of behavior were made at each of 10 different treatment steps passed during dental appointments. The majority of children needed no more than one dental visit and 79% showed positive acceptance at all steps of treatment passed during dental visits. Eight percent of all children sometimes reacted in such a way that treatment could not be carried out without restraint or undue delay. Dental fear was diagnosed in 3% of all children.

Adolescent↗
PubMed1986

A longitudinal study of dental health and treatment need in Swedish teenagers.

Ninety-seven teenagers were followed from the age of 14 1/2 to 19 yr. During that time they were given regular dental care by the Public Dental Service. Data concerning dental caries, gingival status, probing pocket depths, subgingival calculus, defective fillings, loss of attachment and additional preventive care were recorded. The prevalence and increment of caries were low and at 19 one-third of the subjects had still needed no proximal restorative care at all. However, in 26% of the 19-yr-olds subgingival calculus was diagnosed radiographically and during the study period gingival inflammation changed from being merely a result of poor oral hygiene to an indication of initial periodontal disease. There was a sex difference in dental health, which increased with age and was of clinical importance at 19. In spite of a good caries situation, most of the subjects were in need of individual care due to an initial periodontal problem. Furthermore, the change to a treatment strategy based on prevention requires regular check-ups, and an extension of intervals between dental examinations could not be justified in this study, especially as it seemed to be difficult for the regular dentist to predict future disease on a clinical basis.

Adolescent↗
PubMed1986

Salivary lactobacillus counts as a diagnostic and didactic tool in caries prevention.

The usefulness of salivary lactobacillus counts in regular dental care was investigated in 236 13 1/2-yr-old Swedish children for 2 1/2 yr. The average individual preventive care was at least as extensive as the restorative care and the dental health of these children must be considered good with a mean DFS-value of 6.8 at baseline. Nevertheless, it proved possible to reduce caries increment by more than 50%, simply by replacing one NaF-rinsing in school once every 6 months by a saliva sampling session together with subsequent presentation and information of an inoculated and incubated Dentocult dip-slide. The way of determining salivary lactobacillus counts in schoolchildren, as performed in this study, could easily be adopted as a routine part of general care. It proved to be useful for early diagnosis of caries and motivation to home care, and as a supplement to clinical examination it would be a valuable aid in the early selection of high-risk cases as well as identification of low-risk cases, who do not require extensive prevention.

Adolescent↗
PubMed1985

Presence of Lactobacillus casei in saliva from children and adults using a new medium.

The aim of this study was to devise a medium for cultivation of L. casei and to compare the presence of L. casei in saliva from children and adults. The new medium was produced by omitting the sugars from Rogosa SL agar medium and supplementing this medium with melezitose. Although all tested strains of lactobacilli grew on the new medium, the facultatively homofermentative lactobacilli, L. casei and L. plantarum, could be identified by a typical colonial morphology. L. casei was the most common species of oral lactobacilli in saliva from children and made up a significantly higher proportion of the salivary lactobacillus flora in children than in adults.

Adolescent↗
PubMed1984

Variation in human oral lactobacilli following a change in sugar intake.

For 19 wk oral lactobacilli was registered continuously in 10 dental hygienist students. During the study period these subjects were submitted to a change in between-meals consumption, rinsing with chlorhexidine and determination of sugar clearance, flow rate and buffer effect of saliva. An increase in the frequency of sugar consumption increased the number of lactobacilli in saliva, and in particular of Lactobacillus casei. However, in spite of an hourly intake of sugar between 7 a.m. and 9 p.m. every day for 4 wk, this increase of lactobacilli was small. The probable reason for this was the very high dental health consciousness of the test subjects, with a perfect oral hygiene and a strong wish to have a clean taste in the mouth. The sugars were too rapidly eliminated to create such an acid oral environment as favors the aciduric lactobacilli. A week of twice daily rinsing with chlorhexidine had no obvious effect on the number of lactobacilli in saliva.

Adult↗
PubMed1984

Management of dental behaviour problems. A 5-year follow-up.

The aim of the study was to evaluate the lasting results of treatment designed to increase cooperative behaviour in children with advanced anxiety or fear of the dental situation. The first 50 children referred in 1976 to the pedodontic clinic in Orebro, Sweden, on account of management problems, were chosen. Of these children 45 were able to participate in a follow-up study in 1982, comprising information from records and from questionnaires sent to the child/parent as well as to the referring dentist. In 1976 most of the children had not accepted dental treatment for several years and were in great need of dental care. Nevertheless, after systematic stepwise learning, based on the "tell-show-do" method, together with reinforcement, 36 children could be treated conventionally and another 5 after preoperative sedation. In 4 cases postponement was chosen. Of the total treatment time, 28 per cent was spent on managing behaviour problems. If all treatment, including injection, had been carried out with positive acceptance in 1976, as well as during the following 5 years, without the patient being fearful or having physical symptoms, the lasting result of managing behaviour problems was considered positive. These criteria were fulfilled in 78 per cent of the cases. Furthermore, the results indicate that the main reason for dental behaviour problems usually lies in the child's prior experience of the dental situation and that the present treatment model is effective in reducing dental fear and gives most children a lasting positive attitude to dental care and dental health.

Adolescent↗
PubMed1984

Salivary flow rate in children and adolescents.

This paper gives information on the flow rate of mixed whole saliva, stimulated by chewing, from the age at which the child can first co-operate in sampling adulthood. The salivary flow rate increased with age and boys had consistently higher rates than girls. As far as the flow rate is concerned the salivary glands seemed to be fully developed at the age of 15. When the flow rate was determined under standardized conditions, it was relatively stable, not only during daytime and from day to day but also over a longer period of time. Neither the time of day when the sample was taken nor the timing in relation to the last meal could be found to be of significant importance to the flow rate. Furthermore, repeated sampling did not affect the results as the children "learned" how to spit. In the great majority of cases a single determination, using the simple method employed in this study, must be considered fully adequate. However, at a very low flow rate repeated sampling reduces the risk of obtaining a misleading extreme value due to individual variation.

Adolescent↗