Treatment of dental anxiety disorders. Outcome related to DSM-IV diagnoses

In this study we evaluated treatment effects in 70 consecutively admitted patients in a specialized university clinic for treatment of dental fear. Thirty-three (47%) of the patients fulfilled the diagnostic criteria for Specific Phobia alone (Dental Phobia, DP), 24 (33%) had severe dental anxiety without fulfilling the criteria for phobia (ND), and 13 (19%) fulfilled the criteria for multiple DSM-IV diagnoses (MD). Dental anxiety was measured prior to, immediately after and at follow-up (mean = 19 months) using Corah's Dental Anxiety Scale and Dental Fear Survey. Dental attitudes were measured by Getz' Dental Beliefs Survey. Dental attendance and everyday functioning were measured by self-report. DP patients received significantly more treatment-sessions as compared to the ND group. Despite significant overall reductions in scores on all psychometric instruments from pretreatment to follow up, patients in the MD group reported significantly more severe anxiety at pre- and post-treatment and at follow-up as compared to patients in the ND group. There was no interaction between diagnostic group and assessment occasion (pre treatment, post treatment and follow up) on the self-reported anxiety. Patients reported significant improvements in self-esteem, social relations and everyday functioning, regardless of diagnostic group. Sixty-three percentage of the respondents had been to the dentist within 1 year after completed treatment. Patients treated by dentists who had received supervised training in exposure treatment had significantly more often seen the dentist at follow-up.     

A telescopic crown concept for the restoration of partially edentulous patients with aggressive generalized periodontitis: a 3-year prospective longitudinal study

This prospective longitudinal 3-year study compared clinical parameters and implant success rates of removable superstructures supported by both teeth and implants in patients with treated generalized aggressive periodontitis (GAP) and of cemented, implant-retained fixed superstructures in periodontally healthy patients. A total of 17 partially edentulous patients with 54 implants took part in the study. Nine patients with treated GAP received removable superstructures according to the Marburg double crown system, and eight periodontally healthy patients received fixed superstructures. Teeth were examined 2 to 4 weeks before extraction of the nonretainable teeth (baseline) and 3 weeks after insertion of the definitive abutments. Every 3 months over a 3-year period, clinical parameters were recorded and the composition of the subgingival microflora was determined. Intraoral radiographs were obtained at baseline, just after insertion of the superstructure, and 1 and 3 years later. Both groups showed mean plaque and gingival indices below 0.43 at implants and teeth. Mean probing depths around implants increased by approximately 0.7 mm and remained virtually constant for the teeth. Mean attachment loss at implants was 0.9 mm in GAP patients and 0.5 mm in healthy patients. The morphologic distribution of microorganisms in both groups showed healthy conditions. Moderate bone loss at teeth and implants was registered. Implant success rates were 100% in the healthy patients and 97.6% in the GAP patients. No significant differences were seen in the results between the groups.