Biomedical subjects

S Palmqvist

Publications and source records attributed to S Palmqvist.

At least 19 recordsLinked to original sources

PubMed2001

Changes in dental conditions during a decade in a middle-aged and older Swedish population.

A questionnaire measuring dental conditions was sent to 2708 individuals aged 55 79 years in Orebro County, who about 10 years earlier had been randomly selected for a similar study. The response rate was 68% (1848 individuals). Of those, 1665 had participated also in the 1989 study. The objectives were to study changes in dental conditions having occurred during a decade and to evaluate whether impairment in dental conditions among the participants had resulted in prosthodontic treatments. Only small changes in dental conditions were registered among those who participated both in 1989 and in 1999. Loss of a single tooth was the most frequently reported change. Ten per cent fewer reported that they had all teeth remaining in 1999 compared with conditions in 1989. The number of subjects wearing removable dentures increased only slightly. Although the reported changes in dental conditions were small, there had been a need for prosthodontic treatment in many of the subjects. Ten percent of the subjects reported that they had received FPD treatment during the past 10 years. To conclude, the present study showed that only small changes in dental conditions had occurred among the participants during a decade. Nevertheless, a substantial increase in the prevalence of prosthodontic appliances, especially of fixed restorations, was noted.

Aged↗

PubMed2001

Influence of dental care systems on dental status. A comparison between two countries with different systems but similar living standards.

OBJECTIVE: To evaluate the influence of two different dental care systems on dental status, taking into account relevant socio-economic factors. BASIC RESEARCH DESIGN: Questionnaire studies on randomly sampled subjects in Denmark and Sweden using questionnaire forms as identical as possible with regard to the different languages. SETTING: The studies were performed late in 1998 in both countries. PARTICIPANTS: Questionnaires were sent to 1,175 subjects aged 45-69 years in Denmark (response rate 73%) and to 1,001 subjects aged 55-79 years in Sweden (response rate 67%). MAIN OUTCOME MEASURES: Questions about dental status and about socioeconomic factors and attitudes toward dental care were included. In logistic regression models, various dichotomies of dental conditions were used as dependent variables. State (Denmark vs. Sweden) was used as an independent variable together with socioeconomic factors and attitudes. RESULTS: There were great differences between the countries in dental status. In the regression model with 'wearing removable denture(s)' as the dependent variable, state was the strongest predictor with an OR of above 4.1 for Denmark compared to Sweden. much stronger than variables such as age, income, education and residence. CONCLUSION: The results indicate that the Swedish dental care system has been superior to the Danish one regarding dental status in middle aged and older populations in these two countries.

Age Factors↗

PubMed2001

An 8-year follow-up of removable partial denture treatment performed by the Public Dental Health Service in a Swedish county.

The aim of the present study was to evaluate clasp-retained removable partial dentures (RPDs) made in the Public Dental Health Service (PDHS) in Orebro County in 1989. Records from all 25 PDHS clinics concerning RPDs from 1989 were collected after eight years and available information was registered. The entire material consisted of 447 RPDs (both attachment-retained and clasp-retained RPDs) in 387 patients. Of the 316 clasp-retained RPDs that were traceable, 208 were followed from 1989 to 1997. In most instances, information on diagnoses, alternative treatments and design of the RPDs was lacking. One hundred and thirty-two (42%) of the 316 clasp-retained RPDs were judged to still be in use in 1997 while 75 were not in use. The main reason for ceased use was dislike by the patient. There were 108 clasp-retained RPDs that were not possible to follow from 1989 to 1997 because there were no notes regarding follow-ups in the records. The most common technical complications noted in the records during the observation period were clasp fractures and loosened artificial teeth.

Dental Clasps↗

PubMed2000

Dentist-related factors influencing the amount of prosthodontic treatment provided.

OBJECTIVES: To evaluate, using multivariate methods, the associations between indicators of the amount of prosthodontic treatment and dentist-related factors. METHODS: Questionnaires were sent to a random sample of 2,059 general dentists, response rate was 76%. Two indicators of prosthodontic activity were used as dependent variables: 1) reported weekly working hours used for prosthodontics and 2) reported numbers of produced single crowns, fixed partial dentures, and removable dentures. Independent variables were 'social and demographic attributes', 'job situation' and 'attitudes of dentists'. Multiple regression analysis was used in models with continuous dependent variables and logistic regression analysis for categorical dependent variables. RESULTS: 'Weekly working hours used for dental care of adults' showed a strong association in all models with the dependent variable 'weekly working hours used for prosthodontics'. Male dentists provided more prosthodontic services than female dentists, even if reporting less time used for prosthodontics. Private practitioners produced more fixed prosthodontics than dentists employed in the public dental health service. Dentists in the public dental health service reported a higher production of removable dentures than private practitioners. CONCLUSION: The results indicate that factors, besides those in the rational clinical model for decision-making, e.g. gender and delivery system, play a role in the provision of prosthodontic services.

Adult↗

PubMed2000

Dental conditions in middle-aged and older people in Denmark and Sweden: a comparative study of the influence of socioeconomic and attitudinal factors.

In 1998-99 two parallel questionnaire studies were performed in Denmark and Sweden. In Denmark the age group was 45-69 years and in Sweden 55-79 years. One aim was to study the influence of socioeconomic and attitudinal factors on dental status in the two countries. For the comparable age groups 55-69 years there was a striking difference in dental conditions between the countries. In Sweden, 72% had either all teeth remaining, missing teeth replaced by fixed prosthodontics, or only one or two single missing teeth not replaced. The corresponding figure for Denmark was 44%. Among Danes, 34% were wearing removable denture(s) or were edentulous in one jaw or both jaws, compared with 15%, among Swedes. In logistic regression models, higher income and longer education were significantly associated with the best dental status categories in Denmark but not in Sweden. In the model with wearing removable denture(s) as the dependent variable, lower income and lower education level showed a significant influence for the Danes. In Sweden, lower income showed a significant influence but education level was insignificant. In both Denmark and Sweden, a positive attitude toward the importance of dental appearance was associated with an increased risk of wearing removable denture(s).

Aged↗

PubMed2000

Social equality and dental conditions--a study of an adult population in Southern Sweden.

This study aimed to: describe dental conditions--focusing on prosthodontic variables--in relation to social conditions in the late 1990s in an adult population of Southern Sweden, evaluate if a change could be traced in the pattern of socioeconomic influences on dental conditions, and study if various attitudes toward dental care were associated with social as well as dental conditions. The study was based on questionnaire responses. Significant differences in dental conditions and denture prevalence were found for age and education. To a majority of the sample it was very important to have own teeth and/or fixed restorations and the opportunity to attend regular dental care. The cost for dental care was very important for 52% of the sample especially for men, those with low education, and those wearing removable denture. Need for dental care that could not be provided for because of the costs was experienced by 9%. Eighteen percent stated that they once or more had refrained from dental care because of the cost. Those with removable dentures and low education dominated. Besides socioeconomic differences in dental conditions, there were sociodental differences in attitudes concerning the importance of costs, self-estimated needs, and cost-barriers for dental care.

Adult↗

PubMed1999

Congruence between self-reported and actually provided prosthodontic services among Swedish dentists.

The purpose of this study, comprising two parts, was to investigate the congruence between answers given by general dentists in questionnaires concerning prosthodontic services and the recorded information on the services actually performed by each dentist. In Part I it is investigated whether questionnaire reports of weekly working hours devoted to prosthodontics can be used as indicators of actual prosthodontic production. Part II deals with the dentists' self-reported numbers of single crowns, fixed partial dentures (FPDs), and removable dentures. These reported services are compared with the services actually provided. Part I: A regression analysis indicates a lacking precision for the individual dentist, indicated by a relatively low explained variance (R2 = 0.20). However, a highly significant association is seen between the two production measures (P = 0.000). Part II: The congruence between stated and actually provided services is higher for single crowns and removable dentures than for FPDs. Bivariate regression models are statistically significant for all three services. In Part II, the reported weekly working hours used for prosthodontics covaries significantly with prosthodontic production, but the association is not as strong as in Part I. Although the precision in both Part I and Part II is low for the individual dentist, the questionnaire measure is found to be useful as an indicator in a population of dentists. It is concluded that the questionnaire data can be used as reasonably valid expressions of prosthodontic activity in population-oriented analyses among general dentists.

Crowns↗

PubMed1998

A method for communication analysis in prosthodontics.

Particularly in prosthodontics, in which the issues of esthetic preferences and possibilities are abundant, improved knowledge about dentist patient communication during clinical encounters is important. Because previous studies on communication used different methods and patient materials, the results are difficult to evaluate. There is, therefore, a need for methodologic development. One method that makes it possible to quantitatively describe different interaction behaviors during clinical encounters is the Roter Method of Interaction Process Analysis (RIAS). Since the method was developed in the USA for use in the medical context, a translation of the method into Swedish and a modification of the categories for use in prosthodontics were necessary. The revised manual was used to code 10 audio recordings of dentist patient encounters at a specialist clinic for prosthodontics. No major alterations of the RIAS manual were made during the translation and modification. The study shows that it is possible to distinguish patterns of communication in audio-recorded dentist patient encounters. The method also made the identification of different interaction profiles possible. These profiles distinguished well among the audio-recorded encounters. The coding procedures were tested for intra-rater reliability and found to be 97% for utterance classification and lambda = 0.76 for categorization definition. It was concluded that the revised RIAS method is applicable in communication studies in prosthodontics.

Communication↗

PubMed1998

A multilevel analysis of factors affecting the longevity of fixed partial dentures, retainers and abutments.

There is a methodological problem in analysis of data belonging to different hierarchical levels, e.g. patient, arch, and tooth. A method for multilevel modelling (MLM) that resolves this problem is available. This method which is presented in this article, was used to reanalyse previously published long-term treatment results concerning the longevity of fixed partial dentures, retainers and abutments. The main results were consistent, indicating that no great faults were committed when using the conventional logistic regression method. There were, however, differences when calculating the combined risks for various situations. The conventional method was found to over- and underestimate probabilities of survival in different cases, compared to the MLM method. Especially when the most negative factors were combined, the conventional method had a tendency to underestimate the risk. For example, if an abutment had the combination 'endodontically treated'; 'FPD placed by 'another dentist''; 'distal abutment'; and 'marginal bone loss > 50%'; the probability of the tooth remaining after 18-23 years was only 20% according to the MLM method but 35% according to the conventional method. It was concluded that MLM is the method of choice for many situations in dental research where data belonging to different levels are to be analysed.

Dental Abutments↗

PubMed1997

Practice profile differences among Swedish dentists. A questionnaire study with special reference to prosthodontics.

A questionnaire measuring differences in prosthodontic practice profiles was sent to 2100 Swedish dentists working as general practitioners. The response rate was 76%. Among the responders, 58% were men and 42% women. Fifty per cent were private practitioners, the other 50% being publicly employed. The practice profile variables showed a great variation, and several of the distributions differed with regard to sex and dental care system. The working hours per week the time spent on prosthodontics were on average higher for men than for women. Private practitioners more frequently worked in large communities and cities than did dentists working in the Public Dental Health Service. Practically all (98%) of the private practitioners used more than 75% of their clinical time on treating adults, compared with less than half of the dentists in the Public Dental Health Service. Male dentists reported higher percentage figures with regard to clinical time used for dental care of adults and for prosthodontic services than did female dentists. The figures for fixed prosthodontic service rates varied in the same manner. Fixed prosthodontic services were much more common in private practice than in the Public Dental Health Service, in which more removable dentures were made. Even though private practitioners used more time for prosthodontic services, they referred fewer patients to specialists in prosthodontics and consulted a specialist less often than did the dentists in the Public Dental Health Service.

Adult↗

PubMed1996

Long-term changes in marginal and periapical periodontal conditions in patients with fixed prostheses: a radiographic study.

Patients treated at a prosthodontic department during the years 1968-73 with fixed restorations (at least five units) were followed up in 1991-92. The aim of the present study was to compare marginal and periapical periodontal conditions on radiographs from 1968-73 and 1991-92 and relate the changes to the results of the prosthodontic treatment. In the group in which the restorations remained unchanged, 90% of the abutments that were not root filled and showed no periapical radiolucency when the restorations were placed, were still not root filled and showed no periapical radiolucency at the follow-up examination. The corresponding figure for the group in which the restorations had been replaced was only 69%. The changes in marginal bone levels also differed between the groups. In the group with remaining restorations, 66% of the surfaces were given the same score on a five-point scale both in 1968-73 and in 1991-92. In the other group, only 54% were scored the same on both occasions. Thus, unfavourable changes in both periapical and marginal periodontal conditions were associated with poorer results for the fixed restorations.

Adult↗

PubMed1996

Imaging of dental implants in severely resorbed maxillae using detailed narrow-beam radiography. A methodological study.

OBJECTIVE: To evaluate the accuracy of the detailed narrow-beam (DNB) technique with the Scanora multimodal X-ray unit for the assessment of dental implants in severely resorbed maxillae as an alternative to conventional intra-oral radiography. METHODS: The DNB technique was used in 15 consecutive patients with maxillary overdentures supported by implants in the canine regions. Both conventional intra-oral radiographs and DNB radiographs were also obtained for a further 15 consecutive patients with maxillary fixed prostheses on implants in the canine region. The marginal bone height was scored in relation to the threads on the implants. RESULTS: Intra-observer agreement was 95%. There was an 84% agreement between the two radiographic methods: the difference was at most one thread and was not significant (p = 0.43). CONCLUSIONS: The DNB technique is an accurate alternative when conventional intra-oral techniques cannot be used properly.

Alveolar Bone Loss↗

PubMed1996

A questionnaire instrument to assess clinical decision-making in prosthodontics among general practitioners.

There are great variations in dentists' choice of treatment. The aim of this study was to evaluate a Patient Paper Case (PPC) technique to investigate such variation, adjusted for prosthodontics. The questionnaire was sent to all 131 general practitioners (GP) in the Public Dental Service in Orebro County and to all 100 GPs in private practice in Skaraborg County, Sweden, with 81% responding. There were three PPC questions, concerning 1) crown therapy or amalgam/composite filling, 2) fixed or removable partial denture, 3) fixed partial denture or single implant restoration. Respondents were asked to assess 13 or 14 items concerning the patient, dental conditions, and own skills. There was great variation in responses. In factor analysis four factors were found to capture between 54% and 60% of the variance of the items. They were interpreted as a time factor, a patient subjective factor, a clinical factor, and finally, for the PPC 1 and 2, a general health factor. The Swedish insurance regulations of single implant therapy, mandatory caries/filling-free, and vital adjacent teeth were reflected in the factor solution of PPC 3. It is concluded that the PPC method is feasible and useful in studies of clinical decision-making in prosthodontics.

Decision Making↗

PubMed1996

Attitudes towards financing of dental care in a Swedish population.

The aim of the present study was to describe attitudes towards financing of dental care and to investigate the importance of different background factors for these attitudes. A questionnaire was sent to a random sample of 3000 persons aged 45-69 years, living in Orebo County, Sweden, with 79.4% response. In the questionnaire the respondents indicated their agreement with four statements on issues concerning financing of dental care, using visual analogue scales. After the answers had been dichotomized, 45% agreed that "all dental care should be free of charge', 32% agreed that "all dental care should be provided by the county', 46% agreed that "it is more important to use resources on heart transplants than on dental care', and 43% agreed that "no public reimbursement should be given to cosmetic dental care'. The attitudes were associated with the following background factors: gender, age, marital status, place of residence, education, socioeconomic status, dental care system, dentist of choice, time since last dentist contact, and attitudes toward dental appearance and dental function. Different background factors were associated with each of the four different attitudes, and only educational level seemed to covary with all four attitudes. It is concluded that attitudes towards financing of dental care varied considerably within this population and that the different attitudes could be related to different background factors.

Aged↗

PubMed1995

Quality of intraoral radiographs used for prosthodontic treatment planning by general dentists in the public dental health service.

The image quality of intraoral radiographs used by general public health dentists in prosthodontic treatment planning was evaluated on 763 radiographs from 72 consecutive cases. It was found that 349 (45.7%) radiographs were without any type error and that 414 radiographs had a total of 577 errors. The most common errors were projection and film density errors. The number of submitted radiographs ranged from 2 to 22. Three prosthodontists evaluated if the radiographs gave "satisfactory" or "not satisfactory" information for approval or not of the proposed treatment. Of the 72 cases did 34 (47%) not meet the criteria for acceptance. For the cases where the prosthodontists found the radiographic documentation "satisfactory", the mean number of periapical radiographs was 10.8, while for cases found "not satisfactory" the mean number was 7.1. This difference was found to be statistically significant (p < 0.01). It was shown that nearly every seventh tooth planned to be used as an abutment was radiographically not properly documented. The poor radiographic quality found in this study and in other similar studies should be taken into serious consideration, especially as prosthodontic treatment accounts for a substantial part of the total costs for dental insurance in Sweden.

Dental Abutments↗

PubMed1994

Multivariate analyses of factors influencing the longevity of fixed partial dentures, retainers, and abutments.

In logistic regression models, variables were studied for possible influence on the longevity of fixed partial dentures, retainers, and abutments. The type of dental material was the most critical variable for change or removal of fixed partial dentures. Cantilever extension indicated no substantial increased risk of change or removal for the fixed partial dentures. The risk of removal for an abutment was influenced by the following variables: endodontic treatment, distal terminal position, placement in the mandible, and advanced marginal bone loss. Several variables were stronger multivariately than bivariately and this indicated that a combination of risk factors may be the most detrimental for the longevity of the restorations.

Adult↗

PubMed1994

Effects of early placement of a single tooth implant. A case report.

A single tooth implant was placed in a boy aged 12 years and 3 months. The case has been followed for more than 4.5 years. The fixture did not move together with the adjacent teeth as the maxillary growth went on. There was no "loss" of marginal bone on the side of one adjacent tooth where the distance between implant and tooth was appropriate. But a "loss" of marginal bone (measured from the cemento-enamel junction) was noted on the other adjacent tooth where the fixture had been placed too close to the tooth.

Age Factors↗

PubMed1994

Image quality of intraoral radiographs used by general practitioners in prosthodontic treatment planning.

A number of studies have shown a low standard of radiographic image quality in general dental practices. Image quality was evaluated on 1094 radiographs from 100 consecutive cases submitted to a dental insurance office for approval of planned prosthodontic treatment. It was found that only 404 radiographs were without any type of error and that 690 radiographs had a total of 959 errors. The most common errors were projection and film density errors. The number of submitted radiographs ranged from one to 40. Nearly every fourth tooth proposed for treatment was not properly documented. The results also showed that 43 of 100 cases did not meet the criteria for acceptance for assessment of the proposed prosthodontic treatment. This means that they were incompletely documented radiographically so that the treatment plan could not be evaluated. This study suggests that new or additional radiographic documentation ought to be requested frequently before approval of proposed treatment plans.

Denture, Partial, Fixed↗