Calcified carotid artery atheromas in individuals with cognitive dysfunction.

OBJECTIVE: The aim of this case-control study was to investigate whether cognitively impaired individuals have a higher burden of calcified carotid artery atheroma (CCAA) than controls without cognitive impairment. MATERIAL AND METHODS: The study included 154 cases with Alzheimer's disease (n = 52), mild cognitive impairment (n = 51), or subjective cognitive decline (n = 51) diagnosed at a university memory clinic. Seventy-six cognitively healthy controls were sampled through the Swedish population register. All participants underwent clinical oral and panoramic radiographic examinations. Two oral and maxillofacial radiologists performed blinded analyses of the panoramic radiographs for signs of CCAA, which was registered as absent or present and, if present, unilateral or bilateral. Consensus assessment was used for all statistical analyses. RESULTS: CCAA was common (40%) in this middle-aged and older Swedish population. We found no differences in the prevalence of CCAA between cases and controls (40% vs. 42%). CONCLUSION: Cognitively impaired patients do not have a higher burden of CCAA than matched controls without cognitive impairment.

The oral-systemic disease connection: a retrospective study.

OBJECTIVES: The study aimed at determining the association between oral disease and systemic health based on panoramic radiographs and general health of patients treated at Kuwait University Dental Center. The objective was to determine whether individuals exhibiting good oral health have lower propensity to systemic diseases. MATERIALS AND METHODS: A total of 1000 adult patients treated at Kuwait University Dental Center were randomly selected from the patient's records. The general health of patients was assessed from the medical history of each patient recorded during their visit to the clinic. The number of reported diseases and serious symptoms were used to develop a medical index. The oral health of these patients was assessed from panoramic radiographs to create an oral index by evaluating such parameters as caries, periodontitis, periapical lesions, pericoronitis, and tooth loss. RESULTS: In a total of 887 patients, 43.8 % had an oral index between 3 and 8, of which significantly higher (62.1 %) patients were with medical conditions compared to those without (33.2 %; p < 0.001). The Spearmans's correlation (rho') revealed a positive correlation (rho' = 0.360, p 0.001) between oral and medical index. Partial correlation, while controlling demographics, gender, nationality, and age, also showed a significant positive correlation (p < 0.001) between medical and oral index. CONCLUSIONS: The findings of this study showed a significant association between oral health and general health and confirmed the findings of previous reports as regards the existing correlation between dental infections and medical disorders. These results are not indicative of a causal relationship when the diagnosis of oral disease was based primarily on radiographic findings. Future research needs to include prospective clinical and interventional studies. CLINICAL RELEVANCE: The significance of the oral-systemic disease connection highlights the importance of preventing and treating oral disease which have profound medical implications on general health.

Guidelines for dental radiography immediately after a dento-alveolar trauma, a systematic literature review.

The objective with this study was to search for and to analyze the presence of scientific papers, guidelines, and recommendations in dental literature regarding which radiographs should be prescribed after a dento-alveolar trauma. We know from earlier that guidelines and recommendations are available in general in dental traumatology. The International Association of Dental Traumatology (IADT) has earlier developed guidelines for the management of dental trauma cases in general. There are also recommendations about useful intraoral radiographic methods when caries and periodontal disease are studied. An additional objective was to provide some guidelines for general practitioners about the most accurate radiographic examination immediately after a dento-alveolar trauma using intraoral radiographs or a common extraoral imaging method. Because radiographs are an important diagnostic tool for establishing a correct differential diagnosis after a trauma, radiographic guidelines and recommendations are of importance to be able to start the correct treatment. PubMed Central, Cochrane and World Wide Web were searched and the identified existing guidelines for different intraoral radiographic methods in dentistry were analyzed and found to be very few. Those that were identified were in general not so detailed and specific. In conclusion, we found an explicit need for more detailed guidelines regarding which intraoral and other dental radiographs should be prescribed initially in dental traumatology.

A richer, greener and smaller alpine world: review and projection of warming-induced plant cover change in the Swedish Scandes.

Alpine plant life is proliferating, biodiversity is on the rise and the mountain world appears more productive and inviting than ever. Upper range margin rise of trees and low-altitude (boreal) plant species, expansion of alpine grasslands and dwarf-shrub heaths are the modal biotic adjustments during the past few decades, after a century of substantial climate warming in the Swedish Scandes. This course of biotic landscape evolution has reached historical dimensions and broken a multi-millennial trend of plant cover retrogression, alpine tundra expansion, floristic and faunal impoverishment, all imposed by progressive and deterministic neoglacial climate cooling. Continued modest warming over the present century will likely be beneficial to alpine biodiversity, geoecological stability, resilience, sustainable reindeer husbandry and aesthetic landscape qualities. These aspects are highlighted by an integrative review of results from long-term monitoring of subalpine/alpine vegetation in the Swedish Scandes. This forms the basis for some tentative projections of landscape transformations in a potentially warmer future. Notably, these results and projections are not necessarily valid in other regions and differ in some respects from model predictions. Continued monitoring is mandatory as a basis for generation of more realistic vegetation and ecosystem models.

Comparison of radiographic bone height assessments in panoramic and intraoral radiographs of implant patients.

PURPOSE: To compare the ability of 2 radiographic methods, intraoral and panoramic radiography, commonly used in private practices following implant treatment to provide reliable information about the level of peri-implant marginal bone. An additional aim was to compare the inter- and intraobserver reliability. MATERIALS AND METHODS: Patients with implants placed in the mandible in 10 private practices were studied retrospectively. Postoperative intraoral and panoramic radiographs were evaluated at a university oral radiology clinic. Two observers, a specialist in oral and maxillofacial radiology and a specialist in oral and maxillofacial surgery, assessed the bone level, and the thread at which the marginal bone seemed to be attached was registered for the distal and mesial surfaces of all implants at 2 assessments several weeks apart. Kappa statistics was used to compare the agreement between assessments, observers, and methods of radiography. RESULTS: Intraobserver agreement was good or very good, while interobserver agreement was predominantly moderate. The agreement rate between the methods was also moderate. Seven percent of the sites were not possible to assess, with a small difference in favor for panoramic radiographs. In the assessment of the panoramic radiographs, the radiologist found more sites too difficult to assess than the surgeon did. CONCLUSIONS: In this study, panoramic radiographs were found to be as reliable as conventional intraoral radiographs when used to assess the point of bone attachment to implant threads. Intra- and interobserver agreement were reliable but not excellent. The radiologist was more successful in finding sites where the bone level was impossible to assess accurately.

Quality of digital panoramic radiography in a newly established dental school.

Panoramic radiographs are known to be difficult to expose without errors. The aim of this pilot study was to determine the degree of success in taking error free digital panoramic radiographs. An experienced Oral and Maxillofacial Radiologist assessed the subjective image quality of 199 panoramic radiographs exposed in a newly established dental school in Kuwait. The number of errors according to an international "quality standard" in a panoramic radiograph was assessed. All radiographs were exposed by a dentist with minimal experience in taking panoramic radiographs. It was found that the number of errors in each radiograph ranged from 1 to 9 and no radiograph was completely free from errors. The average number of errors in the radiographs was 3.7. Hence, these results confirm that panoramic radiography is a difficult radiographic technique, which needs an experienced operator in order to get high quality radiographs. Both theoretical and practical training is recommended for radiology staff, as in Sweden, where dental staff should be properly trained to make exposures.

Cold-induced dieback of montane spruce forests in the Swedish Scandes - a modern analogue of paleoenvironmental processes.

In 1987 particularly, but also in 1988, primaeval montane coniferous forests of northern Scandinavia experienced needle loss on an unprecedented scale, which affected the character of the entire landscape in certain regions. This study elucidates the dieback event For Norway spruce [Picea abies (L.) Karst.] in an area of the Swedish Scandes. The study includes visual assessment of percentage needle loss, age structure, radial growth and various environmental parameters, along altitudinal transects and within a larger sample plot. Frequency and magnitude of foliage damage were found to be related to elevation. The dieback process of closed forest stands was interpreted as a response to short-term climatic variability. Damage mainly developed during one of the coldest early winters (December January 1986/7) of this century. In combination with sub-normal depth of the snow caver, the severe cold promoted exceptionally deep and persistent soil frost in spruce forest stands. It is hypothesized that damage was mainly due to winter/spring drought (frost-drought). Phenotypically closed forest stands may change in just a few years in response to cooling, a feature which has not been realized previously. The possibility of major retrogressive responses lo short-term climatic events should therefore be considered in studies of historical biogeography and when modelling vegetation succession. The forest studied was probably established after a severe wind storm in 1837. The restocking process was facilitated by the post-Little Ice Age warming, but the stands are at present suffering severe dieback due to the recent cooling of the climate. The results stress the potential importance of short-term climatic disturbance in boreal forest succession. Reasonably, rapid cold-induced dieback of forest stands may have been a recurrent feature of Holocene forest history in the Boreal zone.

Holocene history of the forest-alpine tundra ecotone in the Scandes Mountains (central Sweden).

The Holocene history of the forest-alpine tundra ecotone in Central Sweden (Scandes Mountains) is inferred from radiocarbon analyses of subfossil wood remains. Pinus sylvestris was the dominant subalpine tree species during the early Holocene, when it ascended almost 200 m higher than currently. A short climatic episode (less than 100 years) is postulated to have triggered erosional processes around 6300 n.p., and extinguished the upper part of the subalpine pine woodland. Subsequently, a subalpine belt of Betula pubescens ssp. tortuosa and Alnus incana developed. A Holocene thermal optimum occurred around 6100 b.p., when the birch/alder belt nourished and the tree-limits probably reached their highest levels during the Holocene. Shortly after 6000 b.p., a long-term pine forest retrogression started and the birch/alder belt was disrupted by expanding snow-beds. Pine receded slightly at its tree-limit, but the uppermost belt of closed pine forest (presently dominated by birch) remained intact until c. 3300 b.p., when a severe climatic deterioration occurred. The present-day subalpine belt of pure birch forest developed successively and increased in vertical extent after c. 5300 b.p., when summer temperature declined. The evolution of the birch belt is postulated to have been ultimately a response to decreased seasonally, which favoured birch at the expense of pine. Because of the 'inertia' characterizing the highest pine forest, the birch belt was relatively narrow until a major thermal decline e. 3300 b.p., when it made a massive downslope expansion. The latest phase of pine recession was during the Little Ice Age, 800-300 b.p.