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Biomedical subjects

S Kvint

Publications and source records attributed to S Kvint.

At least 19 recordsLinked to original sources

Possible sites for cylinder implants in Swedish individuals aged 20-70 years. A comparative radiological inventory in 1983 and 1993.

UNLABELLED: The aim of this study was to evaluate the number of possible sites for cylinder implants in an epidemiological sample of adult individuals and to compare these results with those from a similar inventory performed 10 years earlier. This study, which comprised individuals 20-70 years old, is part of two larger epidemiological dental studies of individuals from the community of Jönköping, Sweden, performed in 1983 and 1993. Random samples of 579 and 575 individuals respectively were examined and classified according to the Eichner index. The radiographic examination included an orthopantomogram and a full-mouth intra-oral examination. Only existing spaces anterior to the second molars were considered as possible implant sites. Cylinder implants with a diameter of 3.75 mm and a length between 7 and 20 mm were plotted on the radiographs. RESULT: The most striking result from this study was the reduction by almost a half of the total number of possible implant sites between 1983 and 1993. A certain proportion of existing tooth gaps had been treated with conventional fixed prostheses, usually in small tooth gaps, and this tendency had increased between 1983 and 1993. The need for implants in the anterior frontal region was small but constant (less than 1%) in 1983 and 1993. In the future, implants will be a treatment option in young individuals, most likely in cases of trauma and tooth agenesis. Further it may be assumed that implant treatment in edentulous jaws will continue to increase in relative terms, i.e. the percentage of edentulous jaws that have been treated with implants will increase. In absolute terms, however, the frequency of the treatment will decrease because fewer individuals will be edentulous. Instead, the proportion of partially dentate subjects treated with implants will increase.

Adult↗

Adipose tissue distribution in postmenopausal women with adenomatous hyperplasia of the endometrium.

OBJECTIVE: To investigate body fat distribution in postmenopausal women with adenomatous and atypical hyperplasia of the endometrium. METHODS: A prospective population-based case control study was performed in a health care county in Sweden. General obesity, as reflected by body mass index (BMI), and adipose tissue distribution, expressed as waist to hip circumference ratio (WHR), were evaluated in a cohort of 367 postmenopausal women who underwent dilatation and curettage because of uterine bleeding. The study group consisted of 29 women with adenomatous or atypical hyperplasia of the endometrium. The controls consisted of 49 age-matched postmenopausal women randomly selected from the computerized population register of the same region. RESULTS: The frequency of endometrial adenomatous and atypical hyperplasia in postmenopausal women with bleeding was 7.2%. In the total population of postmenopausal women the incidence of these endometrial lesions was 44 per 100,000 per year. Body weight (P = 0.039), BMI (P = 0.007), and WHR (P = 0.022) were higher in postmenopausal women with endometrial adenomatous and atypical hyperplasia than in controls. In multivariate analysis only BMI remained statistically associated with adenomatous hyperplasia (P = 0.012). CONCLUSIONS: General obesity, but neither upper nor lower body fat distribution, was characteristic of postmenopausal women with adenomatous and atypical hyperplasia of the endometrium. Overall obesity is a risk factor for these endometrial precancerous lesions, as it is also claimed to be for endometrial cancer.

Adipose Tissue↗

A multidisciplinary approach to oral rehabilitation with osseointegrated implants in children and adolescents with multiple aplasia.

Oral rehabilitation of children with extensive aplasia includes a number of dental considerations as well as attention to psychological and physical development. The well-documented results of the use of implants in adults have raised the question of the use of implants and the timing of this procedure in children and adolescents with multiple aplasia. Eight-years' experience of a multidisciplinary approach to oral rehabilitation of children with extensive aplasia is described. Special emphasis is placed on early diagnosis, careful therapy planning, and co-ordination and timing of different parts of the therapy. The specific considerations from the point of view of paediatric dentists, orthodontists, oral surgeons, and prosthodontists are presented. A system for integrating all these aspects and knowledge will be a guarantee for high professional standards and a successful outcome. To exemplify the multidisciplinary approach, three treated cases are presented.

Adolescent↗

Orthodontic pre-treatment prior to autotransplantation of palatally impacted maxillary canines: case reports on a new approach.

Impacted maxillary canines in oblique horizontal positions may make orthodontic appliance treatment hazardous or impossible. Autotransplantation may be considered but the removal of the canine is often difficult and since atraumatic removal of the transplant is essential, autotransplantation is then impossible. A new possibility is orthodontic pre-treatment with distal and vertical traction of the impacted maxillary canine to bring the maxillary canine to a more favourable position and facilitate surgical removal and autotransplantation. Eight canines were surgically exposed and pre-treated prior to autotransplantation. Of 21 autotransplantations of maxillary canines, 20 were successful, among them all eight pre-treated cases. The orthodontic and surgical technique is described and illustrated in two case reports.

Adolescent↗

Histopathological findings in women with postmenopausal bleeding.

OBJECTIVE: To investigate endometrial histopathology in a geographically defined population of women presenting with postmenopausal bleeding. DESIGN: Prospective study with collection of data during an 18-month period. SETTING: The health care county of Skaraborg, Sweden. SUBJECTS: Dilatation and curettage using general anaesthesia was performed on 457 postmenopausal women suffering from uterine bleeding. Women using hormone replacement therapy for climacteric complaints were not included in the investigation. MAIN OUTCOME MEASURES: The frequency of bleeding was correlated to endometrial histopathology, and in relevant cases to pathological conditions in cervix and ovaries in a defined population of postmenopausal women. RESULTS: The incidence of postmenopausal bleeding decreased with increasing age while the probability of cancer as the underlying cause increased. The peak incidence of endometrial carcinoma was found in women between 65 and 69 years of age. Endometrial histopathology showed: atrophy (50%); proliferation (4%); secretion (1%); polyps (9%); different degrees of hyperplasia (10%); adenocarcinoma (8%); not representative (14%); other disorders (3%). In six women a squamous carcinoma of the cervix was found, and eight proved to have ovarian tumours. CONCLUSIONS: The histopathological finding of endometrial adenomatous hyperplasia or cancer in about 15% of the postmenopausal women with bleeding justifies a thorough examination. The probability of cancer as the underlying cause increased with age. The endometrium was atrophic in 50%. Eight women had ovarian tumours. These findings may imply that transvaginal ultrasound examination should be included in the evaluation of postmenopausal bleeding as occasionally endometrial biopsies of atrophic endometrium could be avoided and ovarian pathology detected.

Aged↗

Laparoscopic prostaglandin injection in ectopic pregnancy: success rates according to endocrine activity.

OBJECTIVE: To investigate the clinical performance of local prostaglandin treatment of ectopic pregnancies (EPs) in relation to their biologic activity as determined by preoperative serum hCG levels. DESIGN: Prospective study over a 2-year period of 108 patients with 127 tubal pregnancies. SETTING: A department of obstetrics and gynecology in a central county hospital. PATIENTS: One hundred eight patients who presented with a clinical diagnosis of EP. INTERVENTIONS: Patients with EP were treated with laparoscopy-guided injection of prostaglandin F2 alpha in the surrounding tubal wall and the corpus luteum-bearing ovary. All members of the staff participated. MAIN OUTCOME MEASURES: Success rate, hospitalization cost, and convalescence period. RESULTS: Seven laparotomies (7.5%) were performed postoperatively due to increasing hCG levels or ruptures with circulatory reactions. All except one had an initial (preoperative) hCG value > 1,000 mIU/mL (conversion factor to SI unit, 1.00). The mean hospitalization period was 2.7 days and 90% of the medically treated patients returned home on the first postoperative day. The mean convalescence period was 18 days. CONCLUSION: The procedure is simple and carries an acceptable success rate in cases with hCG levels < 1,000 mIU/mL. The approach demands minimal technical resources and it may reduce health care costs substantially.

Abortion, Induced↗

A radiological inventory of possible sites for cylinder implants in edentulous regions of the jaws. An epidemiological study.

Implant treatment is nowadays requested as an alternative mode of treatment for both total and partial edentulousness. The purpose of the study was to assess the maximum number of possible implant sites in a group of adults. The study material comprised 579 persons divided into the age-groups 20, 30, 40, 50, 60 and 70 years. Based on radiological examination, the subjects were grouped according to Eichner's index. They comprised both dentate and edentulous individuals. Templates, marked with cylinder implants of different dimensions, were placed over edentulous regions. The possible number of cylinder-shaped endosseous implants that could be placed anterior to the second molar was assessed in relation to bone availability and anatomical structures. Gaps treated with fixed bridges were not registered. Altogether 1,048 presumptive fixture sites were marked, of which 78% in the age-groups 60 and 70 years. Eichner groups C 1-3, which comprised the edentulous persons, constituted 12% of the subjects and accounted for 57% of the possible number of implants. All edentulous mandibles and 70% of the edentulous maxillae were judged suitable for placement of implants. On average 5.5 and 5.8 sites were marked per edentulous maxilla and mandible, respectively. Groups B1-4 comprised 21% of the subjects and accounted for 37% of the implants. It is discussed that implant treatment in totally edentulous jaws will increase in relative terms in Sweden as in other Scandinavian countries, i.e. the percentage of edentulous jaws treated with implants will increase. In absolute terms, however, the treatment will probably decrease owing to a marked decrease in the number of edentulous individuals. The future need for implant treatment in the residual dentition will probably increase but it is difficult to predict by how much.

Adult↗

Periodontal healing after impacted lower third molar surgery in adolescents and adults. A prospective study.

The effects of impacted lower 3rd molar surgery on periodontal tissues in the adjacent 2nd molar area have been investigated in a prospective study comprising 176 cases from 2 age groups: less than or equal to 20 years (n = 93) and greater than or equal to 30 years (n = 83), respectively. The preoperative and 1-year postoperative examinations included both clinical and radiographic variables. All patients were subjected to a standardized surgical procedure and optimal plaque control pre-, intra- and postoperatively. Early removal of impacted lower 3rd molars with large angulation and close positional relationship to the adjacent 2nd molar proved to have a beneficial effect on periodontal health.

Adolescent↗

Osseointegrated implants in the oral habilitation of a boy with ectodermal dysplasia: a case report.

The most characteristic oral feature in ectodermal dysplasia is hypodontia. Children and adolescents suffering from ectodermal dysplasia often need extensive and complicated prosthetic treatment. The development of techniques for osseointegrated implants offers new possibilities for the oral habilitation of these children. This paper describes the oral habilitation of a boy with severe ectodermal dysplasia and where Brånemark osseointegrated implants have been used as part of the treatment. The patient was seen at the dental department at the age of 1.5 years. Two conically-shaped upper incisors were at that time the only teeth that had erupted. The treatment was planned in a multidisciplinary odontological group involving paediatric dentistry, orthodontics, prosthodontics, oral surgery and maxillofacial radiology. At the age of 3 years it was verified that the boy had four primary teeth (53, 51, 61, 63) and four permanent teeth (16, 11, 21, 26). There were no teeth in the lower jaw. The alveolar ridges in the edentulous areas were low or missing. During the period 3-6 years of age the boy used an upper partial denture adapted to allow the mesial drift of the 16 and 26 teeth. At the age of 6 years, two Brånemark implants were inserted in the lower front-cuspid region. A specially designed overdenture for the lower jaw was constructed. The overdenture was retained in contact with the male attachments by two cuffs of heat-polymerized resilient silicone. Over the next 4 years the dentures were modified due to the eruption of permanent teeth and growth. However, only minor corrections were necessary concerning the retention system of the lower denture. The implants are well osseointegrated and stable and allow the boy to use a lower denture without any complications.

Anodontia↗

The effect of an airbrasive instrument on soft and hard tissues around osseointegrated implants. A case report.

A 40-year-old woman with natural teeth in the upper jaw and a complete lower denture was treated with six osseointegrated implants connected to a fixed bridge. On a recall visit 6 months posttreatment an air powder abrasive devise Prophy-Jet had been used to remove calculus and debris from the titanium abutments by the referring dentist. This resulted in an acute clinical reaction characterized by pain and submucosal emphysema. Furthermore, radiographs revealed break down of the marginal bone surrounding the fixtures. The treatment and follow-up period became long. These observations suggest that the use of air powder abrasive instruments is not the treatment of choice in the maintenance care of osseointegrated titanium implants.

Adult↗

Immunohistochemical studies of the neurochemical markers, CGRP, enkephalin, galanin, gamma-MSH, NPY, PHI, proctolin, PTH, somatostatin, SP, VIP, tyrosine hydroxylase and neurofilament in nerves and cells of the human attached gingiva.

Punch biopsies were obtained from the buccal gingiva of the lower third molars. Thin nerve fibres, immunoreactive for calcitonin gene-related peptide (CGRP) or substance P (SP), with possible sensory function, were found in the propria often close to the epithelium, sometimes even penetrating into the basal layers. gamma-Melanocyte stimulating hormone (gamma-MSH)-like immunoreactivity was found in sparsely distributed single cells (except in one specimen containing a dense infiltration), resembling neutrophilic granulocytes of the propria. gamma-MSH was present in several single smooth axons and in thick axon bundles of the propria. Surrounding the blood vessels, neuropeptide Y (NPY), tyrosine hydroxylase (TH), vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine amide (PHI) immunoreactive nerve fibres were observed. NPY and TH-positive fibres probably represent sympathetic nerve terminals and VIP/PHI-immunoreactive ones may have a parasympathetic function. Papillae of the propria contained VIP-positive fibres not obviously related to blood vessels. The distribution in papillae of PHI-like immunoreactivity was similar but the PHI-positive reaction was also present in a few cells of the propria, especially near blood vessels. Somatostatin (SOM)-positive reaction occurred in a few dendritic-type cells near or in the epithelium and single nerve fibres close to the epithelium. Several thick axon bundles of the propria contained neurofilament (NF)-immunoreactive material. Some thin NF-fibres were found in the papillae and some seemed to penetrate into the epithelium. No galanin, methionine-enkephalin, parathyroid hormone or proctolin immunoreactive material was found. The rather rich content of several neuropeptides in human attached gingiva, as well as other neurochemical markers, is probably associated with sensory and autonomic functions.

Adult↗

Congenital absence of vagina and uterus.

Agenesia of the Müllerian system is a congenital syndrome seldom seen in siblings. This report concerns two sisters with the syndrome. In one of them, the vagina was successfully reconstructed, and the other is awaiting the same operation.

Abnormalities, Multiple↗

Presurgical planning for osseointegrated implants in the maxilla. A tomographic evaluation of available alveolar bone and morphological relations in the maxilla.

A clinical tomographic method of defining and demonstrating the hard and soft tissue morphology of those parts of the maxilla which are intended for osseointegrated implants is described. This preoperative examination is an useful aid in the choice and planning of the treatment as such, and in the decision concerning the calibre and position of the implants. Hence, it facilitates the surgical procedure.

Alveolar Process↗