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  • 1.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Näsström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lövgren, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Patients' perceived treatment need owing to temporomandibular disorders and perceptions of related treatment in dentistry: a mixed method study2019Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, nr 9, s. 792-799Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To easily identify patients who could benefit from a temporomandibular disorder (TMD) examination, three screening questions (3Q/TMD) have been introduced in large parts of Sweden. The questions are related to a TMD diagnosis. However, how the questions relate to a treatment need is unknown.

    Objectives: The first aim of the study was to identify predicting factors for perceived treatment need among adult individuals who screened positive to the 3Q/TMD. The second aim was to explore individuals' thoughts and experiences related to treatment of their TMD complaint.

    Methods: This mixed‐method study with a case‐control design was conducted in Västerbotten, Sweden, during 2014. Individuals who screened positive to at least one of the 3Q/TMD questions were allocated 3Q‐positives, whereas those with negative answers to all questions were allocated 3Q‐negatives. In total, 300 individuals (140 randomly selected 3Q‐positives, and 160 age‐ and gender‐matched 3Q‐negatives) were included. All individuals answered questions related to treatment need. The answers were analysed in a qualitative approach with qualitative content analysis.

    Results: In total, 81% of 3Q‐positives expressed a treatment need related to their TMD symptoms. The perceived treatment need was predicted by frequent pain (Q1) and frequent functional disturbances (Q3). Among the 3Q‐positives, 54% reported mistrust in dentists' ability to treat TMD symptoms. The informants expressed a need for information about their symptoms and possible treatment options.

    Conclusion: Affirmative answers to 3Q/TMD were associated with TMD treatment need. Dentists should give advice to patients with TMD symptoms and address their concerns.

  • 2. Grigoriadis, A
    et al.
    Johansson, Roland S
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Trulsson, M
    Temporal profile and amplitude of human masseter muscle activity is adapted to food properties during individual chewing cycles2014Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, nr 5, s. 367-373Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Jaw actions adapt to the changing properties of food that occur during a masticatory sequence. In the present study, we investigated how the time-varying activation profile of the masseter muscle changes during natural chewing in humans and how food hardness affects the profile. We recorded surface electromyography (EMG) of the masseter muscle together with the movement of the lower jaw in 14 healthy young adults (mean age 22) when chewing gelatin-based model food of two different hardness. The muscle activity and the jaw kinematics were analysed for different phases of the chewing cycles. The increase in the excitatory drive of the masseter muscle was biphasic during the jaw-closing phase showing early and late components. The transition between these components occurred approximately at the time of tooth-food contact. During the masticatory sequence, when the food was particularised, the size of the early component as well as the peak amplitude of the EMG significantly decreased along with a reduction in the duration of the jaw-closing phase. Except for amplitude scaling, food hardness did not appreciably affect the muscle's activation profile. In conclusion, when chewing food during natural conditions, masseter muscle activation adapted throughout the masticatory sequence, principally during the jaw-closing phase and influenced both early and late muscle activation components. Furthermore, the adaptation of jaw actions to food hardness was affected by amplitude scaling of the magnitude of the muscle activity throughout the masticatory sequence.

  • 3.
    Hedlund, Sven-Olof
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Odontologisk materialvetenskap.
    Johansson, N Gunnar
    Umeå universitet, Medicinsk fakultet, Odontologi, Odontologisk materialvetenskap.
    Sjögren, Göran
    Umeå universitet, Medicinsk fakultet, Odontologi, Odontologisk materialvetenskap.
    A retrospective study of pre-fabricated carbon fibre root canal posts.2003Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 30, nr 10, s. 1036-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although pre-fabricated carbon fibre posts have been used during the past decade clinical evaluations of the technique are still few. Using dental records and radiographs the clinical performance of 65 pre-fabricated carbon fibre posts (Composipost and Endopost) placed in 48 patients who regularly visited a general practice were evaluated in the present study. After an average time of 2.3 +/- 0.8 years (median 2.1 years, range 1-4.9 years) of clinical service the failure rate was 3%. Failure occurred in one tooth with a single crown restoration and in one tooth that was part of a cantilever fixed partial denture. Although the failure rate is lower than those mostly reported for metallic posts and cores more clinical studies are necessary to assess the suitability of pre-fabricated carbon fibre posts for routine use as an alternative to individually cast posts.

  • 4.
    Häggman Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö; Faculty of Odontology, Health Technology Assessment – Odontology (HTA-O), Malmö.
    Alstergren, P.
    Davidson, T.
    Högestätt, E. D.
    Östlund, P.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm.
    Tranaeus, S.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm.
    Vitols, S.
    List, T.
    Pharmacological treatment of oro-facial pain: health technology assessment including a systematic review with network meta-analysis2017Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, nr 10, s. 800-826Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients >= 18 years with chronic (>= 3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [ temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

  • 5.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, P-O
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, E
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Zafar, H
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Evaluation of skin- versus teeth-attached markers in wireless optoelectronic recordings of chewing movements in man1998Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 25, nr 7, s. 527-534Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study evaluated the applicability of skin- and teeth-attached reflex markers fixed to the mandible and the head for optoelectronic recording of chewing movements. Markers were attached to the upper and lower incisors and to the skin on the forehead, the bridge of the nose, the tip of the nose and the chin in seven subjects. Chewing movements were recorded in three dimensions using a high-resolution system for wireless optoelectronic recording. Skin markers were systematically displaced due to skin stretch. The largest displacement was observed for the chin marker, whereas minor displacement was found for markers located on the forehead and the bridge of the nose. In repeated recordings, the smallest intra-individual variation in displacement was found for the marker on the bridge of the nose. In spite of relatively large displacement for the chin marker, the temporal estimates of the mandibular movement were not affected. Teeth markers were found to significantly increase the vertical mouth opening, although the duration of the chewing cycle was unaffected. This indicates an increase in chewing velocity. We suggest that markers located on the bridge of the nose are acceptable for recordings of chewing movements. Skin markers on the chin can be reliably used for temporal analysis. They are also acceptable for spatial analysis if an intra-individual variability of 2 mm is allowed. Teeth-attached markers may significantly influence the natural chewing behavior. Thus, both types of marker systems have advantages as well as disadvantages with regard to the accuracy of the chewing movement analysis. Selection of a marker system should be based on the aims of the study.

  • 6.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö.
    Rezvani, M.
    Department of Orofacial Pain and Jaw Function, Malmö University, Malmö.
    List, T.
    Department of Orofacial Pain and Jaw Function, Malmö University, Malmö and Department of Rehabilitation Medicine, Skåne University Hospital, Lund,.
    Prevalence of whiplash trauma in TMD patients: a systematic review2014Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, nr 1, s. 59-68Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 84% to 70% (median 35%) in TMD populations, compared with 17-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD.

  • 7. Karlsson, S
    et al.
    Molin, M
    Umeå universitet, Medicinsk fakultet, Odontologi, Protetik.
    Effects of gold and bonded ceramic inlays on the ability to perceive occlusal thickness.1995Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 22, nr 1, s. 9-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Any crown or inlay preparation will be accompanied with pulpal involvement and possible altered biomechanical and/or viscoelastic properties concerning the treated tooth. This study was aimed to assess this influence in terms of differences in interocclusal discrimination threshold value, before and after rehabilitation with gold inlays and by composite resin bonded ceramic inlays. Twenty patients were included and treated with one gold and three ceramic inlays each. For purposes of determining the discrimination threshold between the inlays and antagonizing teeth, plastic foils of different thicknesses were used. Each inlay position, as well as a pair of control teeth, were tested before and after treatment. Before rehabilitation an interocclusal and discrimination threshold of 24 microns at the level of 80% right answers were determined. Treatment with inlays, however, resulted in a significantly different and increased threshold for every tooth/inlays combination. No significant differences between the sessions were recorded for the control teeth. It could be concluded that, in the short term, an oral rehabilitation with inlays and in particular bonded inlays will influence mechanosensitive afferents.

  • 8.
    Kou, Wen
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Molin, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Protetik.
    Sjögren, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Surface roughness of five different dental ceramic core materials after grinding and polishing2006Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 33, nr 2, s. 117-124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In clinical practice, core materials can be exposed after adjustments are made to previously-luted all-ceramic restorations. The purpose of this study was to evaluate the surface roughness of five different dental ceramic core materials after grinding and polishing. Five different ceramic core materials, Vita In-Ceram Alumina, Vita In-Ceram Zirconia, IPS Empress 2, Procera AllCeram, and Denzir were evaluated. Vita Mark II was used as a reference material. The surface roughness, Ra value (mum), was registered using a profilometer. The measurements were made before and after grinding with diamond rotary cutting instruments and after polishing with the Sof-Lex system. The surface of representative specimens was evaluated qualitatively using scanning electron microscopy (SEM). Results were statistically analysed using analysis of variance (anova) supplemented with Scheffe's and Bonferroni multiple-comparison tests. Before grinding, Procera AllCeram and Denzir had the smoothest surfaces, while IPS Empress 2 had the coarsest. After grinding, all materials except IPS Empress 2 became coarser. Polishing with Sof-Lex provided no significant (P > 0.05) differences between Denzir, Vita Mark II and IPS Empress 2 or between Procera AllCeram and In-Ceram Zirconia. There were no significant differences (P > 0.05) either between the ground and the polished Procera AllCeram or In-Ceram Alumina specimens. Polishing of Denzir, IPS Empress 2 and In-Ceram Zirconia made the surfaces smoother compared with the state after grinding, whereas the polishing effect on Procera AllCeram and In-Ceram Alumina was ineffective. The findings of the SEM evaluation were consistent with the profilometer readings.

  • 9.
    Kou, Wen
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Sjögren, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Fracture behaviour of zirconia FPDs substructures: fractographic analysis of zirconia2010Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 37, nr 4, s. 292-299Artikel i tidskrift (Refereegranskat)
    Abstract [en]

     The purpose of this study was to evaluate the occurrence of superficial flaws after machining and to identify fracture initiation and propagation in three-unit heat-treated machined fixed partial dentures (FPDs) substructures made of hot isostatic pressed (HIPed) yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) after loaded to fracture. Four three-unit HIPed Y-TZP-based FPDs substructures were examined. To evaluate the occurrence of superficial flaws after machining, the surfaces were studied utilizing a fluorescent penetrant method. After static loading to fracture, characteristic fracture features on both mating halves of the fractured specimens were studied using a stereomicroscope and a scanning electron microscope. Grinding grooves were clearly visible on the surfaces of the machined FPDs substructures, but no other flaws could be seen with the fluorescent penetrant method. After loading to fracture, the characteristic fracture features of arrest lines, compression curl, fracture mirror, fracture origin, hackle and twist hackle were detected. These findings indicated that the decisive fracture was initiated at the gingival embrasure of the pontic in association with a grinding groove. Thus, in three-unit heat-treated machined HIPed Y-TZP FPDs substructures, with the shape studied in this study, the gingival embrasure of the pontic seems to be a weak area providing a location for tensile stresses when they are occlusally loaded. In this area, fracture initiation may be located to a grinding groove.

  • 10.
    Lampa, Ewa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nordh, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Effects on jaw function shortly after whiplash trauma2017Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, nr 12, s. 941-947Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Normal jaw function involves muscles and joints of both jaw and neck. A whiplash trauma may disturb the integrated jaw-neck sensory-motor function and thereby impair chewing ability; however, it is not known if such impairment is present shortly after a neck trauma or develops over time. The aim was to evaluate jaw function after a recent whiplash trauma. Eighty cases (47 women) were examined within 1 month after a whiplash trauma and compared to 80 controls (47 women) without neck trauma. Participants completed the Jaw disability checklist (JDC) and Neck Disability Index (NDI) questionnaires and performed a 5-minute chewing test. Elicited fatigue and pain during chewing were noted, and group differences were evaluated with Fisher's exact test and Mann-Whitney U-test. Compared to controls, cases had higher JDC (P<.0001) and NDI scores (15% vs 2%, P<.0001), and reported more fatigue (53% vs 31%, P=.006) and pain (30% vs 10%, P=.003) during the chewing test. Cases also had a shorter onset time for fatigue and pain (both P=.001) Furthermore, cases reporting symptoms during chewing had higher JDC and NDI scores compared to cases not reporting symptoms (both P=.01). Symptoms mainly occurred in the trigeminal area for both groups, but also in spinal areas more often for cases than for controls. Taken together, the results indicate that jaw-neck sensory-motor function is impaired already within 1month after a whiplash trauma. The association between neck disability and jaw impairment underlines the close functional relationship between the regions, and stresses the importance of multidisciplinary assessment.

  • 11.
    Lindh, Tomas
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Parodontologi.
    Should we extract teeth to avoid tooth-implant combinations?2008Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 35, nr Suppl 1, s. 44-54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The controversy over combining teeth and implants for support of fixed partial dentures still remains after almost three decades of debate. The aim of this review was to evaluate what support that could be found in the literature for extracting teeth in favour of implants, and to elucidate whether tooth-implant prostheses were inferior to solely implant supported constructions in terms of survival and complications. The methods for gathering relevant information entailed electronic searches on PubMed using relevant key words, as well as complementary manual searches in the retrieved publications. The results showed that there was no support for extracting teeth in favour of placing implants. On the contrary, the healthy tooth had a survival that was life-long, which is yet to be shown for the dental implant. Also the use of teeth as abutments in combination with dental implants for support of fixed dental prostheses could be endorsed in certain situations with solid albeit limited scientific support. in a wider sense, such prostheses could be used as a reliable therapy in all regions of the jaws. However the status of the abutment teeth in terms of periodontal support, pulpal status and risk for carious lesions and biomechanical complications should always be considered in relation to the long-term prognosis of the prosthesis. The conclusion was that teeth should not be extracted in favour of placing dental implants without a specific indication, and that tooth-implant supported prostheses should be considered as a viable prosthetic option.

  • 12.
    Lövgren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Marklund, Susanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Visscher, Corine
    Academic Centre for Dentistry Amsterdam (ACTA).
    Lobbezoo, Frank
    Academic Centre for Dentistry Amsterdam (ACTA).
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Malmö Högskola.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Outcome of three screening questions for temporomandibular disorders (3Q/TMD) on clinical decision-making2017Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, nr 8, s. 573-579Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients with temporomandibular disorders (TMD) seem to go undetected and not adequately managed within dentistry. To identify these patients, three screening questions (3Q/TMD) have been introduced within dentistry in parts of Sweden. It is not known whether 3Q/TMD affects the clinical decision-making for these patients. The aim of this study was to evaluate the outcome of 3Q/TMD on the clinical decision-making and to analyse whether gender, age and the fee system the individual was assigned to were related to prescribed TMD treatment. This cohort study was carried out within the Public Dental Health service in Vasterbotten, Sweden. As part of the routine dental check-up, a health declaration including 3Q/TMD was completed. The study population was randomly selected based on their 3Q/TMD answers. In total, 300 individuals with an affirmative answer to any of the 3Q/TMD, and 500 individuals with all negative answers were selected. The 3Q/TMD includes questions on weekly jaw-face-temple pain (Q1), pain on function (Q2) and catching/locking of the jaw (Q3). The 3Q/TMD was analysed in relation to prescribed treatment assessed from dental records. There was significantly more treatment performed or recommended for 3Q-positives (215%), compared to 3Q-negatives (22%) (P < 0001). The odds ratio for TMD-related treatment for 3Q-positives versus 3Q-negatives was 121 (95% CI: 63-234). Although affirmative answers to the 3Q/TMD was related to TMD treatment, the majority of individuals with a screen positive still did not, according to dental records, receive assessment or treatment. Further studies are needed to better understand the clinical decision-making process for patients with TMD.

  • 13.
    Lövgren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Visscher, C M
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Lobbezoo, F
    Marklund, Susanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Validity of three screening questions (3Q/TMD) in relation to the DC/TMD2016Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, nr 10, s. 729-736Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 (JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management.

  • 14.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wänman, A
    A century of controversy regarding the benefit or detriment of occlusal contacts on the mediotrusive side.2000Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 27, nr 7, s. 553-562Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many opinions have been presented in the literature during the past century regarding so-called mediotrusive/balancing/non-working side contacts. During the first half of this century, most authors advocated the advantage of these contacts (it was more or less the state of the art in prosthetic treatments), while during the last 50 years mediotrusive side contacts/interferences have mostly been regarded as a disturbing factor in the functioning of the mandible. Recently, it has been proposed that mediotrusive side contacts have a protective effect on the temporomandibular joint (TMJ). The aim of this study was to review opinions advocated during the twentieth century regarding the advantages and disadvantages of having contacts on the mediotrusive side during lateral excursions of the mandible. We conclude that, at present, there is no uniform body of scientific evidence supporting a balanced occlusion in favour of a mutually protective occlusion or vice versa. Longitudinal studies based on cohorts with different types of occlusal contacts, estimating the risk among these of developing signs and symptoms of temporomandibular disorders, are generally lacking and could provide valuable knowledge in this field.

  • 15.
    Mårell, Lena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Tillberg, A
    Widman, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bergdahl, Jan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Berglund, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Regression of oral lichenoid lesions after replacement of dental restorations2014Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, nr 5, s. 381-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to determine the prognosis and to evaluate the regression of lichenoid contact reactions (LCR) and oral lichen planus (OLP) after replacement of dental restorative materials suspected as causing the lesions. Forty-four referred patients with oral lesions participated in a follow-up study that was initiated an average of 6years after the first examination at the Department of Odontology, i.e. the baseline examination. The patients underwent odontological clinical examination and answered a questionnaire with questions regarding dental health, medical and psychological health, and treatments undertaken from baseline to follow-up. After exchange of dental materials, regression of oral lesions was significantly higher among patients with LCR than with OLP. As no cases with OLP regressed after an exchange of materials, a proper diagnosis has to be made to avoid unnecessary exchanges of intact restorations on patients with OLP.

  • 16.
    Pettersson, Mattias
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Pettersson, Jean
    Department of Chemistry - BMC, Analytical Chemistry, Uppsala, University.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Molin Thorén, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Titanium release in peri-implantitis2019Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, nr 2, s. 179-188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The aim of this study was to investigate the titanium (Ti) content of biopsies from patients with severe peri-implantitis or periodontitis and to examine whether Ti particles can be identified in samples from peri-implantitis lesions.

    Background: Long-term follow-up studies show that implant usage to replace missing or lost teeth is a safe and predictable treatment. However, inflammation and loss of supporting bone around an implant (peri-implantitis) lead to patient suffering and costs. Peri-implantitis is considered to be an infectious disease, but recent studies have shown that Ti can aggravate inflammation in combination with bacterial products. The Ti content of peri-implantitis and periodontitis tissue is unknown.

    Methods: Thirteen patients referred for peri-implantitis and eleven for periodontitis treatment were included in the study. Disease severity was obtained from dental records. Biopsies were taken from both groups and chemically analyzed with inductively coupled plasma mass spectrometry (ICP-MS) for Ti content. Additionally, two patients with peri-implantitis and two with periodontitis were recruited and their biopsies were analyzed microscopically with light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM) with element analysis to investigate the presence of particulate Ti.

    Results: All patients lost one or more implants despite undergoing peri-implant or periodontal treatment. Peri-implantitis tissue contained significantly higher concentrations of Ti than periodontitis tissue with a mean ± SDof 98.7 ± 85.6 μg/g and 1.2 ± 0.9 μg/g, respectively. Particulate metal was identified in peri-implantitis and periodontitis biopsies, but element analyses could confirm only the presence of Ti in peri-implantitis tissue. The mean size ± SDof the visible particles with LM was 10.9 ± 35.7 μm2 (mean of three repeated measurements) (95% CI, 6.5-15.3).

    Conclusion: We showed that high contents of particulate and submicron Ti were present in peri-implantitis tissue. These high Ti contents in peri-implant mucosa can potentially aggravate inflammation, which might reduce the prognosis of treatment interventions.

  • 17. Skog, Caroline
    et al.
    Fjellner, Jesper
    Ekberg, EwaCarin
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Tinnitus as a comorbidity to temporomandibular disorders - A systematic review2019Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, nr 1, s. 87-99Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The aim of this systematic review was to evaluate the prevalence of tinnitus in patients with temporomandibular disorders (TMD) and the possible effects of TMD treatment on tinnitus symptoms. A search of the PubMed, Web of Science and Cochrane databases from inception of each database up to January 2017 found 222 articles. After independent screening of abstracts by two of the authors, we assessed 46 articles in full text. The inclusion and exclusion criteria reduced these to 25 articles of which 22 studies reported prevalence based on 13 358 patients and 33 876 controls, and eight studies reported effect of TMD treatment on tinnitus based on 536 patients and 18 controls. The prevalence of tinnitus in patients with TMD varied from 3.7% to 70% (median 42.3%) whereas the prevalence in control groups without TMD varied between 1.7% and 26% (median 12%). The eight treatment studies indicated that treatment of TMD symptoms may have a beneficial effect on severity of tinnitus. However, only one treatment study included a control group, meaning that the overall level of evidence is low. The finding that tinnitus is more common in patients with TMD means that it can be regarded as a comorbidity to TMD. However, in view of the lack of evidence currently available, further well-designed and randomised studies with control groups are needed to investigate whether possible mechanisms common to tinnitus and TMD do exist and whether TMD treatment can be justified to try to alleviate tinnitus in patients with TMD and comorbidity of tinnitus.

  • 18.
    Sundh, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Sjögren, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    A comparison of fracture strength of yttrium-oxide-partially-stabilized zirconia ceramic crowns with varying core thickness, shapes and veneer ceramics2004Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 31, nr 7, s. 682-688Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The fracture strengths of stylized all-ceramic crowns manufactured using an yttrium-oxide-partially-stabilized (Y-TZP) zirconia ceramic core (Denzir) veneered with lithium disilicate glass-ceramics (IPS Empress 2 or IPS Eris) were evaluated. The Denzir cores were manufactured in two ways: either with different thicknesses in different parts of the restoration, called an ‘adapted Denzir core’; or with a uniform core thickness of 0.5 mm. IPS Empress 2 all-ceramic crowns served as reference. There was no significant difference between the crowns with an ‘adapted Denzir core’ veneered with the two brands of glass-ceramics. No significant difference was seen between the crowns with a 0.5 mm Denzir core veneered with the two brands of glass-ceramics. The crowns with an ’adapted Denzir core’ exhibited significantly higher values than those with a 0.5 mm Denzir core and than the IPS Empress 2 crowns used as reference. No significant differences were seen among the IPS Empress 2 crowns used as reference and the crowns with a 0.5 mm Denzir core. The mode of failure varied among the Empress 2 crowns and the crowns with a core of a Y-TZP zirconia ceramic. Long-term studies are necessary to assess the clinical performance of this restorative system.

  • 19.
    Wänman, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Marklund, Susanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Clinical Oral Physiology, Västerbotten County Council, Umeå, Sweden.
    Treatment outcome of supervised exercise, home exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction: A randomised clinical trial2019Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The best treatment strategy for disturbing temporomandibular clicking sounds is not known. The aim was to evaluate the effect of exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction. The study was a randomised clinical trial of subjects with temporomandibular joint (TMJ) clicking sounds with a reported severity/intensity of >= 4 on a numerical rating scale (0-10) and signs fulfilling the Research Diagnostic Criteria (RDC/TMD) for disc displacement with reduction. Thirty subjects each were randomised to bite splint, home exercise, or supervised exercise programme at the clinic. Two examiners (authors), blinded to the treatment modality, examined the same subject at baseline and at a 3-month follow-up. Non-parametric statistical methods were applied for analyses. A P-value <.05 was considered statistically significant. The dropout rate was highest in the home exercise group. About 50% of the participants reported improvement of their TMJ sounds with no significant difference between treatments. In the supervised exercise and the bite splint groups, approximately 2/3 of the patients reported 30% or more improvement of their TMJ sounds and half reported 50% improvement or more. The supervised exercise group also showed reductions in TMD pain, neck disability, mood disturbances and somatisation. Jaw exercise programmes and bite splint treatments had positive effects on TMJ clicking. The supervised exercise programme had an additional effect on the subject's well-being and thus may help to encourage patient's empowerment and coping strategies.

  • 20.
    Zafar, H
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, P O
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, E
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wireless optoelectronic recordings of mandibular and associated head-neck movements in man: a methodological study.2000Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 27, nr 3, s. 227-238Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human mandibular movements in space are the result of combined motions of the mandible and the head-neck. They can be simultaneously monitored by an optoelectronic recording technique via markers at different locations on the mandible and on the head. Markers can be attached to the teeth or to the facial skin. Mandibular movements relative to the head can be calculated by one- or three-dimensional (1D and 3D, respectively) mathematical compensation for head movements. The present study analysed mandibular and associated head movements during maximal jaw opening-closing tasks in 10 healthy subjects using a wireless 3D optoelectronic movement recording system. The study aimed to: (i) estimate the soft tissue related displacement of skin-attached markers at different locations on the face; (ii) compare 1D with 3D mathematical compensation for associated head movements; (iii) evaluate the influence of marker location on the recorded head and mandibular movement amplitudes; and (iv) compare skin-attached markers with teeth-attached markers with regard to temporal estimates of recorded mandibular and head movements. Markers were attached to the upper and lower incisors and to the skin of the forehead, nose-bridge, nose-tip and chin. Soft tissue related displacement of skin-attached markers varied between locations. The displacement for the chin marker was larger than that of other markers. The least displacement was found for the nose-bridge marker. However, relative to mandibular and head movements, respectively, the displacement of the chin marker was of the same order as that of the nose-bridge marker. The temporal estimates were not significantly affected by displacement of the skin-attached markers. Markers at different locations on the head and the mandible registered different amplitudes. The mandibular movement patterns calculated by 1D and 3D compensation were not comparable. It is concluded that markers attached to the chin and the nose-bridge can be reliably used in temporal analyses of mandibular and head movements during maximal jaw opening-closing. With certain limitations, they are acceptable for spatial analyses. Selection of method of marker attachment, marker location, and method of compensation for associated head movements should be based on the aim of the study.

  • 21.
    Åkesson, Joacim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Sundh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Sjögren, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Odontologisk materialvetenskap.
    Fracture resistance of all-ceramic crowns placed on apreparation with a slice-formed finishing line: Fracture resistance of all-ceramic crowns2009Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, ISSN 0305-182X, Vol. 36, nr 7, s. 516-523Artikel i tidskrift (Refereegranskat)
  • 22.
    Österlund, Catharina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Berglund, H.
    Åkerman, M.
    Nilsson, E.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Petersson, H.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lam, J.
    Alstergren, P.
    Diagnostic criteria for temporomandibular disorders: Diagnostic accuracy for general dentistry procedure without mandatory commands regarding myalgia, arthralgia and headache attributed to temporomandibular disorder2018Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 45, nr 7, s. 497-503Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The clinical examination in diagnostic criteria for temporomandibular disorders (DC/TMD) is a strict procedure and comprises mandatory commands. However, learning and using these mandatory commands in general practice have proven to be difficult and their use of DC/TMD is minimal. To investigate whether reliability on a diagnostic level for DC/TMD diagnoses differs between examiners using the mandatory commands or not. Six examiners were divided into two groups: one using the mandatory commands in DC/TMD for the clinical examination and one who did not use the mandatory commands. A reliability assessment was performed twice, one occasion for each group of examiners. The assessment was performed according to the guidelines from the International Network for Orofacial Pain and Related Disorders Methodology. Each group of examiners thereby examined 16 subjects (11 TMD patients and 5 healthy individuals) each, and the diagnostic agreement (reliability) as compared to diagnoses derived by a reference standard examiner was calculated with Cohen' s kappa coefficient. The DC/TMD diagnoses myalgia, arthralgia and headache attributed to TMD were included in the reliability assessment. There was no significant difference regarding diagnostic agreement reliability between the examiners using or not using the mandatory DC/TMD commands. This study indicates that not using the mandatory commands in DC/TMD in general practice does not impair the diagnostic reliability regarding the diagnoses myalgia, arthralgia and headache attributed to TMD compared to including the commands.

  • 23.
    Österlund, Catharina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nilsson, Evelina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Hellström, Fredrik
    Häger, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Häggman-Henrikson, Birgitta
    Jaw-neck movement integration in 6-year-old children differs from that of adults2019Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.

    OBJECTIVES: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.

    METHODS: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.

    RESULTS: Compared to adults, 6-year-old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra-individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening-closing task.

    CONCLUSION: Despite integrated jaw-neck movements in 6-year-old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behaviour. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well-controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders.

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