Dental Health in Primary Teeth after Prevention of Mother-Child Transmission of Mutans Streptococci. A Historical Cohort Study on Restorative Visits and Maternal Prevention Costs

Mutansstreptokokkitartunnan ehkäisemisen pitkäaikaisvaikutukset maitohampaiden terveyteen. Kohorttitutkimus korjaavan hoidon määrästä ja kariesehkäisyn kustannuksista. Tutkimuksen tarkoituksena oli selvittää varhaisen mutansstreptokokki (MS)-kolonisaation ehkäisyn pitkäaikaisvaikutuksia korkean kariesriskin omaavien lasten maitohampaistossa sekä tarkastella MS-tartunnan estämisen kustannuksia. Tiedot lasten hampaiden terveydestä ja hammashoitotoimenpiteistä syntymästä 10-vuotiaaksi sekä äiteihin kohdistuneen kariesehkäisyn kustannuksista kerättiin Ylivieskan terveyskeskuksen asiakirjoista. Tutkimuksessa oli mukana yhteensä 507 lasta, heistä 148 oli osallistunut aikaisempaan Ylivieskan äiti-lapsitutkimukseen, jossa verrattiin äitien käyttämän ksylitolipurukumin ja äidille tehtyjen fluori- tai klooriheksidiinilakkausten vaikutusta pikkulasten hampaiden terveyteen. Maitohammaskariesta esiintyi 10-vuotiaaksi asti merkitsevästi vähemmän lapsilla, jotka eivät olleet saaneet MS-tartuntaa alle 2-vuotiaana, heidän maitohampaansa säilyivät 3,4 vuotta kauemmin täysin ehjinä (p<0.001) ja he tarvitsivat vähemmän maitohampaiden korjaavaa hoitoa (p=0.005) kuin lapset, joiden hampaisto oli kolonisoitunut MS-bakteerilla jo 2-vuotiaana. Koska ksylitoliryhmän lasten MS-kolonisaatio oli vähäisintä, heidän maitohampaissaan oli vähemmän kariesta ja korjaavan hoidon tarvetta kuin kahden muun korkeariskisen ryhmän lapsilla. Äitien käyttämän ksylitolipurukumin kustannukset olivat yhteensä 116 euroa ja lapsen maitohampaiden säilyminen täysin ehjinä vuoden pidempään maksoi 37 euroa. Kun MS-tartunta oli saatu estettyä, korkean kariesriskin omaavien lasten hampaiden terveys oli samalla tasolla kuin keskimäärin koko ikäkohortilla. Lapsen maitohampaat säilyvät terveinä pidempään ja korjaavan hoidon tarve vähenee, kun MS-kolonisaatio alle 2-vuotiaana saadaan estettyä. Lapsen MS-kolonisaatio vähenee merkitsevästi, kun äiti käyttää ksylitolipurukumia lapsen ollessa 0-2 vuoden ikäinen, siten pikkulapsen äidin säännöllinen ksylitolipurukumin käyttö saattaa olla julkisen tereydenhuollon kannalta tarkoituksenmukainenterveyttä edistävä menetelmä.

Rigid Rod Polymer Fillers in Acrylic Denture and Dental Adhesive Resin Systems

Polymeric materials have been used in dental applications for decades. Adhesion of polymeric materials to each other and to the tooth substrate is essential to their successful use. The aim of this series of studies was two-folded. First, to improve adhesion of poly(paraphenylene) based rigid rod polymer (RRP) to other dental polymers, and secondly, to evaluate the usability of a new dentin primer system based on RRP fillers. Poly(paraphenylene) based RRP would be a tempting material for dental applications because of its good mechanical properties. To be used in dental applications, reliable adhesion between RRP and other dental polymers is required. In this series of studies, the adhesion of RRP to denture base polymer and the mechanical properties of RRP-denture base polymer-material combination were evaluated. Also adhesion of BisGMA-TEGDMA-resin to RRP was determined. Different surface treatments were tested to improve the adhesion of BisGMA-TEGDMA-resin to RRP. Results were based on three-point bending testing, Vickers surface hardness test and scanning electron microscope analysis (SEM), which showed that no reliable adhesion between RRP and denture base polymer was formed. Addition of RRP filler to denture base polymer increased surface hardness and flexural modulus but flexural strength decreased. Results from the shear bond strength test and SEM revealed that adhesion between resin and RRP was possible to improve by surface treatment with dichloromethane (DCM) based primer and a new kind of adhesive surface can be designed. The current dentin bonding agents have good immediate bond strength, but in long term the bond strength may decrease due to the detrimental effect of water and perhaps by matrix metalloproteinases. This leads to problems in longevity of restorations. Current bonding agents use organic monomers. In this series of studies, RRP filled dentin primer was tested in order to decrease the water sorption of the monomer system of the primers. The properties of new dentin primer system were evaluated in vitro by comparing it to commercial etch and rinse adhesive system. The results from the contact angle measurements and SEM showed that experimental primer with RRP reinforcement provided similar resin infiltration to dentin collagen and formed the resin-dentin interface as the control primer. Microtensile bond strength test and SEM revealed that in short term water storing, RRP increased bond strength and primer with BMEP-monomer (bis[2-(methacryloyloxy)-ethyl]phosphate) and high solvent concentration provided comparable bonding properties to the commercial control primers. In long term water storing, the high solvent-monomer concentration of the experimental primers decreased bond strength. However, in low solvent-monomer concentration groups, the long-term water storing did not decrease the bond strength despite the existence of hydrophilic monomers which were used in the system. These studies demonstrated that new dentin primer system reached the mechanical properties of current traditional etch and rinse adhesive system in short time water storing. Improved properties can be achieved by further modifications of the monomer system. Studies of the adhesion of RRP to other polymers suggest that adhesion between RRP and other dental polymers is possible to obtain by certain surface treatments.

The Influence of Certain Processing Factors on the Durability of Yttrium Stabilized Zirconia Used As Dental Biomaterial

In dentistry, yttrium partially stabilized zirconia (ZrO2) has become one of the most attractive ceramic materials for prosthetic applications. The aim of this series of studies was to evaluate whether certain treatments used in the manufacturing process, such as sintering time, color shading or heat treatment of zirconia affect the material properties. Another aim was to evaluate the load-bearing capacity and marginal fit of manually copy-milled custom-made versus prefabricated commercially available zirconia implant abutments. Mechanical properties such as flexural strength and surface microhardness were determined for green-stage milled and sintered yttrium partially stabilized zirconia after different sintering time, coloring process and heat treatments. Scanning electron microscope (SEM) was used for analyzing the possible changes in surface structure of zirconia material after reduced sintering time, coloring and heat treatments. Possible phase change from the tetragonal to the monoclinic phase was evaluated by X-ray diffraction analysis (XRD). The load-bearing capacity of different implant abutments was measured and the fit between abutment and implant replica was examined with SEM. The results of these studies showed that the shorter sintering time or the thermocycling did not affect the strength or surface microhardness of zirconia. Coloring of zirconia decreased strength compared to un-colored control zirconia, and some of the colored zirconia specimens also showed a decrease in surface microhardness. Coloring also affected the dimensions of zirconia. Significantly decreased shrinkage was found for colored zirconia specimens during sintering. Heat treatment of zirconia did not seem to affect materials’ mechanical properties but when a thin coating of wash and glaze porcelain was fired on the tensile side of the disc the flexural strength decreased significantly. Furthermore, it was found that thermocycling increased the monoclinic phase on the surface of the zirconia. Color shading or heat treatment did not seem to affect phase transformation but small monoclinic peaks were detected on the surface of the heat treated specimens with a thin coating of wash and glaze porcelain on the opposite side. Custom-made zirconia abutments showed comparable load-bearing capacity to the prefabricated commercially available zirconia abutments. However, the fit of the custom-made abutments was less satisfactory than that of the commercially available abutments. These studies suggest that zirconia is a durable material and other treatments than color shading used in the manufacturing process of zirconia bulk material does not affect the material’s strength. The decrease in strength and dimensional changes after color shading needs to be taken into account when fabricating zirconia substructures for fixed dental prostheses. Manually copy-milled custom-made abutments have acceptable load-bearing capacity but the marginal accuracy has to be evaluated carefully.

Venture capital investment on SME

This thesis studies venture capital investment on small and medium-sized enterprises (SMEs). The specific objective of the study is to test whether venture capitalists have a positive effect on SMEs. In addition effect of several other factors is studied in financial crisis. Used determinants are formulated based on three capital structure theories. The pecking order theory concerns favoring on financing source over another. The agency theory and the tradeoff theory concentrate on the search of optimal capital structure. The data of this study consist of financial statement data and results of corporate questionnaire. Regression analysis was used to find out the effects of several determinants. Regression models were formed based on the presented theories. SMEs with and without venture capitalists were considered separately. It was found that venture capitalists have a positive effect on SMEs. Although some results between SMEs with and without venture capitalists were mixed.

Investment risks in Russia: A Finnish perspective

Purpose of this study is to analyze the effect of Russia's economic environment changes in the total return indexes of Finnish companies. The research data consisted of Finnish publicly listed companies, which have made physical investments to Russia, and operating in the area. The study used six different variables to model the Russian operating environment. The data consists of total return indexes of Finnish companies. From those we calculated the monthly mean interval between timeline of 1 January 2000 to 31 December 2009. Sample period is divided into two different parts. Variables impact on companies' total return indices is tested by regression analysis. By F-test we tested significance of model and squared coefficient correlation told us how much model explains from changes. Goodness of the β-coefficient is tested in the model by t-test. The research results shows that the Russian operating environment, or changes in which the active Finnish companies in total return indices. On partial sample periods results were not so significant.

Virtual Professional Network as a Value Creator in the Dental Business

The research of virtual professional networks has been enormous but the lack of research in the dental field was obvious. This study focuses on those uses and gratifications, and motives of participants that a virtual pro-fessional network should fulfil. The aim of this study is to understand the factors behind the successful virtual professional network, and motives of participants that support a particular business network’s building up for contributing its further success. In this study the focus is on particular mo-tives, needs and benefits of participants that are significant for the net-work’s further development. The study will explore relevant scientific research and theory that is char-acteristic in networking, and theories of user’s needs and motives. Empiri-cal data was collected from dental professionals by net based question-naire that was sent by e-mail. Data analysis was done by quantitative fac-tor analysis. The findings of this study were obvious that virtual knowledge of implantology is inadequate and knowledge is rather difficult to find in the Internet. Sharing of virtual knowledge, net-learning and communication were seen to improve the quality of impolantological professionalism and also the development of these areas was experienced essential. On the grounds of this study a host of a virtual professional network can focus on those aspects that serve the users at best, can develop professionalism in implantology and can profit in its own business operations.

Carbohydrate intake in children - associations with dietary intakes, growth, serum lipids,and dental health. The STRIP Project

This study is part of the STRIP study, which is a long-term, randomized controlled trial, designed to decrease the exposure of children in the intervention group (n=540) to known risk factors of atherosclerosis. The main focus of the intervention was the quality of dietary fat. The control group (n=522) did not receive any individualized counselling. Food consumption was evaluated with food records, and blood samples were drawn and growth was measured regularly for all participating children from 13 months to 9 years. A subsample of 66 children participated in a dental health survey. The number of studies on children’s carbohydrate intake, especially fibre intake, is insufficient. The current international recommendations for fibre intake in children are based on average assumptions and data extrapolated from intakes in adults and intake recommendations for adults. Finnish nutrition recommendations lack strict recommendations for dietary fibre in children. Due to fibre’s high bulk volume, excessive dietary fibre is considered to decrease energy density and hence it may have an adverse effect on growth. If fats are reduced from the diet, the low-fat diet may become high in sucrose. Therefore, especially in the STRIP study, it is important to determine the use of fibre and sucrose in children and possible associations with growth and nutrition as well as dental health. The results of the present study indicate that a high fibre intake does not displace energy or disturb growth in children and that children with high fibre intake have better quality of diet than those with low fibre intake. Additionally, dietary fibre intake associated inversely with serum cholesterol concentration. Other carbohydrates also affected serum lipid levels as well, since total carbohydrates, sucrose, and fructose increased serum triglyceride concentration. Total carbohydrate intake reduced HDL cholesterol concentration only in children with apoE3 or apoE4 phenotype. Over the period from the 1970s to the 1990s the dental health of children in Finland has substantially improved despite an increase in sucrose intake. The improvement was thought to be due to improved dental hygiene and the use of fluorine. However, during the past twenty years improvement in dental health has stopped. The present study showed that high long-term sugar intake increases risk of caries in children. High intake of sugar had also negative effects on the diet of children, because it worsens dietary quality by displacing essential nutrients. Furthermore, the quality of dietary fat was worse in children with high sucrose intake. In this study the children’s high sucrose intake was not associated with overweight, but interestingly, it associated inversely with growth.

Performance Comparison of Behavioral Finance -based Investment Strategies in the Finnish Stock Market 1996-2010

In this thesis traditional investment strategies (value and growth) are compared to modern investment strategies (momentum, contrarian and GARP) in terms of risk, performance and cumulative returns. Strategies are compared during time period reaching from 1996 to 2010 in the Finnish stock market. Used data includes all listed main list stocks, dividends and is adjusted in case of splits, and mergers and acquisitions. Strategies are tested using different holding periods (6, 12 and 36 months) and data is divided into tercile portfolios based on different ranking criteria. Contrarian and growth strategies are the only strategies with improved cumulative returns when longer holding periods are used. Momentum (52-week high price1) and GARP strategies based on short holding period have the best performance and contrarian and growth strategies the worst. Momentum strategies (52-week high price) along with short holding period contrarian strategies (52-week low price2) have the lowest risk. Strategies with the highest risk are both growth strategies and two momentum strategies (52-week low price). The empirical results support the efficiency of momentum, GARP and value strategies. The least efficient strategies are contrarian and growth strategies in terms of risk, performance and cumulative returns. Most strategies outperform the market portfolio in all three measures. 1 Stock ranking criterion (current price/52-week highest price) 2 Stock ranking criterion (current price/52-week lowest price)

IT Investment Portfolio Management Over Joint Ventures: Case Study in a Multinational Oil & Gas Company

With information technology (IT) playing an increasing important role in driving the business, the value of IT investment is often challenged because not all of those investment decisions are made in a reasonable way or aligned with business strategies. IT investment portfolio management (PfM) is an effective way to prioritize and select the right IT projects to invest in, by taking all the project proposals into consideration as a whole, based on their business value, risks, costs, and interrelationships. There are different decision models to prioritise projects, and the Analytic Hierarchy Process (AHP) is one of the most commonly-used methods and is discussed in this master thesis. At the same time, there are IT projects on different levels for a multinational company, from global to local. For instance, many of them are probably proposed by joint ventures on local level. In the oil & gas industry, joint ventures are often formed especially in the area of the upstream (exploration & production). How to involve those projects into the IT investment PfM approach of the parent company is a challenge, because the parent company cannot make the decisions on its own. It needs to prioritize all projects in an adequate way, communicate with JVs and influence them. Also, different control levels on JVs need to be considered. This paper hence attempts to introduce a tailored approach of IT investment PfM for a multinational oil & gas company to address the issues around JVs.

Diversification benefits for a Finnish non-industrial private forest investor: Real Estate Investment Trusts in the USA

This thesis examined both domestic and international forest investment options for a Finnish non-industrial private forest investor. The focus was on forest-based investment instruments. The influence of movements of currency exchange rates on foreign returns were also taken into account. Annual data from 1995 to 2011 was used. The main portfolio optimization model in this study was the Mean-Variance model but the results were also validated by using the Value at Risk and Expected Shortfall models. In addition, the exchange rate risk hedging was established by using one-week-maturity forward contracts. The results suggested that 75 % of the total wealth should be invested in Finnish private forests and the rest, 25 %, to a US REIT, in this case Rayonier. With hedging, the total return on the portfolio was 7.21 % (NIPF 5.3%) with the volatility of 6.63 % (NIPF 7.9%). Taxation supported US investments in this case. As a conclusion, a Finnish private forest investor may, as evidenced, benefit in diversifying a portfolio using REITs in the US.

Dental Health in Preschool and Schoolchildren in Relation to Dental Fear and Some Fear-Related Factors, and the Outcome of a Caries Prevention Program in Offspring of Fearful Mothers

Dental caries and dental fear and anxiety (DFA) are common interrelated problems but so far little is known about these problems in Estonia. The aim was to study dental health in relation to DFA, some fear-related factors, and to study the effect of a caries prevention program in children of fearful mothers. Dental health and DFA were assessed in two Estonian [2-4-year-olds (n=472) and 8-10-year-olds (n=344)], and the effect of some medical conditions on DFA in one Finnish child group [3-year-olds (n=148)]. 120 mother-child-pairs participated in the xylitol-based prevention program. Dental health was examined using the WHO or the ICDAS criteria and expressed as dmft/DMFT-indices. The modified children’s fear survey schedule dental subscale (MCFSS-DS) was used to assess DFA of schoolchildren, one single question to assess parental DFA, and the Corah’s dental anxiety scale (DAS) to assess DFA of mothers in the prevention study. Dentine caries was diagnosed in 42% of the 2-4-year-old and in 93% of the 8-10-year-old Estonian children. DFA of 8-10-year-olds (17%) was associated with experience of dental treatment, and maternal and paternal DFA. Dental apprehension at 9 years of age was associated with frequent exposure to invasive medical care. The xylitol-based prevention was successful irrespective of poor dental hygiene habits and maternal severe DFA. In conclusion, experience of operative dental treatment and DFA of Estonian children were closely associated. Invasive medical care and parental DFA were also linked to children’s DFA. Habitual use of xylitol by mothers was effective in preventing caries even in children of severely fearful mothers.