Browsing by Subject "dentistry"

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  • Nieminen, Pentti; Uma, Eswara; Mani, Shani Ann; John, Jacob; Laitala, Marja-Liisa; Lappalainen, Olli-Pekka (2022)
    The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, "e-professionalism," has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be "friends"). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students.
  • Salminen, Aino (Helsingin yliopisto, 2016)
    Matrix metalloproteinases (MMPs) are enzymes that are responsible for the degradation of the extracellular matrix (ECM) during development, repair, and remodeling of tissues. MMP-8, also known as neutrophil collagenase, is released from neutrophils when they enter the tissues at the site of inflammation. An imbalance in MMP-8 activity leads to excess degradation of tissues and destructive inflammation, such as periodontitis. Elevated concentrations of MMP-8 in serum and plasma are also associated with cardiovascular diseases (CVDs). Doxycycline has inhibitory effects against MMPs in addition to its well-known property of being antimicrobial. This thesis investigated the genetics of MMP-8, the effect of MMP-8 and its inhibitors on lipid metabolism, and the potential of salivary MMP-8 in diagnostics of periodontitis. We performed a genome-wide association study (GWAS) in two independent populations with a total of 6049 individuals to identify genetic variants and molecular mechanisms that affect serum MMP-8 concentrations. In addition, we studied whether MMP-8-associated genetic variants are related to increased risk of CVDs in over 20 000 individuals. We discovered that genetic polymorphism in the gene of complement factor H (CFH) is strongly associated with the concentrations of MMP-8 in serum. By conducting functional experiments with isolated neutrophils, we found that genetic variation of CFH affected the release of MMP-8 from neutrophils in response to complement activation. In addition, genetic polymorphism in the locus containing the genes of S100 calcium binding proteins A8, A9, and A12 was associated with serum and plasma MMP-8 levels and also with the prevalence and incidence of CVDs. We studied the effect of MMP-8 and its inhibitors on lipid metabolism by conducting cell experiments, in an MMP-8-knockout mouse model, and in a placebo-controlled clinical trial of two years. We discovered that MMP-8 cleaved apolipoprotein A-I (apoA-I), the main protein component of HDL. MMP-8 significantly reduced the ability of HDL to promote cholesterol efflux from cholesterol-loaded macrophages. The cleavage of apoA-I by MMP-8 and the reduction in its cholesterol efflux capacity was inhibited by doxycycline at clinically attainable doses. MMP-8 deficient mice had significantly lower serum triglyceride levels and larger HDL particle size compared to wild type mice. In the clinical trial, the subjects treated with subantimicrobial-dose doxycycline (SDD) displayed a significant increase in cholesterol efflux from macrophages to the serum compared to the baseline, whereas the efflux levels did not change in the placebo group over the study period. We studied the association of three salivary biomarkers, MMP-8, interleukin-1β, and Porphyromonas gingivalis, with periodontal status in 463 subjects. The salivary concentrations of MMP-8, interleukin-1β, and P. gingivalis were associated with the number of deepened periodontal pockets and the extent of alveolar bone loss. The combination of the biomarkers was more strongly associated with moderate to severe periodontitis than any of the biomarkers alone. Our results indicate that activation of the complement system, especially the alternative pathway, contributes significantly to the concentrations of MMP-8 in serum. Genetic polymorphism in S100A8/A9/A12 locus affects circulating MMP-8 levels, and is associated with CVDs. These results emphasize the role of inflammation and the immune system in CVDs. Proteolysis of apoA-I by MMP-8 may disturb HDL metabolism and reverse cholesterol transport, which leads to accumulation of cholesterol in the vessel walls and accelerated atherosclerosis. Inhibition of MMP-8 by doxycycline may reduce the risk of CVDs, especially in vulnerable individuals such as periodontitis patients. Saliva MMP-8, particularly when combined with other biomarkers, has great potential in the diagnostics of periodontitis. MMP-8 in saliva reflects the health of the oral cavity, whereas circulating MMP-8 is associated with systemic diseases such as CVDs. Our results suggest that MMP-8 functions as a link between inflammatory disorders, such as periodontitis, and cardiovascular disorders.
  • Ruuskanen, Arttu (Helsingin yliopisto, 2018)
    Tutkimuksen tarkoitus: HUS-sairaanhoitopiirin alueella hoidetaan vuosittain satoja suun alueen hammasperäisiä märkäpaiseita. Paiseiden ensisijainen hoito on hammaslääketieteellinen infektiofokukseen kohdistuva hoito, mutta sen tukena käytetään usein mikrobilääkkeitä. Mikrobilääke aloitetaan hammaslääketieteellisen hoidon yhteydessä empiirisesti, koska paisemärästä otettu viljelyvastaus valmistuu vasta myöhemmin. Siksi on tärkeää, että käytettävissä on tietoa suun paiseiden mikrobiologiasta ja mikrobien alueellisesta herkkyystilanteesta. HUS-alueella paiseiden bakteeriviljelytutkimukset tehdään HUSLAB:ssa. Tämän tutkimuksen tarkoituksena oli selvittää neljän vuoden ajalta hammasperäisissä paiseissa todetut bakteerilöydökset sekä löydösten mikrobilääkeherkkyys. Tutkimuksessa saatua tietoa voidaan käyttää empiirisen lääkehoidon valinnan tukena suun alueen paiseissa. Materiaalit ja menetelmät: Tutkimusaineistona oli HUSLAB:ssa vuosina 2012-2015 aikana tutkitut suun märkäpaiseiden bakteeriviljelytulokset. Viljelylöydöksistä tutkittiin saadut mikrobilöydökset ja löydösten mikrobilääkeherkkyydet. Näytteitä oli yhteensä n=1239. Tulokset: Yleisin löydös oli anaerobi gram-negatiivinen sauvasekafloora (739 näytettä). Tämän jälkeen yleisimmät löydökset olivat alfahemolyyttisiin streptokokkeihin kuuluvat Streptococcus anginosus- ryhmän streptokokit (267 näytettä) ja muut Viridans-ryhmän streptokokit (233 näytettä) sekä anaerobeihin gram-positiivisiin kokkeihin kuuluva Parvimonas micra-ryhmä (261 näytettää). Myös Candida albicans oli varsin yleinen löydös (189 näytettä). Tutkimuksessa havaittiin, että anaerobi gram-negatiivinen sauvasekafloora oli merkittävässä osassa löydöksiä resistentti usein empiirisessä hoidossa käytettävälle penisilliinille, mutta herkkä metronidatsolille. Sen sijaan Viridans-ryhmän streptokokeista valtaosa oli penisilliinille herkkiä. Sen sijaan Viridans-ryhmän streptokokkien herkkyys klindamysiinille on HUS-sairaanhoitopiirin alueella jonkin verran heikentynyt. Johtopäätökset: Suun alueen paiseissa on tyypillisesti sekä aerobeja että anaerobeja bakteereja sisältävää sekaflooraa, jonka löydökset tutkituin osin ovat pääsääntöisesti herkkiä penisilliinin ja metronidatsolin yhdistelmälle. Vain harvoin näytteissä todetaan esim. Staphylococcus aureusta, johon kyseinen lääkeyhdistelmä ei tehoa. Tutkimuksen tulokset tukevat toukokuussa 2017 julkaistun päivitetyn Hammasperäiset äkilliset infektiot ja mikrobilääkkeet Käypä hoito -suosituksen suosittelemia ensisijaisia mikrobilääkkeitä akuuttien suun alueen märkäpaiseiden hoidossa.
  • Rouhiainen, Vilma (Helsingin yliopisto, 2021)
    Introduction: Many studies, globally, have aimed at elucidating reasons to choose a career in dentistry. The most common motives found are reasonable working hours and aspiration to help. The aim of this study was to explore whether eventual past personal experience of orthodontic treatment and particularly the interpersonal skills of the treating orthodontist are of significance in this respect. Materials and methods: An electronic questionnaire, consisting of multiple choice and descriptive questions about dental history and experiences in dental care, was sent to dental and, as controls, psychology students within the same Faculty of Medicine, University of Helsinki, Finland. The answers between the two groups were compared and differences tested statistically. Results: The questionnaire was answered by 143 (46.0%) dental students and 94 (17.6%) psychology students. Dental students, compared to psychology students, had more positive views of their dentition and dental treatment in general (P=0.000). Among participants, 47.9% of dental students and 57.4% of psychology students had received orthodontic treatment. Of those, dental students had perceived their orthodontic treatment as less painful (P=0.001) and less uncomfortable (P=0.000) than psychology students. Moreover, dental students reported more often experiences of orthodontist taking into account their situation in life during treatment (P=0.011), and gave more positive descriptions of the orthodontist’s interpersonal skills (P=0.031). Conclusions: Dental students, compared to psychology students, had statistically significantly more positive personal experiences related to dentistry and orthodontics, supporting our hypothesis that positive experiences with orthodontic treatment likely increases the probability of choosing dentistry as the future career.
  • Rouhiainen, V; Karaharju-Suvanto, T; Waltimo-Siren, J (2022)
    Introduction Many studies, globally, have aimed at elucidating reasons to choose a career in dentistry. The most common motives found are reasonable working hours and aspiration to help. The aim of this study was to explore whether eventual past personal experience of orthodontic treatment and particularly the interpersonal skills of the treating orthodontist are of significance in this respect. Materials and methods An electronic questionnaire, consisting of multiple choice and descriptive questions about dental history and experiences in dental care, was sent to dental and, as controls, psychology students within the same Faculty of Medicine, University of Helsinki, Finland. The answers between the two groups were compared and differences tested statistically. Results The questionnaire was answered by 143 (46.0%) dental students and 94 (17.6%) psychology students. Dental students, compared to psychology students, had more positive views of their dentition and dental treatment in general (p = 0.000). Amongst participants, 47.9% of dental students and 57.4% of psychology students had received orthodontic treatment. Of those, dental students had perceived their orthodontic treatment as less painful (p = 0.001) and less uncomfortable (p = 0.000) than psychology students. Moreover, dental students reported more often experiences of orthodontist taking into account their situation in life during treatment (p = 0.011) and gave more positive descriptions of the orthodontist's interpersonal skills (p = 0.031). Conclusions Dental students, compared to psychology students, had statistically significantly more positive personal experiences related to dentistry and orthodontics, supporting our hypothesis that positive experiences with orthodontic treatment likely increase the probability of choosing dentistry as the future career.
  • Al-Samadi, Ahmed (Helsingin yliopisto, 2015)
    Recurrent aphthous ulcer (RAU) is an ulcerative disease of the oral mucosa characterised by the appearance of ulcerations in the oral mucosa accompanied by an erythematous halo area surrounding the ulcer and showing signs of acute inflammation. While RAU affects approximately 20% of the population globally, its pathogenesis remains poorly understood. Furthermore, most studies concentrate on treatment while few address the pathogenesis of the disease. This project aimed to determine the mechanisms of oral epithelial cell death in RAU, the role of these cells in disease pathogenesis in terms of toll-like receptor (TLR) expression, and the ability of the these cells to produce chemokines, pro-inflammatory cytokines, and antimicrobial peptides. Together these may first aggravate and, then, down-regulate the inflammation and initiate the healing process. For this purpose, we collected 13 aphthae and 11 healthy control biopsies for immunohistochemical staining, immunofluorescence staining, and quantitative PCR. For functional studies, we cultured primary oral keratinocytes and oral squamous cell carcinoma cell-line SCC-25 and tested their responses to different stimuli. Our results highlight the importance of oral epithelial cells in RAU; interestingly, oral epithelial cells in RAU tested positive for apoptosis markers caspase-3, especially at the superficial and spinous layer, and TUNEL, but negative in controls. We also found that TLRs are primarily present in the basal and suprabasal layers of control epithelium, but their expression extends to the superficial layer in RAU epithelium. Additionally, we found significally higher expressions of tumour necrosis factor-α (TNF-α), interleukin-8 (IL-8), IL-17C, and beta defensin 2 (BD-2) in RAU oral epithelium compared with control epithelium. Functional studies on cultured primary oral keratinocytes and SCC-25 supported our results from RAU biopsies since these cells responded to damage-associated molecule patterns (DAMPs), such as self-DNA and pro-inflammatory cytokines including IL-17C, TNF-α, and interferon gamma (IFN-γ), through a significant increase in the expression of selected molecules including TLR2, TNF-α, and BD-2. Based on our findings, RAU may begin with a strong initiating factor activating a self-amplificatory cycle. This cycle is characterised by the induction of epithelial cells apoptosis at the superficial layer down to the basal layer, a change in the pattern of TLR distribution, the up-regulation of several chemokines and pro-inflammatory cytokines, and, finally, the secretion of antimicrobial peptides initating the healing process. As a result of the lack of adaptive immunity in RAU, the cycle recurs when the mucosa is subjected to an initiating factor of the same sequence.
  • Karaharju-Suvanto, Terhi; Choroszewicz, Marta; Näpänkangas, Ritva; Suominen, Anna Liisa; Tolvanen, Mimmi; Koivumaki, Jaakko (2021)
    Introduction For over the last 20 years, approximately 70% of working dentists in Finland have been women. However, there is internal division of the profession along gender lines. Female dentists work more often in the public sector and male dentists in the private sector. The aim of this study was to investigate the gender differences in young dentists' early career choices, specialization plans, values and perceptions of professional identity. Materials and methods The data were taken from a national e-mail questionnaire study called "Young Dentist," which was sent to 458 dentists who had received their licence to practise dentistry in 2014-2016 from all four universities with dental curricula in Finland. A total of 52% young dentists (n = 238) answered the questionnaire. Results and discussion The results indicated that whereas female dentists were more likely to perceive themselves as comforters, social workers and health promoters, male dentists tended to perceive themselves as technicians. These professional identities were interrelated with early-stage career choices in which female dentists worked more often in the public than in the private sector when compared to male dentists. There were also clear gender differences in the importance of values and the specialization plans of the young dentists. Conclusion Young dentists in Finland make career choices and develop professional identity in accordance with the attributes traditionally associated with cultural ideals related to femininity and masculinity.
  • Tuomi, Tytti (Helsingin yliopisto, 2019)
    Työn tuunaaminen on työntekijästä itsestään lähtöisin oleva prosessi, jossa työntekijä muokkaa työtä itselleen mielekkäämmäksi. Työn tuunauksella työntekijä pyrkii lisäämään työnsä voimavaroja, jotka työn voimavarojen ja vaatimusten mallin mukaisesti vähentävät työn kuormitustekijöiden negatiivisia vaikutuksia. Työn tuunaamisella pyritään myös lisäämään työn imua, joka on työhyvinvoinnin positiivinen tila. Osa Helsingin kaupungin suun terveydenhuollon esimiehistä on tutkimusten, työhyvinvointikyselyiden, palautteiden ja arkiviestinnän mukaan kuormittuneita. Tämän tutkimuksen tarkoituksena oli selvittää, onko esimiehillä mahdollisuuksia tuunata työtään ja millä keinoin he tuunaavat työtään, jos tuunaavat ja pystyvätkö he vaikuttamaan omaan työhyvinvointiinsa työtä tuunaamalla. Tutkielmassa käsitellään työn tuunaamista, työn imua ja niihin olennaisesti liittyvää työn vaatimusten ja voimavarojen mallia. Lisäksi käsitellään esimiestyötä yleisellä tasolla ja tehtyjä hammaslääkäreiden työhyvinvointiin liittyviä tutkimuksia sekä Helsingin kaupungin suun terveydenhuollon esimiehille toteutettua voimavaroja ja kuormitustekijöitä kartoittavaa tutkimusta, jota käytettiin tukena tämän tutkimuksen aineistonkeruussa käytetyn haastattelurungon muodostamisessa. Aineisto kerättiin haastattelemalla vapaaehtoisia Helsingin kaupungin suun terveydenhuollon esimiehiä. Yksilöhaastatteluja tehtiin yhteensä yhdeksän. Saatu aineisto analysoitiin aineistolähtöistä sisällönanalyysimenetelmää mukaillen. Tulosten mukaan Helsingin kaupungin suun terveydenhuollon esimiehet kokevat työn tuunaamiselle hyvät mahdollisuudet. Toisaalta tuunaamista rajoittavat kuormittuneisuus ja kiire. Esimiehet tuunaavat työtehtäviään, näkökulmaa työhönsä ja työssään tapahtuvaa vuorovaikutusta erilaisin keinoin. Työn tuunaamisella esimiehet voivat muokata työtään itselleen mielekkäämmäksi ja vaikuttaa positiivisesti työyhteisön ilmapiiriin. Esimiehen hyvinvointi heijastuu työyhteisöön ja sen toiminnan tuloksellisuuteen, joten työn tuunaamisella ja sen vaikutuksilla esimiehen hyvinvointiin voi olla positiivisia vaikutuksia koko työyhteisön toimintaan.