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  • 1.
    Isehed, Catrine
    et al.
    Department of Odontology/Molecular Periodontology, Umeå University, Umeå, Sweden; Department of Periodontology, Gävle County Hospital, Gävle, Sweden; Center for Research & Development, Region Gävleborg, Gävle, Sweden; Center for Research & Development, Uppsala University, Uppsala, Sweden.
    Holmlund, Anders
    Department of Periodontology, Gävle County Hospital, Gävle, Sweden; Center for Research & Development, Region Gävleborg, Gävle, Sweden; Center for Research & Development, Uppsala University, Uppsala, Sweden.
    Renvert, Stefan
    Department of Health Sciences, Kristianstad University, Kristianstad, Sweden; School of Dental Sciences, Trinity College, Dublin, Ireland; Blekinge Institute of Technology, Karlskrona, Sweden.
    Svenson, Björn
    Örebro University, School of Medical Sciences. Department of Oral Radiology, Postgraduate Dental Education Center, Örebro, Sweden.
    Johansson, Ingegerd
    Department of Odontology/Cariology, Umeå University, Umeå, Sweden.
    Lundberg, Pernilla
    Department of Odontology/Molecular Periodontology, Umeå University, Umeå, Sweden.
    Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis: A randomized controlled trial2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 10, p. 863-873Article in journal (Refereed)
    Abstract [en]

    Objective: This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri-implantitis alone or in combination with enamel matrix derivative (EMD).

    Methods: Twenty-six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD. Bone level (BL) change was primary outcome and secondary outcomes were changes in pocket depth (PD), plaque, pus, bleeding and the microbiota of the peri-implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months.

    Results: In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD, the number of osseous walls in the peri-implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram-/anaerobic microbial flora and presence of bleeding and pus, with a cross-validated predictive capacity (Q(2) ) of 36.4%. Similar, but statistically non-significant, trends were seen for BL, PD, plaque, pus and bleeding in univariate analysis.

    Conclusion: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.

  • 2.
    Isehed, Catrine
    et al.
    Department of Molecular Periodontology, Umeå University, Umeå, Sweden; Department of Periodontology, Gävle County Hospital, Public Dental Health County Council of Gävleborg, Gävle, Sweden; Center for Research and Development, Region Gävleborg, Uppsala University, Gävle, Sweden.
    Svenson, Björn
    Örebro University, School of Medical Sciences. Örebro University Hospital. Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Lundberg, Pernilla
    Department of Molecular Periodontology, Umeå University, Umeå, Sweden.
    Holmlund, Anders
    Department of Periodontology, Gävle County Hospital, Public Dental Health County Council of Gävleborg, Gävle, Sweden; Center for Research and Development, Region Gävleborg, Uppsala University, Gävle, Sweden.
    Surgical treatment of peri-implantitis using enamel matrix derivative, an RCT: 3- and 5-year follow-up2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 6, p. 744-753Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the clinical and radiographic outcomes 3 and 5 years after the surgical treatment of peri-implantitis per se or in combination with an enamel matrix derivative (EMD).

    MATERIALS AND METHODS: At baseline, 29 patients were randomized to surgical treatment with adjunctive EMD or no EMD. One year after the surgical treatment of peri-implantitis, 25 patients remained eligible for survival analyses at the 3- and 5-year follow-up. The primary outcomes were implant loss and bone level (BL) change measured on radiographs, and the secondary outcomes, bleeding on probing, pus and plaque at each implant, were analyzed in 18 and14 patients at the 3- and 5-year follow-up, respectively.

    RESULTS: After exclusion of 4 patients who discontinued the study, at the 3-year follow-up, 13 (100%) implants survived in the EMD group, and 10 of 12 (83%) in the non-EMD group. At the 5-year follow-up, 11 of 13 (85%) implants in the EMD group and 9 of 12 (75%) in the non-EMD group survived. In multivariate modelling, BL changes and EMD-treatment were positively associated with implant survival. Similarly, the same trend was seen in univariate analysis.

    CONCLUSIONS: An exploratory analysis suggests that adjunctive EMD is positively associated with implant survival up to five years, but larger studies are needed. This article is protected by copyright. All rights reserved.

  • 3.
    Olsson, Lars
    et al.
    Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral Radiology, Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Nilsson, Mats
    Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Radiation Physics, Skåne University Hospital, Malmö, Sweden.
    Svenson, Björn
    Örebro University, School of Medical Sciences. Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Hellén-Halme, Kristina
    Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
    The effect of anatomical noise on perception of low contrast in intra-oral radiographs: an in vitro study2016In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 45, no 4, article id 20150402Article in journal (Refereed)
    Abstract [en]

    Objectives: Radiographic images suffer from varying amounts of noise. The most studied and discussed of these is random noise. However, recent research has shown that the projected anatomy contributes substantially to noise, especially when detecting low-contrast objects in the images. Our aim, therefore, was to evaluate the extent to which overprojected anatomical noise affects the detection of low-contrast objects in intra-oral images.

    Methods: Our study used four common sensor models. With each sensor, we took four series of images, three series with and one series without an anatomical phantom present. In each series, we exposed a low-contrast phantom at 18 different exposure times using a standardized method. 4 observers evaluated all 288 images.

    Results: The low-contrast characteristics differed substantially when imaging low contrast on a homogeneous background compared with imaging low contrast when an anatomical phantom was present. For three of the sensors, optimal exposure times for low-contrast imaging were found, while the fourth sensor displayed a completely different behaviour.

    Conclusions: Calibrating the low-contrast properties of an imaging system using low-contrast objects on a homogeneous background is not recommended. On an anatomical background, low-contrast properties are completely different, and these will mimic the clinical situation much more closely, directing the operator how to best use the system. There is a clear demand for further research on this subject.

  • 4.
    Svenson, Björn
    et al.
    Örebro University, School of Medical Sciences. Dental Research Department, Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Ståhlnacke, Katri
    Örebro University, School of Medical Sciences. Dental Research Department, Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Karlsson, Reet
    Department of Radiology, Skaraborg Hospital Skövde, Skövde, Sweden.
    Fält, Anna
    Dentists' use of digital radiographic techniques: Part I - intraoral X-ray: a questionnaire study of Swedish dentists2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Objective: The present study aims to gain knowledge about the dentist's use and choice of digital intraoral imaging methods.

    Materials and methods: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the type of X-ray technique used, problems experienced with digital radiography, and reasons for choosing digital technology, and about indications, clinic size and type of service. Response rate was 53%.

    Results: Ninety-eight percent of the dentists had made the transition to digital radiography; only 2% used film technique, and solid-state detector (SSD) was the most used digital technique. More years in service decreases the likelihood of applying individual indications for performing a full mouth examination. More retakes were done with SSDs compared to storage phosphor plates. Reasons for choosing digital techniques were that work was easier and communication with the patients improved. However, dentists also experienced problems with digital techniques, such as exposure and projection errors and inadequate image quality. The Swedish Radiation Safety Authority states that all radiological examinations should be justified, something not always followed.

    Conclusions: This study showed that 98% of the respondents, Swedish dentists within the Swedish Dental Society, used digital techniques, and the most used was the solid-state technique.

  • 5.
    Svenson, Björn
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Dental Research Department, Postgraduate Dental Education Center, Örebro, Sweden.
    Ståhlnacke, Katri
    Örebro University, School of Medical Sciences. Örebro University Hospital. Dental Research Department, Postgraduate Dental Education Center, Örebro, Sweden.
    Karlsson, Reet
    Department of Radiology, Skaraborg Hospital Skövde, Skövde, Sweden.
    Fält, Anna
    Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Dentists' use of digital radiographic techniques: Part II - extraoral radiography: a questionnaire study of Swedish dentists2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 2, p. 150-157Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The present study aims to gain knowledge about the dentist's use and choice of digital extraoral imaging methods, panoramic radiography and cone beam computed tomography (CBCT).

    MATERIALS AND METHODS: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the panoramic technique and CBCT technique used, education, clinic size and type of service. The response rate was 53%.

    RESULTS: The study showed that 61% of the Swedish dentists had access to panoramic techniques and that 84% used a direct digital sensor, while 6% used storage phosphor plate techniques. Around 8% of the Swedish dentists had access to CBCT. It was also observed that group practices had two times higher odds of having panoramic equipment compared with solo practices. Approximately 40% of the dentists had undergone postgraduate education in oral radiology during the last 5 years. Dental nurses and dental hygienists exposed 92% of the panoramic radiographs and 75% of the CBCTs. Thirty per cent of those clinics with access to a panoramic unit exposed >30 panoramic radiographs per month and 56% of the clinics having access to CBCT did more than 75 examinations per year.

    CONCLUSIONS: Today 61% of Swedish dentists have access to panoramic radiography and 8% have access to CBCT. There is a greater likelihood of having access if the dentist works in the public dental health service or in a group practice and if the dentist has undergone any postgraduate course in oral radiology.

  • 6.
    Svensson, Björn
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Dental Research Department, Postgraduate Dental Education Center, Örebro, Sweden.
    Båth, Magnus
    Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiation Physics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Karlsson, Reet
    Department of Radiology, Skaraborg Hospital, Skövde, Sweden.
    Can adaptive post-processing of storage phosphor plate panoramic radiographs provide better image quality? A comparison of anatomical image quality of panoramic radiographs before and after adaptive processing2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 5, p. 328-333Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of the present study was to study the effect of adaptive image processing on the visibility of anatomical structures in storage phosphor plate (SPP) panoramic images.

    MATERIALS AND METHODS: Three hundred SPP panoramic X-ray radiographs of children and adolescents were used. The radiographs were post-processed using general operator processor (GOP) technology, resulting in both a standard-processed and a GOP-processed radiograph. Four specialists in dental radiology compared the structural image quality of all standard-processed and GOP-processed panorama images for six anatomical structures, using a six-point scale for visual grading characteristics (VGC) analysis.

    RESULTS: For three of the anatomic structures - the root canal space of the mandibular left first premolar, mandibular canal left side and periodontal ligament space of the mandibular right first molar - there was a statistically significant difference to the GOP's advantage. For the three remaining structures - dentino-enamel junction of the maxillary right first molar, crista alveolaris of the mandibular left molar area and floor of maxillary sinus right side - no significant difference between standard processing and GOP processing was obtained.

    CONCLUSIONS: The study demonstrates that it is possible to improve the quality of SPP radiographs and the visibility of anatomical structures by using the GOP technique. Manufacturers' image-processing programs can be further developed, as there is a possibility of improving the diagnostic content of an image with external processing.

  • 7.
    Svensson, Björn
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Dental Research, Postgraduate Dental Education Center, Örebro, Sweden.
    Båth, Magnus
    Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiation Physics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Reet
    Department of Radiology, Skaraborg Hospital Skövde, Skövde, Sweden.
    Persson, Bo
    Department of Radiology, Skaraborg Hospital Skövde, Skövde, Sweden.
    A comparison of perceived diagnostic image quality in direct digital panoramic images between standard and advanced external GOP image processing2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 8, p. 560-565Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of the present study was to study the effect of adaptive image processing (GOP processing) on the visibility of anatomical structures in direct digital panoramic images.

    Material and methods: The study comprised panoramic images of 50 consecutive adult individuals aged 18-60 years. Nine dentists working with dental radiology compared the structural image quality of all standard-processed and GOP-processed panoramic images for six anatomical structures, using a six-point scale for visual grading characteristics analysis.

    Results: For all anatomic structures a statistically significant difference in favour of the GOP was found.

    Conclusions: The present study shows that it is possible to improve perceived diagnostic image quality of direct digital panoramic radiography using GOP technology compared to the manufacturers' standard processing. Manufacturers' image-processing programs can be further developed, as there is a possibility of improving the perceived diagnostic content of an image with external processing

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