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Biomedical subjects

P Axelsson

Publications and source records attributed to P Axelsson.

At least 37 records · Page 2Linked to original sources

Effect of two preventive programs on oral health knowledge and habits among Brazilian schoolchildren.

The effect upon dental health knowledge and dental health behavior of a comprehensive and a less comprehensive preventive program was compared in a 3-yr follow up study. The comprehensive program included active participation of the students and parental involvement. The study group consisted of 186 Brazilian schoolchildren 13 yr of age at the start of the program. A reference group from another school of similar socioeconomic level was included in the analyses. The data were collected from questionnaires filled in by the children under surveillance after the completion of the program. Significant differences in knowledge as well as in reported behavior were observed. The children enrolled in the comprehensive program in general scored higher in dental health knowledge than did those in the less comprehensive program. However, the latter group of children seemed to have acquired more correct knowledge during the period than had the control and reference children. Similar results were obtained concerning reported dental health behavior.

Adolescent↗

The effect of a new oral hygiene training program on approximal caries in 12-15-year-old Brazilian children: results after three years.

This study evaluated the effects of a new oral hygiene training program on approximal caries in a population of 12-13-year-old Brazilian schoolchildren with a well-established habit of daily toothbrushing with a F dentifrice. Two hundred twenty-two children were randomly allocated into two test groups (I and II) and one control group (III). Group I subjects were trained to establish needs-related oral hygiene habits based on self-diagnosis and a new behavioral principle, the 'linking method', for establishment of habits. The first three visits (20 minutes each) were scheduled at two-day intervals. They were recalled for a monthly check-up during the first 4 months, and then every 3 months for reevaluation of the results based on self-diagnosis. Group II subjects were recalled at the same intervals for detailed oral hygiene instruction on how to clean every tooth surface using dental tape, toothbrush, and fluoride dentifrice. Group I developed significantly fewer (p < 0.001) new approximal manifest (dentin) caries lesions than groups II and III. The mean values (SEM) were 2.3 (0.29), 4.7 (0.59), and 5.3 (0.68), respectively. The conclusions from our study are: In a toothbrushing population using fluoride dentifrices and fluoridated drinking water, the oral hygiene training program with behavioral modification significantly reduced caries incidence on approximal surfaces. Frequent repetition of training in meticulous oral hygiene is almost redundant.

Adolescent↗

Long-term effect of two preventive programs on the incidence of plaque and gingivitis in adolescents.

The efficacy of two oral hygiene training programs on the control of plaque and the prevention of gingival inflammation in adolescents was evaluated during a 3-year period. A population of 227 Brazilian schoolchildren were divided into 3 groups. The first group received a comprehensive program based on individual needs and included information sessions pertaining to the etiology and prevention of dental diseases together with extensive training in self-diagnosis and oral hygiene. In addition, an information session was arranged for parents and teachers of these children. The second group received a less comprehensive program consisting of conventional oral hygiene training. The third group (control) received no preventive program. The programs were presented through frequent initial training sessions ensued by infrequent follow-up visits. During the experimental period, the two oral hygiene training programs involved 3.5 and 1.5 hours per child, respectively. The children were examined clinically at baseline and annually over the next 3 years to assess plaque and gingival bleeding and the data were analyzed by a multi-level variance component analysis. All children showed a perpetual improvement in their oral hygiene and gingival state during the course of the study. However, the improvements observed in the comprehensive group were significantly better than that of the control group. Results from the less comprehensive group were not significantly different from the control group. Longer exposure to the programs appeared to produce more improvement; children with higher plaque and gingivitis scores prior to the program showed less favorable results; girls exhibited better results than boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4 (2-7) years.

We report the outcome of 71 consecutive posterolateral lumbar fusions without spinal instrumentation. The indication for the operation was spondylolysis-olisthesis, degenerative disc disease/facet joint arthrosis, or pain after prior laminectomy. Concerning pain relief, 29/43 patients with spondylolysis-olisthesis were classified as good. The corresponding figures in the group with degenerative disc disease and/or facet joint arthrosis were 8/16 patients and in the group with pain post-laminectomy, 6/12 patients. No surgical complications were noted. In the total material 54 patients had a solid fusion, as defined by radiographic osseous trabecular bridging at all intended levels. One-level fusions tended to heal solidly in a higher frequency than two-level fusions. For the spondylolysis-olisthesis group, healed fusion correlated with a good clinical result. Such a correlation could not be verified for the other diagnostic groups. We conclude that non-instrumented posterolateral lumbar fusion is a valid method for treating low-grade spondylolysis-olisthesis, especially when the aim is to fuse a single level. Improved patient selection methods are required in fusion for degenerative disc disease and pain after laminectomy.

Adolescent↗

Lumbar orthosis with unilateral hip immobilization. Effect on intervertebral mobility determined by roentgen stereophotogrammetric analysis.

To determine the additional stabilizing effect of unilateral hip fixation on external lumbar supports, nine patients with a posterolateral lumbosacral fusion without internal fixation were examined by roentgen stereophotogrammetric analysis. The roentgen stereophotogrammetric analysis was performed with the patients in supine and erect positions 1 month after surgery, that is, before fusion consolidation. Each patient was examined without lumbar support and with a molded, rigid thoracolumbosacral orthosis with extension to one thigh, thus immobilizing one hip. The additional hip immobilization had no consistent or significant stabilizing effect on the sagittal, vertical, or transverse intervertebral translations in the lower lumbar spine. This study using roentgen stereophotogrammetric analysis gave no support for including hip immobilization when using lumbar orthoses after spinal fusion in patients adequately cooperating to minimize gross body motions.

Adult↗

How Swedish dental hygienists apply their training program in the field.

The purpose of this study was to evaluate how clinical practice by Swedish dental hygienists was related to type of dental delivery system, period of training, educational institution attended and patient category. Dental hygienists from 14 different dental hygiene schools were represented. Of these schools, 11 are still in operation. A specially designed questionnaire was posted to all dental hygienists in Sweden (n = 1857). A total of 1399 questionnaire (75.3%) were completed and returned, providing data on 15,546 dental appointments. 37.2% of the Swedish dental hygienists are presently working in private practices, 45.8% in the public dental health service and 6.2% in both. Of the patients treated by hygienists, 88.7% were adults: 99.5% in private practice and 78.4% in the public dental health service. 42.0% of all dental hygienists were trained in 1980-84. The mean treatment time per appointment in private practice was 49.7 min and 45 min in the public dental health service. Scaling, root-planning and removal of overhangs took 27 min per visit in private practice and 22 min in the public dental health service. However, there were no significant differences in methods in the two delivery systems with respect to examinations, self-care training, professional mechanical toothcleaning (PMTC), topical fluoride application, or salivary and oral microbiology tests. The adult patient categories were periodontal risk (45.1%), caries risk (9.1%) and hygiene (34.6%). In periodontal risk patients, scaling, root-planning and removal of overhangs took 28 min per appointment and 14 min in caries risk patients.

Adolescent↗

Integrated caries prevention: effect of a needs-related preventive program on dental caries in children. County of Värmland, Sweden: results after 12 years.

Twenty years ago the caries prevalence in Swedish children was among the highest in the world; within Sweden, it was highest in the County of Värmland. Ongoing clinical research projects were initiated to evaluate the separate and combined effects of preventive measures, and in 1978 a preventive program, based on caries risk assessment, was introduced for 3- to 19-year-olds in the county. The effects were monitored by a computerized epidemiological system. From 1979 to 1991, caries prevalence and incidence decreased by 75-90 and 75-85%, respectively. The percentage of caries-free 3-year-old children increased from 51 to 94%, and in 12-year-old children, the caries prevalence decreased from 6.5 to 1.0 DFS, the lowest in Sweden. The program is very cost-effective, and in 1990 the mean annual treatment time per child was the lowest in Sweden. Currently, new methods of caries risk prediction and integrated caries prevention are being developed, with special reference to cost-effectiveness.

Adolescent↗

Current role of pharmaceuticals in prevention of caries and periodontal disease.

Epidemiological studies, based on the tooth surface as a unit of reference, confirm a strong correlation between dental plaque and the initiation of dental caries and periodontal disease. Therefore, prevention of caries and periodontal disease must be based on plaque control. Dental plaque can be controlled both mechanically and chemically. Both methods can be achieved by self-care, or professionally by dentists and dental hygienists. Chemical antimicrobial products are used for non-specific plaque control, as well as against specific microbes associated with the aetiology of caries and periodontal disease. Most products are applied topically (mouthrinses, gels, dentifrices and varnishes). The use of fluoride is generally accepted specifically for caries prevention. It is evident that the caries preventive effects of fluorides are mainly post-eruptive due to fluoride in drinking water, milk, salt and tablets. Dentifrices are the major, most widespread commercial product for topical use, followed by mouthrinses, gels, prophy pastes and slow-release fluoride products such as varnishes and glass ionomers. Dentifrices, mouthrinses and gels containing both fluorides and antimicrobial agents are also available. Products, methods and programmes for all individuals and selected risk individuals are discussed.

Chlorhexidine↗

New ideas and advancing technology in prevention and non-surgical treatment of periodontal disease.

Analytical, oral epidemiological studies in adult 'toothbrushing' populations show that the highest prevalence of missing teeth is for molars and maxillary premolars ('key-risk' teeth). The highest prevalence of subgingival microflora, gingivitis (CPITN-1), plaque retentive factors, such as subgingival calculus and restoration overhangs (CPITN-2), and diseased pockets > 3 mm (CPITN-3-4) is found on the approximal surfaces of the same teeth ('key-risk' surfaces). Primary and secondary prevention, as well as treatment of periodontal disease should be focused on these 'key-risk' surfaces. One single, well-executed subgingival scaling and root-planning procedure in deep, diseased periodontal pockets, followed by oral hygiene training and professional mechanical tooth-cleaning (PMTC) at need-related intervals, will prevent further loss of periodontal attachment. However, if the root cementum is removed during instrumentation, and the post-treatment plaque control programme fails, microorganisms will recolonize and invade the rough exposed root dentine, resulting in recurrence of periodontitis and possibly, root caries and pulpitis. Some of these problems may be overcome by the application of new instruments and methods for self-care, PMTC, removal of overhangs, scaling and root-planing without removing 'non-diseased' cementum.

Dental Devices, Home Care↗

Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion. A roentgen stereophotogrammetric and radiographic analysis.

To determine the influence of the duration of postoperative lumbar immobilization with the aid of a rigid lumbar orthosis on the consolidation of posterolateral lumbosacral fusions, 22 patients with no previous osseous spinal surgery and with fusion without osteosynthesis due to spondylolysis-olisthesis Grade 1 to 2 or intervertebral disc or facet joint disorder were examined by roentgen stereophotogrammetric analysis in supine and erect positions and by conventional radiography for 1 year after surgery. In Series 1, patients (n = 11) were instructed to keep the trunk straight with the aid of a molded, rigid lumbar orthosis for 5 months after surgery; and in Series 2 (n = 11), the same instructions were given, but for 3 months. In Series 1, osseous fusion was seen on radiographs in eight patients. In these patients, the intervertebral translations between the fused vertebrae began to decrease 3-6 months after surgery, and within 1 year, the fusions became rigid, as defined by roentgen stereophotogrammetric analysis, or intervertebral translations of mostly less than 1 mm persisted. In three patients with poor fusion still seen on radiographs 1 year after surgery, no rigid fusion was obtained and intervertebral translations of up to 10 mm persisted. In Series 2, a similar roentgen stereophotogrammetric analysis pattern was noted in two patients with osseous fusion and in seven with poor fusion seen on radiographs. The fusion was radiographically doubtful in two patients. In these patients, the intervertebral translations decreased, but translations of 1.5 mm persisted 1 year after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of lumbar orthosis on intervertebral mobility. A roentgen stereophotogrammetric analysis.

To determine the stabilizing effect of external lumbar supports on the intervertebral mobility in the lower lumbar spine, seven patients with a posterolateral lumbosacral fusion without internal fixation were examined by roentgen stereophotogrammetric analysis in supine and erect positions 1 month after surgery, that is, after soft tissue healing but before fusion consolidation. Each patient was examined without lumbar support, with a molded, rigid orthosis and with a canvas corset with molded, plastic posterior support. Neither of the two types of lumbar support had any stabilizing effect on the sagittal, vertical, or transverse intervertebral translations. This study using roentgen stereophotogrammetric analysis confirms that lumbosacral orthosis has effect by restricting gross motions of the trunk rather than intervertebral mobility in the lumbar spine.

Adult↗

On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults.

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

Adult↗

Salivary Streptococcus mutans and caries prevalence in Brazilian schoolchildren.

The aim of the present study was to determine the levels of salivary Streptococcus mutans in Brazilian schoolchildren, and its possible correlation with caries prevalence. A positive correlation between different levels of S. mutans and caries prevalence was observed, individuals with high levels of S. mutans (greater than 100 colonies) had a DMFS significantly higher than those with low or no detectable S. mutans (0, 1-20, 21-40 colonies).

Adolescent↗

Efficacy of mouthrinses in inhibiting dental plaque and gingivitis in man.

The aim of the present trial was to determine the effect of different mouthwash preparations used as supplements to regular oral hygiene measures on dental plaque and gingivitis in humans. 96 volunteers were recruited for the study. Following a baseline examination, each subject was given a careful prophylaxis, following which the mouthrinse regimens were initiated. During the 6 weeks of trial, the subjects continued to exercise their regular non-supervised, self-performed plaque control measures. The 96 volunteers were assigned either to 1 or 3 different treatment groups or to a control group according to a randomized code. The members of the control group and the listerine group rinsed with 20 ml of the mouthrinse for 30 s, twice daily, while the members of the chlorhexidine groups (using either a 0.2% or a 0.1% solution) rinsed with 10 ml of the antiseptic solution for 60 s twice daily. Examinations regarding extrinsic stain and plaque were performed at baseline and after 3 and 6 weeks, while the conditions of the gingiva were examined at baseline and after 6 weeks. Extrinsic stain was evaluated using the Lobene index, plaque was assessed by the Turesky modification of Quigley-Hein index and the gingival condition was examined using the gingival index system of Loe & Silness. The results of the trial demonstrated that the 3 active mouthwash preparations used as supplements to regular tooth cleaning measures markedly improved both the oral hygiene status and the gingival conditions of the participating human volunteers, compared to the control rinse.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗