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Mattila V, Wilkman T, Avellán NL, Mesimäki K, Furuholm J, Ruokonen H, Nylund K. Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft-two-year follow-up. Clin Oral Investig 2024; 28:117. [PMID: 38273180 PMCID: PMC10811186 DOI: 10.1007/s00784-023-05479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The primary aim of the present study was to compare head and neck cancer treatment modality surgery and surgery with radiotherapy or chemoradiotherapy alone for dental implant (DI) survival. The second aim was to evaluate the prevalence of mucosal overgrowth around DI after treatment with or without mucosal grafts. MATERIALS AND METHODS An observational retrospective study consisted of 59 patients with malignant head and neck tumors that received DI between 2015 and 2019. Treatment modalities together with information on oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions were gathered from the hospital records. Radiation doses were determined using a sum of three-dimensional dose distributions. RESULTS Overall DI survival rate was 88%, in irritated jaw 89%, and in nonirradiated jaw 88% in this observational period (p = 0.415, mean follow-up was 2 years 10 months, range 9-82 months). Mucosal overgrowth was found in 42 of 196 implants (21%), of which 36 cases (86%) were associated in grafted areas (p < 0.001). Oral lichen planus/lichenoid reaction was diagnosed in 14 of all 59 (24%) oral cancer patients. CONCLUSION Implant survival was not significantly influenced by radiation therapy in this observational period. In grafted bone, implant survival was significantly inferior than in native bone. Mucosal overgrowth around implants was more common in mucosal grafted areas versus nongrafted. CLINICAL RELEVANCE This study demonstrates the impact of grafted bone to dental implant survival rate and mucosal overgrowth.
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Affiliation(s)
- Viivi Mattila
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Tommy Wilkman
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Nina-Li Avellán
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karita Nylund
- Department of Oral and Maxillofacial Diseases, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Nylund K, Helenius‐Hietala J, Åberg F, Hagström J, Ruokonen H. Persistent oral mucosal lesions preceding diagnosis of Crohn's disease and primary sclerosing cholangitis. Clin Case Rep 2023; 11:e07226. [PMID: 37180315 PMCID: PMC10172456 DOI: 10.1002/ccr3.7226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Oral mucosal lesions may persist years before symptoms or diagnosis of inflammatory bowel disease (IBD) and subsequent primary sclerosing cholangitis (PSC). Since a dental practitioner may be the first clinician to suspect IBD with extraintestinal manifestations (EIMs), early referral, and close collaboration with a gastroenterologist are recommended.
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Affiliation(s)
- Karita Nylund
- Department of Oral and Maxillofacial DiseasesHUS Helsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Jaana Helenius‐Hietala
- Department of Oral and Maxillofacial DiseasesHUS Helsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Fredrik Åberg
- Department of Transplantation and Liver SurgeryHUS Helsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Jaana Hagström
- Department of Oral Pathology and Radiology, Faculty of MedicineUniversity of TurkuTurkuFinland
- Department of PathologyHUS Helsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial DiseasesHUS Helsinki University Hospital and University of HelsinkiHelsinkiFinland
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de Voogd F, Bots S, Gecse K, Gilja OH, D’Haens G, Nylund K. Intestinal Ultrasound Early on in Treatment Follow-up Predicts Endoscopic Response to Anti-TNFα Treatment in Crohn's Disease. J Crohns Colitis 2022; 16:1598-1608. [PMID: 35639823 PMCID: PMC9624292 DOI: 10.1093/ecco-jcc/jjac072] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/02/2022] [Accepted: 05/26/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND To assess treatment response, objective measures are superior to clinical improvement in Crohn's disease [CD]. Intestinal ultrasound [IUS] is an attractive, non-invasive alternative to endoscopy, demonstrating early transmural changes after treatment initiation. Therefore, we investigated IUS and contrast-enhanced ultrasound [CEUS] to predict [early] endoscopic treatment response. METHODS Consecutive patients with endoscopically active CD, starting anti-TNFα therapy, were included. Clinical, biochemical, IUS, and CEUS parameters at baseline [T0], after 4-8 weeks [T1] and 12-34 weeks [T2] were collected. The most severely inflamed segment at endoscopy (highest segmental Simplified Endoscopic Score for Crohn's Disease [SES-CD]) and IUS (highest segmental bowel wall thickness [BWT]) was identified. At T2, endoscopic response [decrease in SES-CD ≥ 50%] and remission [SES-CD = 0] were scored. RESULTS A total of 40 patients were included: 14 reached endoscopic remission and 17 endoscopic response. At T1 (3.1 mm [1.9-4.2] vs 5.3 mm [3.8-6.9], p = 0.005) and T2 (2.0 mm [1.8-3.1] vs 5.1 [3.0-6.3] mm, p = 0.002) BWT was lower in patients with endoscopic remission. At T1 and T2, 18% (area under the receiver operating curve [AUROC]: 0.77; odds ratio [OR]: 10.80, p = 0.012) and 29% [AUROC: 0.833; OR: 37.50, p = 0.006] BWT decrease predicted endoscopic response, respectively. To determine endoscopic remission, BWT 3.2 mm was most accurate [AUROC: 0.94; OR: 39.42, p < 0.0001] at T2. In addition, absence of colour Doppler signal [OR: 13.76, p = 0.03] and the CEUS parameter wash-out rate [OR: 0.76, p = 0.019] improved the prediction model. CONCLUSIONS Reduction in BWT, already after 4-8 weeks of follow-up, predicted endoscopic response and remission. CEUS parameters were of limited value. Furthermore, we have provided accurate cut-offs for BWT reflecting endoscopic response and remission at different time points.
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Affiliation(s)
- F de Voogd
- Corresponding author: Floris de Voogd, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | | | - K Gecse
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - O H Gilja
- National Centre of Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - G D’Haens
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - K Nylund
- National Centre of Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Norrman A, Nylund K, Ruokonen H, Mauno J, Mesimäki K, Haapaniemi A, Lassus P, Helenius-Hietala J. Oral findings and treatment of patients with face transplants in Helsinki. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:44-51. [PMID: 33563570 DOI: 10.1016/j.oooo.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Oral health and balanced occlusion are important aspects of a well-functioning face transplant. This study describes the oral and dental status, dental management, and sialoendoscopy of the first 2 patients in Helsinki who underwent face transplantations. STUDY DESIGN Two patients received near-full face transplantations in 2016 and 2018, respectively. The transplanted tissues included a Le Fort type II maxilla, angle-to-angle mandible, all oral mucosa, ventral tongue tissue, and the muscles of the floor of the mouth. Comprehensive oral examinations and all required dental treatment, including follow-up examinations, were performed for both patients after the transplantations. RESULTS Both patients rehabilitated well, and their quality of life improved. Stable, functioning dentition and occlusion were achieved for both patients. Hyposalivation and dental caries were issues for both patients. Patient 1 also experienced infections in the jaws. Implants were placed in the transplanted jaws of patient 2 with successful osseointegration. CONCLUSIONS We report successful tooth-bearing face transplantations in 2 patients. Patient selection, particularly regarding oral health, is crucial in avoiding posttransplantation complications. Moreover, the oral and dental status of the donor should be examined by a dentist before transplantation, and regular follow-up dental examinations should be performed after transplantation.
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Affiliation(s)
- Annika Norrman
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland.
| | - Karita Nylund
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Jari Mauno
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland; Department of Plastic Surgery, Helsinki University Hospital
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Aaro Haapaniemi
- Department of Ear, Nose and Throat Diseases, Helsinki University Hospital
| | - Patrik Lassus
- Department of Plastic Surgery, Helsinki University Hospital
| | - Jaana Helenius-Hietala
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
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Arenius I, Ruokonen H, Ortiz F, Furuholm J, Välimaa H, Bostanci N, Eskola M, Maria Heikkinen A, Meurman JH, Sorsa T, Nylund K. The relationship between oral diseases and infectious complications in patients under dialysis. Oral Dis 2020; 26:1045-1052. [PMID: 32026534 DOI: 10.1111/odi.13296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Association was investigated between oral health before dialysis and the incidence of systemic infections during dialysis. We hypothesized that low-grade systemic inflammation caused by poor oral health associates with infectious episodes in patients on dialysis, despite earlier eradication of oral infection foci. SUBJECTS AND METHODS A total of 117 patients (46 with peritoneal and 71 with hemodialysis) were examined and treated at predialysis stage and followed up during dialysis. Number of infection episodes and microorganisms cultured from blood and peritoneal fluid were analyzed. Number of teeth, periodontal inflammatory burden, and total dental index scores were assessed, and salivary matrix metalloproteinase 8, triggering receptor on myeloid cells 1, peptidoglycan recognition protein 1 (PGLYRP1), and interleukin-1β were measured. RESULTS In hemodialysis, 134 infection episodes were recorded, while peritoneal dialysis group had 77 peritonitis episodes. Culture-negative samples were 69% in hemodialysis and 23% in peritoneal dialysis group. Staphylococci were the most frequently associated microorganisms. Infections during dialysis did neither associate with oral health parameters nor associate with salivary inflammatory biomarkers, except for PGLYRP1, which associated with number of infection episodes during hemodialysis (p = .046). CONCLUSIONS A number of infection episodes during hemodialysis were associated with salivary PGLYRP1 but not the other salivary markers or oral infection markers.
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Affiliation(s)
- Ilona Arenius
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Fernanda Ortiz
- Division of Nephrology, Department of Medicine, Helsinki University Hospital, Helsinki, Finland.,Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hannamari Välimaa
- Department of Virology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nagihan Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Maija Eskola
- Division of Nephrology, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Karita Nylund
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Ruokonen H, Nylund K, Meurman JH, Heikkinen AM, Furuholm J, Sorsa T, Roine R, Ortiz F. Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation. Clin Oral Investig 2018; 23:2207-2213. [PMID: 30276517 DOI: 10.1007/s00784-018-2647-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 09/20/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist. MATERIAL AND METHODS Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics. RESULTS OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = - 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage. CONCLUSION OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis. CLINICAL RELEVANCE Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.
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Affiliation(s)
- Hellevi Ruokonen
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland.
| | - Karita Nylund
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland
| | - Jukka H Meurman
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland
| | - Anna M Heikkinen
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland
| | - Jussi Furuholm
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland
| | - Timo Sorsa
- Head and Neck Center, Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, P.O.Box 263, Kasarmikatu 11-13, FI-00029 HUS, Helsinki, Finland.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Risto Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Social and Health Management, University of Eastern Finland, Kuopio, Finland
| | - Fernanda Ortiz
- Abdominal Center, Nephrology, Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
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Bots S, Nylund K, Löwenberg M, Gecse K, Gilja OH, D'Haens G. Ultrasound for Assessing Disease Activity in IBD Patients: A Systematic Review of Activity Scores. J Crohns Colitis 2018; 12:920-929. [PMID: 29684200 DOI: 10.1093/ecco-jcc/jjy048] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/16/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Ultrasound [US] indices for assessing disease activity in IBD patients have never been critically reviewed. We aimed to systematically review the quality and reliability of available ultrasound [US] indices compared with reference standards for grading disease activity in IBD patients. METHODS Pubmed, Embase and Medline were searched for relevant literature published within the period 1990 to June 2017. Relevant publications were identified through full text review after initial screening by two investigators. Data on methodology and index characteristics were collected. Study quality was assessed using a modified version of the Quadas-2 tool for risk of bias assessment. RESULTS Of 20 studies with an US index, 11 studies met the inclusion criteria. Out of these 11 studies, 7 and 4 studied Crohn's disease [CD] and ulcerative colitis [UC0 activity indices, respectively. Parameters that were used in these indices included bowel wall thickness [BWT], Doppler signal [DS], wall layer stratification [WLS], compressibility, peristalsis, haustrations, fatty wrapping, contrast enhancement [CE], and strain pattern. Study quality was graded high in 5 studies, moderate in 3 studies and low in 3 studies. Ileocolonoscopy was used as the reference standard in 9 studies. In 1 study a combined index of ileocolonoscopy and barium contrast radiography and in 1 study histology was used as the reference standard. Only 5 studies used an established endoscopic index for comparison with US. CONCLUSIONS Several US indices for assessing disease activity in IBD are available; however, the methodology for development was suboptimal in most studies. For the development of future indices, stringent methodological design is required.
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Affiliation(s)
- S Bots
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Nylund
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - M Löwenberg
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Gecse
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - O H Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - G D'Haens
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
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Nylund K, Meurman JH, Heikkinen AM, Honkanen E, Vesterinen M, Ruokonen H. Oral health in predialysis patients with emphasis on periodontal disease. Quintessence Int 2017; 46:899-907. [PMID: 26345099 DOI: 10.3290/j.qi.a34698] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Oral and periodontal infection load need to be treated in the predialysis stage among chronic kidney disease (CKD) patients in order to avoid later complications in dialysis or transplantation. Periodontal health was studied by specifically comparing diabetic nephropathy patients with those with other kidney disease. METHOD AND MATERIALS This descriptive retrospective study comprised 144 predialysis patients (47 women), aged 23 to 83 years, examined at the Helsinki University Hospital, Finland. Of them, 52 (36%) had diabetic nephropathy. Oral and general health data, Periodontal Inflammatory Burden Index (PIBI), and Total Dental Index (TDI) were recorded from hospital records. Results were analyzed with cross tabulation, Pearson chi-square test, and binary logistic regression with Wald test. RESULTS Of the diabetic nephropathy patients 39%, and of those with high A1C values 36%, respectively, had two or more sites with probing depths ≥ 6 mm compared with 19% in the other CKD group, and 18% of those with lower A1C values. TDI scores were high among 55% of the diabetic nephropathy patients. A1C values ≥ 6.5% associated with moderate periodontitis in 67%, and elevated PIBI in 62%. CONCLUSION High A1C values associated with high oral infection burden indices. Diabetic nephropathy patients had more often high TDI scores and deep periodontal pockets compared with the other CKD patients.
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Ruokonen H, Nylund K, Furuholm J, Meurman JH, Sorsa T, Kotaniemi K, Ortiz F, Heikkinen AM. Oral Health and Mortality in Patients With Chronic Kidney Disease. J Periodontol 2017; 88:26-33. [DOI: 10.1902/jop.2016.160215] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Engjom T, Lærum B, Nylund K, Erchinger F, Gilja O, Dimcevski G. 229 Pancreatic genotype–phenotype co-variations in cystic fibrosis. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arteaga-Marrero N, Rygh CB, Mainou-Gomez JF, Nylund K, Roehrich D, Heggdal J, Matulaniec P, Gilja OH, Reed RK, Svensson L, Lutay N, Olsen DR. Multimodal approach to assess tumour vasculature and potential treatment effect with DCE-US and DCE-MRI quantification in CWR22 prostate tumour xenografts. Contrast Media Mol Imaging 2015; 10:428-37. [PMID: 26010530 DOI: 10.1002/cmmi.1645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/16/2015] [Accepted: 04/04/2015] [Indexed: 01/01/2023]
Abstract
The aim of this study was to compare intratumoural heterogeneity and longitudinal changes assessed by dynamic contrast-enhanced ultrasound (DCE-US) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in prostate tumour xenografts. In vivo DCE-US and DCE-MRI were obtained 24 h pre- (day 0) and post- (day 2) radiation treatment with a single dose of 7.5 Gy. Characterization of the tumour vasculature was determined by Brix pharmacokinetic analysis of the time-intensity curves. Histogram analysis of voxels showed significant changes (p < 0.001) from day 0 to day 2 in both modalities for kep , the exchange rate constant from the extracellular extravascular space to the plasma, and kel , the elimination rate constant of the contrast. In addition, kep and kel values from DCE-US were significantly higher than those derived from DCE-MRI at day 0 (p < 0.0001) for both groups. At day 2, kel followed the same tendency for both groups, whereas kep showed this tendency only for the treated group in intermediate-enhancement regions. Regarding kep median values, longitudinal changes were not found for any modality. However, at day 2, kep linked to DCE-US was correlated to MVD in high-enhancement areas for the treated group (p = 0.05). In contrast, correlation to necrosis was detected for the control group in intermediate-enhancement areas (p < 0.1). Intratumoural heterogeneity and longitudinal changes in tumour vasculature were assessed for both modalities. Microvascular parameters derived from DCE-US seem to provide reliable biomarkers during radiotherapy as validated by histology. Furthermore, DCE-US could be a stand-alone or a complementary technique.
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Affiliation(s)
- N Arteaga-Marrero
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - C B Rygh
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - J F Mainou-Gomez
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - K Nylund
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - D Roehrich
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - J Heggdal
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - P Matulaniec
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - O H Gilja
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - R K Reed
- Department of Biomedicine, University of Bergen, Bergen, Norway.,Centre for Cancer Biomarkers (CCBIO), University of Bergen, Norway
| | - L Svensson
- Section of Immunology, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - N Lutay
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - D R Olsen
- Department of Physics and Technology, University of Bergen, Bergen, Norway
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Arteaga-Marrero N, Mainou-Gomez J, Nylund K, Olsen D, Rygh C. 9: DCE-MRI and DCE-US quantification in CWR22 prostate tumour xenografts. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Nylund K, Hausken T, Ødegaard S, Eide GE, Gilja OH. Gastrointestinal wall thickness measured with transabdominal ultrasonography and its relationship to demographic factors in healthy subjects. Ultraschall Med 2012; 33:E225-E232. [PMID: 22504939 DOI: 10.1055/s-0031-1299329] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To describe the gastrointestinal (GI) wall thickness and the thickness of individual wall layers in healthy subjects using ultrasound and to determine whether demographic factors, the ultrasound transducer frequency, or a fasting state influences these measurements. MATERIALS AND METHODS After overnight fasting, the GI wall thickness and wall layers were measured in several regions with transabdominal, high-frequency ultrasound. 122 healthy subjects aged 23 - 79 were included. All measurements were performed with both 8 and 12-MHz transducers except for the rectum measurement (4 MHz). 23 patients were given a 300 Kcal test meal and re-examined after 30 minutes. RESULTS Wall thickness measurements of the GI tract with transabdominal ultrasonography are dependent on transducer frequency (p < 0.001), weight (p < 0.001) and age (p < 0.018). The thickness of individual wall layers in the ileum and the sigmoid colon was found to be dependent on both age (p = 0.007) and weight (p < 0.001). The mean wall thickness from the jejunum to the sigmoid colon ranged from 0.9 to 1.2 mm with standard deviations (SD) of 0.3 mm or less. The mean (SD) was 2.9 (0.8) mm in the gastric antrum, 1.6 (0.3) mm in the duodenum, and 2.1 (0.5) mm in the rectum. The gastric antrum was thinner and the ileum and sigmoid colon were thicker after the test meal (p < 0.05). CONCLUSION GI wall thickness depends on weight and age. Provided adequate measurement, an abnormal GI wall should be suspected if the thickness exceeds 2 mm except for in the gastric antrum, duodenum and rectum. Reference values for wall thickness can be used regardless of fasting state or probe frequency except for in the gastric antrum.
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Affiliation(s)
- K Nylund
- Institute of Medicine, University of Bergen
- Department of Medicine, Haukeland University Hospital
| | - T Hausken
- Institute of Medicine, University of Bergen
- Department of Medicine, Haukeland University Hospital
| | - S Ødegaard
- Institute of Medicine, University of Bergen
- Department of Medicine, Haukeland University Hospital
| | - G E Eide
- Department of Public Health and Primary Healthcare, University of Bergen
- Centre for Clinical Research, Haukeland University Hospital
| | - O H Gilja
- Institute of Medicine, University of Bergen
- Department of Medicine, Haukeland University Hospital
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14
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Uitto VJ, Nylund K, Pussinen P. [The association of oral microbiota and general health]. Duodecim 2012; 128:1232-1237. [PMID: 22822598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mouth is in direct contact with the outside world of the body and therefore abundant microflora sets there already in childhood. Even in a healthy mouth there is a plethora of bacteria, viruses and fungi. Oral microbial diseases usually arise from growth of opportunistic pathogens. Predisposing factors for oral infections are contact with pathogen carriers, impaired immune system, poor oral hygiene, and smoking. In chronic periodontitis tooth attachment is lost as a result of inflammation, and pockets formed between the tooth and gingiva. Chronic periodontitis is associated with an increased risk for cardiovascular diseases, pulmonary infections, and poor glycemic control of diabetes. This may be due to constant release of pathogenic bacteria and proinflammatory cytokines into the bloodstream.
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15
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Karstensen KH, Ringstad O, Rustad I, Kalevi K, Jørgensen K, Nylund K, Alsberg T, Olafsdóttir K, Heidenstam O, Solberg H. Methods for chemical analysis of contaminated soil samples--tests of their reproducibility between Nordic laboratories. Talanta 2009; 46:423-37. [PMID: 18967163 DOI: 10.1016/s0039-9140(97)00401-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/1997] [Accepted: 10/14/1997] [Indexed: 11/15/2022]
Abstract
In an effort to develop common analytical methods for contaminated soil samples the Environmental Authorities of the Nordic countries have, together with Nordtest, published the report Nordic Guidelines for Chemical Analysis of Contaminated Soil Samples. The aim of these guidelines has been to describe analytical methods which could be accepted in all the Nordic countries and in that way contribute to reducing the variation in the analytical results between laboratories. The methods covered, reflects environmental concerns and priorities in the Nordic countries for now, i.e. heavy metals, chlorophenols, creosote, volatile organic compounds, PCB, THC and PAH. The repeatability and reproducibility of the guideline methods were determined in a Nordic inter-laboratory test in 1996, and the results showed some variations. The analytical methods and the results from the inter-laboratory tests are given for heavy metals, chlorophenols, creosote, volatile organic compounds and PCB.
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17
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Abstract
The removal of interproximal plaque was compared using a standard toothbrush alone, a toothbrush with unwaxed dental floss and a toothbrush with an interdental brush. 30 previously treated periodontal patients were given the cleaning aids in a three-way crossover study design. After each 1 month trial period, scores for gingivitis, buccal/lingual plaque and proximal plaque were recorded. Mean GI scores for subjects were 0.37 using the toothbrush only, 0.36 using the toothbrush with floss and 0.32 using the toothbrush with the interdental brush. Mean buccal/lingual plaque scores were 0.64 using the toothbrush only, 0.62 using the toothbrush with floss and 0.51 using the toothbrush with the interdental brush. Mean plaque scores were 2.32 with the toothbrush only, 1.71 using the toothbrush with floss and 1.22 using the toothbrush with the interdental brush. Statistically significant differences were seen in proximal plaque scores between the 3 treatment groups. The results indicate that the interdental brush used in combination with a toothbrush is more effective in the removal of plaque from proximal tooth surfaces than a toothbrush used alone or in combination with dental floss.
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Affiliation(s)
- R D Kiger
- Jerry L. Pettis Memorial Veterans Hospital, Loma Linda, CA 92357
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18
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Abstract
The purpose of the present study was to evaluate the effects of subgingival irrigations with tetracycline as a supplement to mechanical plaque control and root debridement on clinical conditions of periodontal furcation pockets. 20 subjects with molar teeth having furcation pockets of varying depths and different grades of furcation involvement served for the study. Following oral hygiene instruction and root debridement at baseline, test teeth were irrigated subgingivally by a professional with a solution of 50 mg/ml of tetracycline, and control teeth with saline every 2nd week for 3 months. Records of dental plaque, bleeding on probing, probing depth and probing attachment level were obtained at 0, 1, 2, 3, 6, 9 and 12 months. The results failed to demonstrate any significant differences between test and control teeth for any of the subgroups of furcation sites at any observation interval. It is suggested that future studies may need to be performed over longer periods of time, and that the antimicrobial agents may need to be administered in vehicles, which provide prolonged periods of active subgingival concentrations.
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Affiliation(s)
- K Nylund
- School of Dentistry, Loma Linda University, CA
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19
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Claffey N, Nylund K, Kiger R, Garrett S, Egelberg J. Diagnostic predictability of scores of plaque, bleeding, suppuration and probing depth for probing attachment loss. 3 1/2 years of observation following initial periodontal therapy. J Clin Periodontol 1990; 17:108-14. [PMID: 2406292 DOI: 10.1111/j.1600-051x.1990.tb01071.x] [Citation(s) in RCA: 171] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Recordings of supragingival plaque, bleeding, suppuration and probing depth were obtained for 42 months following initial periodontal therapy. Scores accumulated after various time intervals during monitoring were studied for their predictive value in revealing probing attachment loss as determined by regression analysis during the 0-42 month period. Accumulated plaque scores demonstrated low predictability. Accumulated bleeding scores showed modest predictive values. Suppuration on probing was not a frequent finding during the observation interval and also had modest predictive power. Increase in probing depth compared to baseline and deep residual probing depth had modest predictability after 3 and 12 months, but showed increasing accuracy in revealing probing attachment loss over later time intervals. After a few years of maintenance, increase in probing depth, particularly if combined with high frequency of bleeding on probing, showed the highest predictive value for probing attachment loss of the scores examined.
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Affiliation(s)
- N Claffey
- School of Dentistry, Loma Linda University, CA
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20
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Abstract
12 patients were studied longitudinally to monitor the effects of basic periodontal therapy in molar and non-molar teeth. Periodontal sites were grouped into molar furcation sites, molar flat-surface sites and non-molar sites. Clinical measurements were taken at baseline and directly followed by full mouth root debridement. Subsequently, measurements were taken every 3rd month until 24 months. At each of these appointments, the patients were monitored for their oral hygiene performance and given supragingival prophylaxis. The mean results indicated that initially moderately deep and deep molar furcation sites responded less favorably to therapy compared to non-molar sites and molar flat-surface sites of similar probing depth. Initial improvements in probing measurements for moderately deep and deep molar furcation sites were limited and also tended to revert during the observation interval. Identification of individual sites with probing attachment loss disclosed that 25% of molar furcation sites lost probing attachment as compared to 7% for non-molar sites and 10% for molar flat-surface sites. These results corroborate previous findings and call for additional or alternative treatment regimens for periodontal furcation pockets.
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Affiliation(s)
- B Loos
- School of Dentistry, Loma Linda University, CA
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