LB

Lars Bjørndal

Department of Odontology, University of Copenhagen, University of Copenhagen

Research areas: Dentistry · General Dentistry · Endodontics and Root Canal Treatments · Dental materials and restorations · Dental Health and Care Utilization

ORCID iD 0000-0002-2183-6400
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About

Research profile
The following objectives include my research profile:

i. To investigate caries pathology and treatment with a focus on gaining best know-how for arresting caries at a non-operative level as well as on an operative level.
ii. To optimize treatments that prevent inflammation of the dental pulp and as a model to understand inflammation.
iii. To initiate practice-based research and clinical trials involving cariology and endodontics to ensure the best possible dental health with enhanced focus on limiting the prevalence of oral diseases caused by microbiological dysbiosis.
iv. To investigate AI and Big Data (BD) in general dentistry within diagnostics and treatment outcomes and with focus on cariology, endodontics and general health.

Brief coverage of academic issues
For the past 30 years, I have worked with preventative aspects within caries and endodontics. Within the field of Cariology and based on my PhD dissertation from 1991, a more detailed understanding is obtained, on what is happening in the dental pulp when caries is progressing. We have pushed the limit for when it is necessary to carry out a root canal treatment for an otherwise deep caries attack by carrying out a less invasive carious removal procedure (Stepwise excavation based on selective procedures) in the tooth. It is known that residues of the cariogenic biofilm (i.e. the carious provoking bacteria) can be left in the cavity without invasive drilling required and that the root canal treatment is hereby avoided. A recent Ph.D.-project examined the reaction pattern of the tooth nerves at extremely deep caries attacks, and this has provided a better understanding of when you can perform less-invasive treatments, and when it is not possible, so that the decision about the right treatment can be taken more correctly at once.

When it is not possible to avoid root-treatment, it is, in addition to removing pain, about preventing an infection in the root canal or treating a root canal infection. As the root canal infection progresses an inflammation occurs around the root tip (periodontitis apicalis), which in the worst case can lead to infections in other parts of the body. The actual presence of inflammation around the root also contributes to the inflammation of the entire body, which can affect a number of systemic diseases, such as diabetes and cardiovascular diseases, and with subsequent hospitalizations. The importance of high-quality root treatment is therefore crucial.

In 2011, the doctoral thesis was defended, and it was documented that there was not only a huge and ongoing need for root canal treatment, but also that the technical requirements for treatment would increase, partly because the population today keeps the teeth for a long time and partly because the root canal treatment would now primarily take place on the molar, which is technically more difficult to carry out.

The thesis documented for the first time thoroughly factors concerning complaints within the field of dental care. The root-treatment region was unfortunately one of the most frequent reasons for patient complaints. It was also documented that if the dentists were to be better prepared for the future, then they would not just need better technological methods, but also a better understanding of how to treat the root canal infection. Among other things, the root canal treatment was to be carried out with as little risk of contamination as possible, not least in the form of a persistent recommendation for the re-use of the bacterial protective dam (rubber dam) surrounding the tooth during a root canal treatment.

Experience of getting research into practice
I have been the main responsible trial coordinator for several participating universities and dental clinics by successfully completing a major international randomized clinical trial on the prevention of pulp exposure following a caries treatment. This highly ranked research has led to a successful implementation of a nationally funded treatment to avoid root fillings (Stepwise excavation) and is currently part of the financial agreement between the Danish National Board of Health and the Dental Association in connection with the reimbursement of dental treatments.

I have been one of the lead authors of the international implementation of treatment-guidelines aimed at avoiding pulp exposures.

I have contributed to an international consensus group on caries treatment with regard to the global prevention of less invasive pulpal treatments, and recently contributed to a systematic overview article (Cochrane) concerning evidence of dental caries treatment. I am also part of a Scandinavian research group (EndoReCo), which has studied e.g. tooth survival after root canal treatments.

On going project deals with AI and BIG DATA within dentistry

Employment

  • Department of Odontology, University of Copenhagen Associate prof., Head of Endodontics
    2015 - Present

Education

Projects & Funding

Projects & funding information is unavailable.

Publications (94)