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  • 1.
    Al-Taai, Nameer
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ransjö, Maria
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Westerlund, Anna
    Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    A superimposition-based cephalometric method to quantitate craniofacial changes2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 10, article id 5260Article in journal (Refereed)
    Abstract [en]

    To assess the craniofacial changes related to growth and/or to orthodontic and orthognathic treatments, it is necessary to superimpose serial radiographs on stable structures. However, conventional superimposition provides only a graphical illustration of these changes. To increase the precision of growth and treatment evaluations, it is desirable to quantitate these craniofacial changes. The aims of this study were to (1) evaluate a superimposition-based cephalometric method to process numerical data for craniofacial growth changes and (2) identify a valid, reliable, and feasible method for superimposition. Forty pairs of cephalograms were analyzed at T1 and T2 (mean age 9.9 and 15.0 years, respectively). The superimposition-based cephalometric method involved relating the sagittal and vertical measurements on the T2 radiographs to the nasion and sella landmarks on the T1 radiographs. Validity and reliability were evaluated for three superimposition methods: the sella-nasion (SN); the tuberculum sella-wing (TW); and Björk’s structural. Superimposition-based cephalometrics can be used to quantify craniofacial changes digitally. The numerical data from the superimposition-based cephalometrics reflected a graphical illustration of superimposition and differed significantly from the data acquired through conventional cephalometrics. Superimposition using the TW method is recommended as it is valid, reliable, and feasible.

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  • 2.
    Al-Taai, Nameer
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Orthodontics, Department of Odontology, Umeå University, Umeå, Sweden.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology. Orthodontics, Department of Odontology, Umeå University, Umeå, Sweden.
    Ransjö, Maria
    Umeå University, Faculty of Medicine, Department of Odontology. Orthodontics, Department of Odontology, Umeå University, Umeå, Sweden;Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology. Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.
    Fors, Ronny
    Umeå University, Faculty of Medicine, Department of Odontology. Orthodontics, Department of Odontology, Umeå University, Umeå, Sweden.
    Westerlund, Anna
    Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Craniofacial changes from 13 to 62 years of age2022In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 44, no 5, p. 556-565Article in journal (Refereed)
    Abstract [en]

    Background: In long-term studies of orthodontic, orthognathic, and prosthodontic treatments, control subjects are needed for comparison.

    Objectives: To study the craniofacial (skeletal, soft tissue, and dental) changes that occur in untreated subjects with normal occlusion between13 and 62 years of age.

    Materials/Methods: Thirty subjects with a Class I normal occlusion and harmonious facial profle were studied. X-ray examinations were performed at 13 (T1), 16 (T2), 31 (T3), and 62 (T4) years of age, and data were obtained from cephalograms. In total, 53 angular and linear parameters were measured using superimposition-based and conventional cephalometric methods to describe the craniofacial changes.

    Results: The jaws showed signifcant anterior growth from T1 to T2, and signifcant retrognathism from T3 to T4. The anterior face height andjaw dimensions increased signifcantly until T3. Signifcant posterior rotation of the mandible and opening of the vertical jaw relation, in additionto signifcant retroclination of the incisors and straightening of the facial profle, were found from T3 to T4.Limitations: Given the small sample size at T4, it was not possible to analyse the gender dimension.

    Conclusions/Implications: Craniofacial changes continue up to the sixth decade of life. These changes are consistent, albeit to a lesser extent,with the adolescent growth patterns for most of the studied parameters, with the exceptions of incisor inclination, sagittal jaw position, verticaljaw relation and inclination, and posterior face height.

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  • 3.
    Al-Taai, Nameer
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ransjö, Maria
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology.
    Westerlund, Anna
    Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Dentoskeletal and soft tissue changes after treatment of crowding with premolar extractions: a 50-year follow-up2023In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 1, p. 79-87Article in journal (Refereed)
    Abstract [en]

    Background: The long-term effects on dentofacial morphology of interceptive treatment with premolar extractions, in the absence of subsequent orthodontic treatment, have not been fully explored.

    Objective: The aim was to investigate the effects of premolar extractions (without subsequent orthodontic treatment) on the dentoskeletal and soft tissue profile of patients aged between 12 and 62 years with Class I malocclusion with severe crowding, as compared to untreated controls.

    Materials and methods: The Extraction group (N = 30 with Class I crowding malocclusion) had their first premolars removed in early adolescence without subsequent orthodontic treatment. The Control group included 30 untreated subjects with Class I normal occlusion. Cephalograms were taken at 12 (T1), 15 (T2), 30 (T3), and 62 (T4) years of age. A superimposition-based cephalometric method was used to assess the dentoskeletal and soft tissue changes.

    Results: There were no significant differences between the Extraction and Control groups in terms of skeletal sagittal relation, incisor inclination, and protrusion, or most of the soft tissue parameters throughout the observation period. However, significant differences were observed between the groups with respect to the vertical relations in T2-T3, such that the Extraction group showed more-pronounced decreases in the ML/NSL, ML/NL, and Gonial angles and more-pronounced increases in facial heights.

    Conclusions and implications: Treatment for subjects with Class I malocclusion with severe crowding by the extraction of four premolars, without subsequent orthodontic treatment, does not affect the long-term dentoskeletal and soft tissue profile, as compared to an untreated Control group. The degree of crowding, rather than changes in dentofacial morphology, is crucial in deciding on extraction therapy.

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  • 4.
    Blom, Björn
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Evertsson, Lars
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Perlinski, Marek
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    European social and caring professions in transition2017In: Social and caring professions in European welfare states: policies, services and professional practicies / [ed] Björn Blom, Lars Evertsson and Marek Perlinski, Bristol: Policy Press, 2017, p. 1-17Chapter in book (Refereed)
  • 5.
    Blom, Björn
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Evertsson, LarsUmeå University, Faculty of Social Sciences, Department of Social Work.Perlinski, MarekUmeå University, Faculty of Social Sciences, Department of Social Work.
    Social and caring professions in European welfare states: policies, services and professional practices2017Collection (editor) (Refereed)
    Abstract [en]

    This collection provides new insights about current welfare professions in a number of European countries.

    Focusing on research representing different types of European welfare states, including the Scandinavian and the Continental, the book offers in-depth understandings of professionals' everyday work within different contextual conditions, explored from empirical and theoretical perspectives. Subjects covered include knowledge and identity, education and professional development, regulation, accountability, collaboration, assessment and decision making.

    This is a valuable contribution to the discussion of professionalism and welfare professions, offering lessons learned and ways forward.

  • 6.
    Evertsson, Lars
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Blom, Björn
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Perlinski, Marek
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Rexvid, Devin
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Can complexity in welfare professionals' work be handled with standardised professional knowledge?2017In: Social and caring professions in European welfare states: policies, services and professional practices / [ed] Björn Blom, Lars Evertsson and Marek Perlinski, Bristol: Policy Press, 2017, p. 209-221Chapter in book (Refereed)
  • 7.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nickel in dental plaque and saliva in patients with and without orthodontic appliances.2006In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 28, no 3, p. 292-297Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the content of nickel in the saliva and dental biofilm in young patients with and without orthodontic appliances. The possible influence of a dietary intake of nickel on recorded nickel levels was examined. Nickel content in unstimulated whole saliva and in dental plaque of 24 boys and girls (mean age 14.8 years) with intraoral fixed orthodontic appliances was compared with 24 adolescents without such an appliance. Sample collection was set up to exclude nickel contamination. Diet intake was recorded for the preceding 48 hours to account for the influence of recent nickel content in food. Saliva and plaque were analysed for nickel content using an electrothermal atomic absorption spectrometric (ETAAS) method. The acidified saliva samples were analysed as Millipore-filtered saliva with filter-retained fractions and plaque following dissolution in acids. No significant difference in nickel content of filtered saliva was found between the test and the control samples (P = 0.607); the median values of nickel content were 0.005 and 0.004 mug/g saliva, respectively. On the other hand, a significant difference was found for the filter-retained fraction (P = 0.008); median values for nickel were 25.3 and 14.9 mug/g, respectively. A significant difference in nickel content between test and control samples was also found in plaque collected at various tooth sites (P = 0.001; median values 1.03 and 0.45 mug/g, respectively). A stronger difference was found when comparing plaque collected from metal-covered tooth surfaces than from enamel surfaces of orthodontic patients. No association could be found between calculated dietary intake of nickel and recorded nickel in the test and control samples. It is concluded that nickel release occurs into the dental plaque and components of saliva of orthodontic patients, a situation that may reflect time dependence of its release from orthodontic appliances into the oral cavity and an aggregation of nickel at plaque sites.

  • 8.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Bergström, Erik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stymne, Birgitta
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Lifestyle and nickel allergy in a Swedish adolescent population: effects of piercing, tattooing and orthodontic appliances2012In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 92, no 6, p. 664-668Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to estimate the prevalence of life-style practices in adolescents and their association with nickel allergy. Upper secondary school pupils (n = 4,376; 15-23 years) were patch-tested for nickel aller-gy, follow-ing completion of a questionnaire (answered by 6,095). Almost 86% girls and 21% of boys reported piercing. More girls (6%) than boys (3%) had a tattoo. Twenty-six percent of the girls and 18% of the boys were regular smokers. Vegetarian/vegan diets were reported by 20% of girls and by 6% of boys. Piercing, female gender, and vocational programme increased the risk of nickel allergy, whereas orthodontic appliance treat-ment prior to piercing reduced the risk of nickel allergy. Pupils in vocational programmes had the highest prevalence of nickel allergy. Lifestyle behaviours are interconnected and cluster in subgroups of adolescents. Female sex, piercing and choice of educational programme are prominent lifestyle markers. A trend shift is observed, where more girls than boys report tattooing.

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    Lifestyle and nickel allergy in a Swedish adolescent population: effects of piercing, tattooing and orthodontic appliances
  • 9.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bergström, Erik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stymne, Birgitta
    Department of Dermatology, Örebro University Hospital, Örebro .
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Nickel allergy: prevalence in a population of Swedish youths from patch test and questionnaire data2008In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 58, no 2, p. 80-87Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of body piercing and orthodontic treatment has increased during recent decades. Such changes in lifestyle may influence the occurrence of nickel allergy.

    Objectives: The aim of this study was to describe the prevalence of nickel allergy in a Swedish youth population.

    Methods: In a cross-sectional survey, 6095 adolescents answered a questionnaire on their lifestyle and medical history, and 4439 consented to patch testing for contact allergy. Patch test results were adjusted for dropouts by a missing value analysis.

    Results: The prevalence of self-reported dermatitis from contact with metal items was 14.8%. Patch testing showed nickel sensitization in 9.9% of the subjects, and in significantly more girls than boys, 13.3% versus 2.5%, respectively. Taking the dropout into account, the estimated true prevalence of nickel sensitivity evaluated by test reading at D4 is 11.8% in girls and 1.6% in boys.

    Conclusions: The prevalence of nickel sensitization was higher for girls and slightly lower for boys compared with previous Swedish data. Self-reported information on metal dermatitis as an estimate of nickel allergy has low validity. When possible, missing value analysis should be performed to account for dropouts.

  • 10.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
    Nickel allergy in relation to piercing and orthodontic appliances: a population study2012In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 67, no 6, p. 342-350Article in journal (Refereed)
    Abstract [en]

    Background. Studies have shown conflicting results on the association between nickel exposure from orthodontic appliances and nickel sensitization.

    Objectives & Method. In a cross-sectional study, we investigated the association between nickel sensitization and exposure to orthodontic appliances and piercings. 4376 adolescents were patch tested following a questionnaire asking for earlier piercing and orthodontic treatment. Exposure to orthodontic appliances was verified in dental records.

    Results. Questionnaire data demonstrated a reduced risk of nickel sensitization when orthodontic treatment preceded piercing (OR 0.46; CI 0.27–0.78). Data from dental records demonstrated similar results (OR 0.61, CI 0.36–1.02), but statistical significance was lost when adjusting for background factors. Exposure to full, fixed appliances with NiTi-containing alloys (OR 0.31, CI 0.10–0.98) as well as a pooled ‘high nickel-releasing’ appliance group (OR 0.56, CI 0.32–0.97) prior to piercing was associated with a significantly reduced risk of nickel sensitization.

    Conclusion. High nickel-containing orthodontic appliances preceding piercing reduces the risk of nickel sensitization by a factor 1.5–2. The risk reduction is associated with estimated nickel release of the appliance and length of treatment. Sex, age at piercing and number of piercings are also important risk indicators. Research on the role of dental materials in the development of immunological tolerance is needed.

  • 11.
    Perlinski, Marek
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Blom, Björn
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Evertsson, Lars
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Social and caring professions in European welfare states: trends and challenges2017In: Social and caring professions in European welfare states: policies, services and professional practices / [ed] Björn Blom, Lars Evertsson and Marek Perlinski, Bristol: Policy Press, 2017, p. 253-265Chapter in book (Refereed)
  • 12.
    Persson, Maurits
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Al-Taai, Nameer
    Umeå University, Faculty of Medicine, Department of Odontology.
    Pihlgren, Karin
    Department of Orthodontics, Public Dental Health Service, Eskilstuna, Sweden.
    Westerlund, Anna
    Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Early extractions of premolars reduce age-related crowding of lower incisors: 50 years of follow-up2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, no 6, p. 4525-4535Article in journal (Refereed)
    Abstract [en]

    Objectives: To study the effects of extraction of four premolars, without subsequent orthodontic treatment, on the crowding of lower incisors in subjects between early adolescence and late adulthood, as compared to untreated subjects.

    Materials and methods: A total of 45 subjects were included in this study. The extraction group comprised 24 subjects who had all the first premolars removed at a mean age of 11.5 years, to relieve crowding in a class I malocclusion without subsequent orthodontic treatment. The control group had 21 untreated subjects, having a normal occlusion at a mean age of 13.0 years. The participants were documented with dental casts and cephalograms at mean ages of 11.4 and 13.0 years, for the two groups respectively (T1), and at mean ages of 30.9 years (T2) and 61.7 years (T3). Changes in lower incisor crowding were described as changes in “irregularity” and “space deficiency.”

    Results: The extraction group showed no changes in the irregularity of the lower incisors and significant improvement of the space deficiency of the lower teeth into late adulthood. While in the control group, both irregularity of the lower incisors and space deficiency of the lower teeth increased significantly into late adulthood.

    Conclusion: Lower incisor alignment remains mainly unchanged into late adulthood in subjects who have all their first premolars removed in childhood, as the only treatment to relieve teeth crowding.

    Clinical relevance: Severe crowding in a class I occlusion can be solved solely with premolar extraction, allowing for spontaneous adjustments with more stable incisor alignment up to late adulthood.

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  • 13.
    Shungin, Dmitry
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Olsson, Alexandra Ioannidis
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Orthodontic treatment-related white spot lesions: a 14-year prospective quantitative follow-up, including bonding material assessment.2010In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 138, no 2, p. 136.e1-8; discussion 136Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: White spots (WS) related to orthodontic treatment are severe cariologic and cosmetic complications, but they are shown to be partially reduced by remineralization or abrasion in short-term follow-ups. In this prospective study, we quantitatively analyzed changes in WS in general and in treatment-related white spot lesions (WSL) during orthodontic treatment and at a 12-year follow-up after treatment. In addition, we quantitatively compared the effects of an acrylic bonding material vs a glass ionomer cement (GIC) on WSL. METHODS: Sum areas of WS and WSL were calculated on scans of standardized photos of the vestibular surfaces of 4 teeth in consecutive orthodontic patients (median treatment time, 1.7 years) bonded with the 2 materials in a split-mouth design. Comparisons were made in 59 patients before treatment (BF), at debonding (T0), at 1 year (T1), and at 2 years (T2), and in 30 patients at a 12-year follow-up (T3) with the Friedman test followed by pairwise comparisons with the Wilcoxon matched-pairs signed rank test. Differences of the effects of acrylic vs GIC on the sum areas of WSL were tested for each observation period with the Mann-Whitney U test. RESULTS: Increases in the sum areas of WS and WSL from BF to T0 (P <0.001) were followed by significant decreases at T1 (P <0.001) and T2 (P <0.01 for WS; P <0.001 for WSL). Significant changes were also found in the sum areas for WS at T3 compared with T2 (P <0.01), but not for WSL (P = 0.328). The sum areas of WS and WSL at T3 did not return to BF levels (P <0.001). Sum areas of WSL were higher for surfaces bonded with acrylic compared with GIC for each observation period from BF to T2 (P >0.001), and from T2 to T3 (P >0.05). CONCLUSIONS: Although significantly reduced during the 12-year follow-up and significantly lower with the GIC than the acrylic material at bonding, WSL are a cariologic and cosmetic problem for many orthodontic patients.

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