[Insertion of intrauterine device in general practice. Which women choose the IUD, and how is the procedure done?]. / Spiraloplaegning i almen praksis. Hvem får oplagt spiral, og hvordan er proceduren?

INTRODUCTION: In Denmark most IUDs are inserted by general practitioners (GPs). The aim of this study was to throw light on which women choose IUD, the procedure used, and difficulties associated with insertion. MATERIAL AND METHODS: All 232 GPs in Frederiksborg County were invited to participate and 88 agreed. The GP filled in a questionnaire concerning the type of IUD, the age, parity, etc, of the woman and information about the insertion. RESULTS: Eighty-eight GPs contributed with 562 IUD insertions. IUD was mostly used by women above 25 years of age and by women who had given birth to a child. There were no differences in the insertion procedures used by the doctors. Fifty-nine per cent of the women were previous IUD users. Of the former users, 37% reported problems with the previous use of the IUD. Twenty-five per cent of the women in this study reported that they had had heavy or long-lasting menstruation before insertion. Fifty-five per cent of the women had a test for chlamydia before insertion. Twenty-three (4.1%) insertions were abandoned. 26 (4.6%) insertions were described as difficult. The highest frequency was in women using gestagen-releasing IUDs. CONCLUSION: IUD was mainly used by women, who had given birth to a child. The gestagen releasing IUD was mostly used by the elder group and by women with heavy bleedings before insertion. The procedure was very identical and the number of abandoned and difficult insertions were low and only related to the type of IUD. More female than male doctors participated. Doctors working in partnerships participated more frequently than doctors working alone.

Is the 16S-23S rRNA internal transcribed spacer region a good tool for use in molecular systematics and population genetics? A case study in cyanobacteria.

We amplified, TA-cloned, and sequenced the 16S-23S internal transcribed spacer (ITS) regions from single isolates of several cyanobacterial species, Calothrix parietina, Scytonema hyalinum, Coelodesmium wrangelii, Tolypothrix distorta, and a putative new genus (isolates SRS6 and SRS70), to investigate the potential of this DNA sequence for phylogenetic and population genetic studies. All isolates carried ITS regions containing the sequences coding for two tRNA molecules (tRNA and tRNA). We retrieved additional sequences without tRNA features from both C. parietina and S. hyalinum. Furthermore, in S. hyalinum, we found two of these non-tRNA-encoding regions to be identical in length but different in sequence. This is the first report of ITS regions from a single cyanobacterial isolate not only different in configuration, but also, within one configuration, different in sequence. The potential of the ITS region as a tool for studying molecular systematics and population genetics is significant, but the presence of multiple nonidentical rRNA operons poses problems. Multiple nonidentical rRNA operons may impact both studies that depend on comparisons of phylogenetically homologous sequences and those that employ restriction enzyme digests of PCR products. We review current knowledge of the numbers and kinds of 16S-23S ITS regions present across bacterial groups and plastids, and we discuss broad patterns congruent with higher-level systematics of prokaryotes.

Abrasive effect of a rotating electrical toothbrush on dentin.

The Rota-dent brush has been compared to conventional manual toothbrushes as to the abrasive effect on the dentin. Thirty-two teeth were embedded in epoxyresin. The test blocks were ground and polished, thereafter brushed with Jordan Soft, Jordan Blå Kjerne, Wisdom Plaque Master (hard) and three different Rota-dent brushes, Standardpoint, Hollow-cup and Longpoint. The brushing experiment was made in a test chamber filled with distilled water. After the brushing, the profiles of the brushtracks on the blocks were measured. On all the blocks, small tracks appeared which were not measurable. Conventional toothbrushes and Rota-Dent brushes used without dentifrice gave minimal abrasion on the dentin.

Serum levels of antibodies against Actinobacillus actinomycetemcomitans in various forms of human periodontitis.

Serum levels of IgG, IgA, and IgM antibodies against extracts from Bacteroides gingivalis PER8, Actinobacillus actinomycetemcomitans Y4, and Bacteroides fragilis NCTC 9343 were determined in three categories of periodontitis patients by means of enzyme-linked immunosorbent assay. The test groups comprised 10 patients with juvenile periodontitis (JP), 18 young patients with severe periodontitis (YP), and 31 patients with adult periodontitis (AP). Nine subjects with healthy periodontium (HP) served as a reference group. Increased frequencies of patients with significantly elevated IgG and IgA antibody values against B. gingivalis and A. actinomycetemcomitans were found in the three periodontitis groups as compared with the HP group. The AP group, however, showed lower IgM values than the other groups. The results support the contention that A. actinomycetemcomitans may play a contributory role in adult periodontitis and that B. gingivalis is a suspected periopathogenic bacterium in juvenile periodontitis. The clinical YP classification was not supported by the present serologic findings.

Tooth hypersensitivity after periodontal treatment. A case report including SEM studies.

Sensitive teeth after periodontal treatment are a rather common finding. Therefore, it has been questioned whether all the cementum on the root surfaces ought to be removed during periodontal therapy, since the sensitivity is caused by exposure of the dentin. Usually, the hypersensitivity represents a minor problem and will decrease or disappear with time. However, the following case demonstrates that repeated instrumentation of periodontally involved teeth can lead to an extreme degree of hypersensitivity.

Attachment of human gingival fibroblasts to planed root surfaces exposed to human plasma in vitro.

We studied the effect of exposing planed dentin surfaces (DS) to human plasma on the attachment of human gingival fibroblasts (HGF) in vitro as compared with their attachment to citric-acid-demineralized DS. Sixty-six DS were prepared from root-planed roots of surgically extracted human third molars. In a pilot experiment 30 DS were demineralized in citric acid (pH 1.0 for 3 min), and each of 3 DS were placed in a culture dish and incubated with fresh plasma for 0, 10, or 30 sec, 1, 10, or 30 min, or 1, 1.5, 2, or 4h. In a second experiment, three culture dishes containing three DS each were assigned to each of four groups. These were untreated (control), incubated with plasma for 2h, acid-demineralized only, or acid-demineralized and then incubated with plasma for 2h. To each dish was added 0.2 X 10(6) HGF, and these were incubated for 2, 6, or 24 h. The unattached cells were then removed, and the DS fixed and processed for SEM. The results showed that exposing demineralized dentin surfaces to plasma causes the absorption of a coating layer, presumably of organic nature, as early as 30 sec after exposure. Acid-demineralized DS alone or together with plasma treatment enhanced both the attachment and the growth of HGF. However, treatment with plasma alone seemed to enhance the HGF attachment less than did acid demineralization alone.

Radiographic quantification of alveolar bone level changes. A 2-year longitudinal study in man.

The "random burst" theory has recently been proposed as an explanation of the pattern of periodontal disease progression. The theory predicts that the progression of bone loss at individual sites is not dependent upon previous bone loss and age. A longitudinal radiographic study was designed to test this hypothesis, and to describe the changes in bone level over 2 years in a group of 180 subjects (18-68 years of age) who were not under systematic periodontal treatment. The results indicated that 94% of the sites did not show significant changes in the alveolar bone level during the observation period. The mean annual bone loss for the total population was 0.11 mm. By regressing longitudinal bone loss upon age, it was shown that the rate of bone loss increased rapidly between 33 and 56 years of age while a different pattern was shown for the age intervals 18-32 and 57-68 years. Also, the rate of bone loss increased with increasing initial bone loss. This was less evident in the oldest age group. It was concluded that the progression of bone loss in the present material is consistent with a "burst" theory. However, the progression did not occur randomly with regard to previous loss of alveolar bone and time.

Premedication before day surgery. A double-blind comparison of diazepam and placebo.

Premedication with diazepam 0.25 mg kg-1 by mouth was compared with placebo in a double-blind trial in patients undergoing day-case surgery under general anaesthesia. Diazepam decreased significantly preoperative discomfort and apprehension. The patients were discharged on time regardless of the type of premedication, and complaints at the time of discharge and on the following day could be related only to the length of anaesthesia and not to the type of premedication. Premedication given early in the morning remained effective for up to 6 h.

Comparison of the effect of chlorhexidine and CuSO4 on plaque formation and development of gingivitis.

Recent studies have shown that several metal ions inhibit plaque formation and reduce the acidogenicity of dental plaque. The aim of the present study was to compare the effect on plaque and gingivitis of 2.2 mM CuSO4 with an equimolar solution of chlorhexidine in a modified experimental gingivitis model. The study was performed according to a double-blind cross-over design. Before each experimental period the GI was recorded and the participants' teeth were scaled and polished to remove all supragingival deposits. All mechanical oral hygiene was suspended during the experimental periods. The mean PII after rinsing with chlorhexidine, CuSO4 and water was 0.29, 0.79 and 1.25, respectively. The corresponding GI values were 0.57, 0.83 and 1.02. All differences were statistically significant. The results showed that CuSO4 inhibits plaque formation and development of gingivitis, but not to the same degree as chlorhexidine.