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Restoring endodontically treated teeth: a survey of current opinions among board-certified prosthodontists and general dental practitioners in Sweden.

PURPOSE: The main aim was to investigate the current opinions among general dental practitioners and board-certified prosthodontists in Sweden on how to restore root-filled teeth. MATERIALS AND METHODS: A questionnaire containing 31 multiple-choice questions was mailed to 892 general practitioners and 150 board-certified prosthodontists in Sweden. The questions asked for information on when the clinicians used posts in endodontically treated teeth and what kind of clinical procedure they used. They were also asked if they believed that a post strengthened a root-filled tooth. RESULTS: Sixty percent of the general practitioners and 67% of the prosthodontists returned the questionnaire. Twenty-nine percent of the responding general practitioners and 17% of the prosthodontists were of the opinion that a post reinforces a root-filled tooth. Only a few clinicians used posts "always" or "most of the time" when restoring endodontically treated teeth with fillings, while the vast majority used posts when restoring such teeth with crowns or fixed partial dentures. In both groups of dentists, cast posts were most commonly used. Despite the present knowledge that parallel-sided posts have a significantly higher success rate than tapered cast posts, only a minority of Swedish dentists use parallel-sided posts. CONCLUSION: In contrast to the results of several current studies, a high proportion of both general practitioners and prosthodontists believe that a post reinforces an endodontically treated tooth. This is one probable explanation for the almost ubiquitous application of posts when teeth are restored with crowns or fixed partial dentures.

Attitude of Health Personnel↗
PubMed2001

Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden--the LiVicordia Study.

AIMS: Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated. METHODS: The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Linköping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample. RESULTS: Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum beta-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class. CONCLUSIONS: The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries.

Antioxidants↗
PubMed1995

[Dermato-venereology as a special subject in medical education in Sweden. A historical review].

In 1861 a professorship in syphilology was founded at the Karolinska Institute in Stockholm. However, unlike the conditions in Denmark, Finland and Norway, a combined chair in dermatology and syphilology was not established until in 1927. The main reason for this delay was that, according to the laws applicable to the hospitals of Sweden, patients with venereal diseases could be treated solely in special hospitals ("kurhus"). Only in 1901, when these laws were changed, it was possible to establish departments for both skin and venereal diseases. The article is a survey of the development of dermato-venereology as a subject in medical education in Sweden until our time.

Dermatology↗
PubMed1994

[Anton Nyström: the first practitioner in dermatology in Sweden and the controversy about his book on skin disorders].

Anton Nyström (1842-1931), practitioner and author, was at the end of the nineteenth and the beginning of the twentieth century a well-known but also controversial personage in Swedish cultural and intellectual life. The posterity remembers him mainly for having introduced the philosophical system of Auguste Comte and founded a Society for Positivism in Sweden as well as having founded an institution ("Arbetarinstitutet") in Stockholm with the purpose to give an all-round education to the working classes through lectures by leading personalities in the world of culture and science. In numerous publications he treated besides medical topics also religious, cultural, social, political and historical themes. Immediately after his medical graduation in May 1868, he went abroad to study dermatology and stayed for this purpose for nearly one and a half years in Vienna, Paris and London. Back in Sweden in the autumn of 1869, he began writing a book with the title "Theoretical and practical essays on skin disorders." This book is for us today interesting because it illustrates the different views of that time on skin diseases held by Hebra in Vienna, Bazin and Hardy in Paris and Wilson and Tilbury Fox in London. In Paris Nyström had been fascinated by Bazin's and Hardy's theories on constitutional diseases and diathetic states and had, as he says, "embraced the doctrines of Bazin". In Vienna, however, he had disapproved of Hebra's way to reject speculations on internal etiology for skin diseases and to look upon them as having mainly an external cause and of his method to treat skin diseases preferably with local remedies. In London he was on very friendly terms with Tilbury Fox, who to his satisfaction also sympathized with the opinions held by Bazin. ...

Dermatology↗
PubMed2001

Prevention of cardiovascular disease in Sweden: the Norsjö community intervention programme--motives, methods and intervention components.

OBJECTIVES: When epidemiologic data on cardiovascular disease (CVD) mortality rates in different Swedish regions were published in the early 1980s, there was great concern about the high CVD incidence in the northernmost counties of Sweden, namely Västerbotten and Norrbotten. This paper describe the development of a Northern Sweden community intervention programme for the prevention of CVD. METHODS: As there were no Swedish prototypes, the programme was designed by drawing on experiences from other community interventions. One unique emphasis of the Norsjö intervention programme was to combine a population strategy with efforts to contact each person individually when they became 30, 40, 50, and 60 years of age (the primary care approach). Using the primary care system as part of the community intervention, systematic risk factor screening and counselling by family medicine providers were carried out at the same time as the community intervention programme invoked other efforts to raise public awareness. RESULTS: During the first 10 years of the programme >90% of those invited participated in the individual health screening and counselling. A new food labelling system was introduced in the grocery stores, which after a few years became the official Swedish food labelling system. Sales statistics regarding dairy products showed a significant turnover of low fat products. According to public opinion, the health screening and counselling were reported to be the most influential factors supporting lifestyle changes. CONCLUSIONS: It was possible in Norsjö to create a local health promotion collaboration between healthcare providers, grocery stores, schools, municipal authorities, and the public in order to develop a Swedish model for community intervention. The different programme components were well received by the public.

Adult↗
PubMed2001

[The incidence of gallbladder cancer in Sweden has decreased. The poor prognosis can possibly be improved by radical surgery].

Gallbladder cancer is a rare disease with poor prognosis and short survival time. The condition is usually associated with gallstones and predominantly affects women. We have taken data from the National Cancer Register and the Cause of Death Register in Sweden and studied the annual incidence of and mortality due to gallbladder cancer from 1988 to 1997. Incidence has declined during this period, which may be explained by a high rate of cholecystectomies in Sweden between 1950 and 1970. Prognosis has traditionally been poor, with a median survival time of 3.5 months, which might be explained by the fact that the disease usually is diagnosed at an advanced stage. Epidemiological figures show that prognosis may have improved during the past decade. In several retrospective studies, mainly from Japan, better results with longer survival times are reported after extended surgery. In a small group of 11 patients with gallbladder cancer, Nevin grade II-V, who underwent extended surgery at The University Hospital in Linköping, there are no signs of recurrent disease in 10 patients after a follow-up of 1-8 years.

Aged↗
PubMed2001

Immunization against Haemophilus influenzae type b in Sweden--a study of the introduction process.

AIMS: To study the introduction of Haemophilus influenzae type b (Hib) vaccination in Sweden, and to identify factors promoting and inhibiting the process. METHODS: The introduction of general childhood vaccination against Hib in Sweden in 1992-93 was studied using the Cultural Historical Activity Theory as a theoretical framework. RESULTS: Five activity systems were found to be involved in the introduction process, the systems of vaccine production, government administration, news distribution, science, and disease prevention. The critical factors for introduction of the programme were found to be the vaccine product, conception of the disease, government economy and public decision-making. CONCLUSIONS: The results show that a broad range of non-biomedical aspects must be considered when a public health intervention such as a general vaccination programme is introduced.

Child↗
PubMed2002

[Resistant tuberculosis is spreading in Sweden. Molecular epidemiological strain identification by "fingerprinting" can make the infection tracing easier].

Resistance of Mycobacterium tuberculosis to antibiotics is a world wide problem. A study is reported with the aim to analyse the spread of resistant isolates of M tuberculosis complex from patients with tuberculosis in Sweden. The study is based on a sample of 192 M tuberculosis complex isolates from patients with drug resistant tuberculosis during 1994-2000. All isolates resistant to at least one of the drugs streptomycin, isoniazid, ethambutol and rifampicin were included in the study. Restriction fragment length polymorphism (RFLP) was performed, using IS6110 as a probe for hybridisation. Visualised bands were analysed by Gel Compar software. The majority of the isolates were from patients born in high TB prevalence countries. During the years 1996-2000 there was one major cluster generated from 34 isolates. In 1996-1998 there were two isolates per year, in 1999 it increased to 20 isolates, and eight cases in 2000. All strains were resistant to isoniazid. All patients in this cluster were found to be from Africa. In comparing the pattern in the T-base the strains matched with strain BEA-000007341 isolated from a patient in Rwanda. The majority of patients with drug resistant tuberculosis in Sweden are immigrants from countries with high incidence of tuberculosis. Spread of disease to the Swedish born population is uncommon. However, an increasingly prevalent clone of isoniazid resistant tuberculosis was found among African immigrants, mainly living in the Stockholm area.

Adolescent↗
PubMed2002

[Oocyte donation to be legalized in Sweden. Excellent results reported from other countries].

Oocyte donation is an effective solution for treating infertile women whose ovaries are non-functional. This infertility condition is known as premature ovarian failure and is most commonly caused by genetic or autoimmune diseases, chemo- or radiotherapy, severe endometriosis and ovarian cancer. Oocyte donation also benefits those women who have functional ovaries yet respond poorly to ovarian hyperstimulation for in vitro fertilisation. Not only does oocyte donation provide healthy oocytes to infertile women, it also allows any genetic diseases of the recipient to be avoided. The process is simple beginning with ovarian hormonal stimulation of the donor followed by trans-vaginal oocyte retrieval. The mature oocytes are then fertilised with the sperm of the recipient's partner and the resulting embryo is transferred to the uterus two to five days later. Careful counselling of all parties involved is necessary before commencing treatment. International experience using oocyte donation has been excellent revealing normal, healthy relationships between the children and their families. Until now, oocyte donation has been illegal in Sweden, yet on 25th April 2002 the Swedish Parliament accepted a change in the law regarding assisted reproduction. According to this new law, oocyte donation will be permitted in Sweden from the beginning of January 2003 providing new hope for infertile couples.

Adult↗
PubMed1989

[Families in France and Sweden: the search for new models].

"Examination of the evolution of family models in France and Sweden reveals many similar trends: increase in the divorce rate, fall in marriage and fertility rates, decrease in the size of the average family, increase in the number of single parent families, diversity of rearranged households, etc. However, the authors stress the extent to which the historical and ideological context of this evolution is different in the two countries. Whereas new conjugal models are diffused rapidly in Sweden without provoking reactions of rejection, a certain ideology in France recommends an ideal of conjugal stability and demands a policy openly favouring an increased birth rate. The Swedes find contraception and abortion natural whereas they are still the subject of impassioned debates in France. The attitude to children is very different in the two countries. However, in both cases, although the evolution of family ties still has an experimental aspect it seems sufficiently radical to make it necessary to rethink the nature of social ties in general." (SUMMARY IN ENG)

Abortion, Induced↗
PubMed1991

An interpretation of the effects of age on migration: Nordic migrants' choice of settlement in Sweden.

A model of the relationship between age and migration is developed and applied to data concerning migrants from other Scandinavian countries who settled in Sweden between 1968 and 1985. The author shows "how changes in Sweden's domestic economic conditions and distance determine the probability for settlement in any of its 24 provinces for migrants of different ages. The results show that in the integrated Nordic labor market, wages at destination do not explain differences in migrants' settlement behavior across ages. Instead they suggest that the major factors to explain the differences are the labor market situation for the different age groups and distance."

Age Factors↗
PubMed2002

Do changes in surgical procedures for breast cancer have consequences for hospital mean length of stay? A study of women operated on for breast cancer in Sweden, 1980-95.

BACKGROUND: Between 1986 and 1996, the overall mean overnight length of stay for all diagnoses in Sweden decreased from 20.8 to 7.1 days. OBJECTIVES: The study describes changes in surgical technique, from mastectomy to breast-conserving surgery, in treatment of female breast cancer and the parallel change in average length of hospital stay, and discusses the possible link between the trends. RESEARCH DESIGN: The study was performed as a descriptive register study on hospital admission data from the Swedish Hospital Discharge Register over a 16-year period (1980-95). RESULTS: During the study period, the mean length of stay for surgical curative breast cancer treatment in Sweden decreased by 56%. In 1980, the proportion of women receiving conservative surgery was 7%. At the end of the period, this share had increased to 51%. Breast-conserving surgery had an approximately 30% shorter mean length of stay compared with mastectomy. The gap was remarkably stable during the study period. The shift from mastectomy to breast-conserving surgery had a limited effect on the share of patients that went through lymph node dissection. Neither age nor the number of operations per woman could, to any significant extent, explain the decrease in mean length of stay. Approximately 14% of the overall decline can be attributed to the changes in technique. CONCLUSIONS: Clinical practice style, in this case the surgical technique, has had an effect on length of stay, but the surgical technique can only to some extent explain the trend.

Adult↗
PubMed2002

Caries prevalence in 3-year-old children living in a low socio-economic multicultural urban area in southern Sweden.

The aim of this study was to investigate the prevalence of dental caries in 3-year-old children living in a multi-cultural low socio-economic urban area of Malmö, Sweden, and to establish its relationship to some medical, oral and behavioural factors associated with caries risk. All 238 children that became 3 years of age between July and December 2000 were invited to participate and 94% showed up for examination. The parents completed a structured questionnaire concerning social and ethnic background, medical history and oral health behaviour and a clinical examination of the child was performed in optimal light with a mirror and probe. Visible plaque, gingival health and occurrence of initial and manifest caries lesions, extractions and fillings (defs) were scored. The prevalence of caries was 85% with a mean defs value of 4.4 +/- 4.3. Of those with caries, 55% had manifest lesions while 45% exhibited lesions that were limited within the enamel. The variables significantly associated with caries were frequent intake of meals (odds ratio, OR = 6.0), gingivitis (OR = 3.7), presence of visible plaque (OR = 3.2) and compromising medical conditions (OR = 2.7). Children without fluoride supplements or fluoridated toothpaste had significantly (p < 0.05) more caries that those with a daily intake of fluoride (mean defs 7.2 +/- 5.3 vs 4.0 +/- 4.0). In conclusion, a high prevalence of caries was found in a low socio-economic multi-cultural population in an urban area of Malmö, Sweden. Thus, early childhood caries may still be a public health problem in certain groups, which calls for collective preventive measures to be re-instituted.

Cariostatic Agents↗
PubMed2003

Sustainability concept for a newly built urban area in Malmö, Sweden.

National goals regarding sustainable development from the Swedish government were decisive in the planning process when the newly built city district Western Harbour was established in the city of Malmö, Sweden. A systems analysis was used as a tool for evaluating different collection and treatment systems. This type of analysis does not include more subjective factors such as acceptance of organic fertilizers based on human waste and user acceptance of collection schemes. These aspects, however, will often determine the success of a technical solution. When the system for collection and treatment of old organic waste and wastewater was designed, both subjective and objective factors were considered. This meant that a centralised solution for wastewater treatment was selected. In order to facilitate a more sustainable solution for sludge management a treatment process with recovery of phosphorus will have to be introduced. Organic waste is sorted out and treated in an anaerobic digestion process. Source sorting of solid organic waste has been difficult to implement in Sweden due to inadequate sorting discipline. As a consequence two relatively new systems are tested in the area. A comprehensive evaluation will be carried out during a period of two years.

Cities↗
PubMed2003

[Few teenage pregnancies in Sweden--a comparison between five Western industrialized countries. Support from and attitudes in the society explain the differences].

Cross-national comparisons of teenage sexual and reproductive behavior in five Western industrialized countries show vast differences in teenage pregnancy rates and birthrates. The lowest rates are found in Sweden and France, moderate rates in Canada and Great Britain, and the highest in the USA. Since age and frequency of sexual activity are similar across countries, the variations in pregnancy rate reflect young people's motivation and ability to prevent unwanted pregnancies. Sweden and France offer the most positive attitudes to sexuality combined with a clear expectation that teenagers can make responsible decision about sexuality and delay childbearing. Societal acceptance of teenage sexuality is reflected in open-minded sexuality education and easy access to contraceptive services. In contrast the official message in USA is to delay childbearing until marriage by abstinence only, and use of contraceptives is not supported. Differences in societal support for employment and education also played a major role.

Adolescent↗
PubMed2003

Use of mandibular implant overdentures: treatment policy in prosthodontic specialist clinics in Sweden.

The aim was to examine the use of mandibular implant overdentures in Swedish prosthodontic specialist clinics. Questionnaires related to treatment with mandibular implant overdentures during 2001 were sent to the heads of the 30 prosthodontic specialist clinics of the Public Dental Health Service in Sweden. Completed questionnaires were received from 28 (93%). The number of treatments with mandibular implant overdentures varied much among the clinics (0 to 22). Seven clinics had not performed any such treatment, and the median number was 2. The number of fixed implant-supported prostheses was much higher (median value 17, range 4 to 100). The correlation between the number of implant overdentures and fixed implant-supported prostheses in edentulous mandibles was weak (r = 0.33; P = 0.10). The most common anchorage system was ball attachments on two unsplinted implants. The most common reason for the choice of the overdenture treatment was the reduced cost, whereas the patient's main wish to improve denture retention came next. The question whether the demand for implant overdentures had increased during the last few years, was answered with "no" by 19, with "yes" by 5 and with "don't know" by 4 clinics. All but one responded that their attitude to implant overdentures had not changed after the introduction of free pricing in Swedish dentistry. It can be concluded that compared to the rapidly increasing international use of mandibular implant overdentures, this treatment of edentulous patients is rare in Sweden, where fixed implant-supported prostheses still are predominant.

Dental Clinics↗
PubMed1992

Telepathology in Sweden. A national study including all histopathology and cytology laboratories.

Quality improvement and standardization of diagnosis in histopathology and cytology are important for the future of the discipline. Nominal scale diagnoses dominate the practice and their standardization depends on relevant and reproducibly identifiable criteria as well as on communication of these among pathologists. Telepathology, i.e. the transmission of adequately detailed colour images of microscopic fields over the telephone network is now a realistic possibility. All 30 laboratories for histopathology and cytology in Sweden will have access to Telepathology work stations for at least 8 weeks each during 1992-1993. Two centers will have permanent stations from September 1992. The images will be transmitted over the ISDN network, allowing a compressed image to appear instantaneously. This image is then gradually and imperceptibly decompressed during 15-60 seconds, the time depending on the complexity of the image. A program for consultation and quality testing is being set up, which will be evaluated during 1993. Based on a recognition of the conditions for diagnosis in pathology and cytology indicated above, the Swedish Society of Pathology has initiated a project called "Telepathology in Sweden". It is a joint effort with active participation by Swedish Telecom and the Swedish Planning and Rationalization Institute for the Health and Social Services, Stockholm as well as by Innovativ Vision AB, Linköping, a company providing hard- and software for image analysis, image banks and communication.

Cell Biology↗
PubMed1992

Oral health in preschool children living in Sweden. Part II--A longitudinal study. Findings at three years of age.

Scientific epidemiological studies of dental health in children three years of age are relatively few in Sweden. The aim of this study was to describe the oral health of three-year-old children living in Sweden, with special reference to immigration and failure to attend health examinations. All of 671 children requested to take part in an earlier investigation (Wendt et al. 1991) were invited for a new dental examination at three years of age. A total of 632 children were examined. At the age of three years 71.7 per cent of the children were caries free. Of the children with caries, 33.5 per cent were immigrants and of the total number of immigrants, 50.5 per cent had caries compared to 21.9 per cent of the non-immigrant children. Among those children, who failed to attend the earlier investigations at one or two years of age, 61.5 per cent had caries at the age of three. Compared to studies on dental health in three-year-old children from the 70's and 80's (Hugoson et al. 1986), this study shows that dental health in three-year-old children has not improved significantly during the last decade. Furthermore, this study supports the suggestion that special preventive dental programmes should be developed for immigrant children and that extra attention should be paid to children who fail to attend health examinations and their families.

Child, Preschool↗