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  • 1.
    Afaag, Ali
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Sandelin, Benjamin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Polymerization Shrinkage of Dental Composites Registered by a Video-imaging Device. A pilot study2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The use of composite materials for dental fillings has become more common due to demands for more esthetic filling materials and a national ban against using mercury-containing products, among others dental amalgam. However, one of the drawbacks with composites is their polymerization shrinkage. Filler particles are incorporated into composites among other things to minimize the shrinkage. The sizes of the filler particles have in recent years become smaller and most composites have nano-particles incorporated.

    The aims of the study were to investigate if a) the filler load, b) the curing time and c) tested after "best-before date" will affect the polymerization shrinkage of commercial dental composites. The hypotheses are that high filler loads will result in low shrinkage, and that different curing times and tested after "best-before date" will not significantly affect the shrinkage.

    The polymerization shrinkage of ten commercial composites was studied and three different curing times were used. 150 specimens were manually formed and AcuVol was used to register the volumetric shrinkage.

    The mean volumetric polymerization shrinkage values of the composites ranged between 1.8% and 5.0% for the recommended curing times. The composite with the highest filler load (Kalore) had the lowest mean shrinkage, and the composite with the lowest filler load (SDR) had the highest mean shrinkage.

    The video-imaging device could be used to register the polymerization shrinkage of dental composites. The composites polymerization shrinkage was related to the filler loads when the composites were arranged in groups based on their type. No conclusion could be made about the effect of different curing times and "best-before date".

  • 2. Agudo, Antonio
    et al.
    Bonet, Catalina
    Travier, Noemie
    Gonzalez, Carlos A.
    Vineis, Paolo
    Bueno-de-Mesquita, H. Bas
    Trichopoulos, Dimitrios
    Boffetta, Paolo
    Clavel-Chapelon, Francoise
    Boutron-Ruault, Marie-Christine
    Kaaks, Rudolf
    Lukanova, Annekatrin
    Schuetze, Madlen
    Boeing, Heiner
    Tjonneland, Anne
    Halkjaer, Jytte
    Overvad, Kim
    Dahm, Christina C.
    Ramon Quiros, J.
    Sanchez, Maria-Jose
    Larranaga, Nerea
    Navarro, Carmen
    Ardanaz, Eva
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Key, Timothy J.
    Allen, Naomi E.
    Trichopoulou, Antonia
    Lagiou, Pagona
    Palli, Domenico
    Sieri, Sabina
    Tumino, Rosario
    Panico, Salvatore
    Boshuizen, Hendriek
    Buchner, Frederike L.
    Peeters, Petra H. M.
    Borgquist, Signe
    Almquist, Martin
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Gram, Inger T.
    Lund, Eiliv
    Weiderpass, Elisabete
    Romieu, Isabelle
    Riboli, Elio
    Impact of Cigarette Smoking on Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study2012Inngår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 30, nr 36, 4550-4557 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose Our aim was to assess the impact of cigarette smoking on the risk of the tumors classified by the International Agency for Research on Cancer as causally associated with smoking, referred to as tobacco-related cancers (TRC). Methods The study population included 441,211 participants (133,018 men and 308,193 women) from the European Prospective Investigation Into Cancer and Nutrition. We investigated 14,563 participants who developed a TRC during an average follow-up of 11 years. The impact of smoking cigarettes on cancer risk was assessed by the population attributable fraction (AF(p)), calculated using the adjusted hazard ratios and 95% CI for current and former smokers, plus either the prevalence of smoking among cancer cases or estimates from surveys in representative samples of the population in each country. Results The proportion of all TRC attributable to cigarette smoking was 34.9% (95% CI, 32.5 to 37.4) using the smoking prevalence among cases and 36.2% (95% CI, 33.7 to 38.6) using the smoking prevalence from the population. The AF(p) were above 80% for cancers of the lung and larynx, between 20% and 50% for most respiratory and digestive cancers and tumors from the lower urinary tract, and below 20% for the remaining TRC. Conclusion Using data on cancer incidence for 2008 and our AF(p) estimates, about 270,000 new cancer diagnoses per year can be considered attributable to cigarette smoking in the eight European countries with available data for both men and women (Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Sweden, Denmark). 

  • 3.
    Ahmed, Hammad
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Batinic, Mario
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Prevalence and Risk Factors of Neck Pain Among Dentists and Dental Hygienists2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    During the past years it has been reported that musculoskeletal disorders (MSD) have increased in working life. The body region with the highest prevalence of reported pain is the neck region. Several studies show that MSD in the neck region varies between 20–68% among dentists and dental hygienists. The dental personnel work with a limited field of vision and space, which often results in an unnatural work posture. The aim of this study was to evaluate the prevalence of neck pain in dentists and dental hygienists working in the county of Västra Götaland, Sweden and to explore possible work-related and individual risk factors. The study was based on a questionnaire, which was sent out to all dentists and dental hygienists (n = 473) who worked at Folktandvården (response rate 60%). The overall prevalence of neck pain (neck pain every day the past month) was 23%. Female dentists and dental hygienists had an increased risk of neck pain compared to male dentists (OR 2.68, 95% CI 1.22 - 6.75). Dental personnel that experienced severe stress tended to have an increased risk of neck pain compared to those who perceived low stress (OR 2.08, 95% CI 0.94 - 4.53). We conclude that neck pain is a common problem among dental personnel in the county of Västra Götaland. Female dentists and female dental hygienists are at greater risk concerning the prevalence of neck pain.

  • 4.
    Al-Zuheri, Insam
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Persson, Gina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The Effect of Topical Anesthesia on Jaw Pain Thresholds in Patients with Generalized Pain2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Chronic widespread pain and fibromyalgia often coexist with temporomandibular disorders (TMD) and affects mostly women. Studies have shown lower pressure pain thresholds (PPT) in these patients indicating that hyperalgesia is involved. The aim for this study was to investigate the effect of topical anesthesia on PPT for jaw muscles in patients with widespread pain. The hypothesis was that the PPT in these patients would increase after applying topical anesthetic cream. Ten women (aged 25-64 years, median: 50 years) diagnosed with TMD associated with widespread pain, reported from at least three different anatomical sites apart from the jaw region and pain to palpation according to the American College of Rheumatology criteria 1990, were included in the study. The double blind randomized trial was based on measurements of PPT with an Algometer before and after the application of anesthetic cream (EMLA) or placebo cream. The chosen measurement sites were the anterior part of the temporal muscle bilaterally, the belly of the masseter muscle bilaterally and the pollicis transversa muscle of the dominant hand. In the statistical analysis Wilcoxon’s rank sum test was used and a P-value <0.05 was considered statistically significant. There was a large inter-individual variation of PPT. No statistically significant differences in PPT-values before and after application of the EMLA or placebo creams were observed.

    In conclusion, the study showed that application of topical anesthesia had no significant effect on PPT in patients with widespread pain. Mechanisms related to central sensitization may have contributed to this result.

  • 5.
    Asad, Lanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Jumaa, Hifi
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The Significance of Person-Centered Information on Dental Anxiety – a mixed method study2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Dental anxieties are one of the most common forms of anxieties today and represent an obstacle for both the patients and the therapists. The aim of this study was twofold; first, to describe experiences of and assess dental anxiety among patients, and second, based on this develop, implement and evaluate a person-centered information program to decrease experiences of dental anxiety. Our hypothesis was that person-centered information reduces dental anxiety estimated by the Dental Anxiety Scale (DAS). The higher initially measured anxiety the greater reduction of anxiety at the final measurement. This is a descriptive intervention study with a mixed method design based on individual interviews and questionnaires about dental anxiety. Eight patients, median age 51.50 + Q1=35.00, Q3=67.00 completed the program. Dental Anxiety Scale was used to measure the level of dental anxiety and to evaluate the effect of person-centered information. The analysis of the interviews resulted in three content areas: causes of dental anxiety, expressions of dental anxiety and preference of information. Pre-intervention median DAS was 13.50 + Q1=12.25, Q3=16.50. In seven of the participants the score of the dental anxiety decreased and one did not change in scores on DAS. The post-intervention median DAS was 9.50 + Q1=8.25, Q3=12.75, with a statistically significant change (p<0.05). In conclusion, the hypothesis was supported. Person-centered information based on the history of dental anxiety and the participants’ preferences, may be helpful in reducing dental anxiety.

  • 6.
    Axelsson, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Carlsson, Elsa
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The Effect of Topical Anaesthesia on Pressure Pain Thresholds in symptom-free subjects2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Palpation, a standard procedure in the diagnostic process of muscular pain conditions – myalgia, aims to provoke a muscular pain response. The origin of pain elicited by palpation is not fully understood. There is also a possibility that the pressure elicit response from mechanoreceptors in skin, sub mucosal tissue or periosteum, which may affect the validity of the method.

    The aim of this study was to evaluate the effect of topical anesthesia on pressure pain thresholds at masseter, temporal and thumb muscle sites in healthy individuals.

    Twenty symptom-free subjects (ten males/ ten females) mean age 24.6 years (SD 2.6) participated in this double blind randomized experimental trial. An algometer (Somedic AB) was used to measure Pressure Pain Thresholds (PPT), on the masseter, temporal and thumb before and after topical application of EMLA or a placebo cream.

    There was no statistically significant change in PPTs at any of the tested sites between the baseline and after application of EMLA and placebo cream. Furthermore, there was no significant difference in PPTs between sexes. There was no significant difference in PPTs between the different muscle sites, apart from a higher PPT for the thumb site compared to the masseter muscle.

    In conclusion, PPT was not affected by topical anaesthesia in symptom-free subjects. This indicates that palpation pain is not dermal. Furthermore did PPT not differ between the masseter and temporal muscles. The study indicates that the same palpation pressure may be used for extra-oral palpation of the temporal and masseter muscle for both sexes.

  • 7.
    Bengtsson, Py
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Carlsson, Klara
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Treatment Results after Intra-articular Injection of Corticosteroids in Patients with TMJ Arthritis2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Arthritis is a common disease affecting the temporomandibular joint. The inflammation causes local pain and decreased function of the masticatory system. Temporomandibular joint arthritis can result from mechanical overloading, general autoimmune disease or individual susceptibility. The aim of this study was to investigate objective and subjective treatment results after intra-articular injection of corticosteroids in patients with temporomandibular joint arthritis. The hypothesis was that treatment with intra-articular injection of corticosteroids relieves clinical signs and subjective symptoms and no difference between objective and subjective treatment outcome was anticipated.

    An outcome assessment study with consecutive sample was performed. Objective and subjective data was registered from 70 subjects treated with intra-articular injection of corticosteroids. Statistics were analyzed in SPSS. Subgroup analysis was performed to evaluate and distinguish confounding variables such as sex, age, autoimmune disease (general), previous physical trauma and hard tissue changes.

    Maximum mouth opening capacity was increased by 8.7% after treatment demonstrating an objective improvement. Subjects with an initial impaired maximum mouth opening capacity <40 mm showed a greater increase compared to those within the normal range. Subjective assessment at follow-up presented a self-reported improvement in 77% of the subjects. The routines regarding follow-up were found to be inconsistent and subjective assessments scales were missing in about 50% of the cases.

    Objective and subjective improvement was observed after intra-articular injection of corticosteroids. This confirms the present treatment recommendations that intra-articular injection is an effective method in relieving signs and symptoms of temporomandibular joint arthritis.

  • 8.
    Bengtzboe, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Öskog, Stina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Surgical Treatment of Peri-implantitis: Treatment Results -a pilot study2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Peri-implantitis is an infectious disease and one of the treatment methods involves surgical debridement of the infected area. The aim of this pilot study was to investigate treatment outcome after surgical treatment of peri-implantitis in humans. Outcome measures were reduction in pocket probing depth (PPD) and bleeding on probing and/or suppuration (BOP/Sup). Eight patients, with a total amount of 28 implants, who were diagnosed with peri-implantitis were surgically treated with a non regenerative surgical method including debridement and removal of granulation tissue combined with osteoplasty. Oral hygiene instructions were given and after 6 to 18 months a clinical re-examination was performed by two dental students at Umeå University. PPD and BOP/Sup data at the re-examination were retrospectively compared to baseline data.

    The results of the study showed a reduction in mean PPD and BOP/Sup after surgery at patient level. A significant reduction in mean PPD was shown (p <0.05), while the reduction in BOP/Sup was not significant. At patient level, the mean reduction in mean PPD was 1.6 mm and in BOP/Sup 26%. Results varied among patients, suggesting that treatment outcome is influenced by several different factors. Tendencies that risk factors such as smoking and poor oral hygiene may have affected the treatment result were noted. In conclusion, our study shows that surgical therapy may be a beneficial treatment method for peri-implantitis in terms of reduction of PPD and BOP/Sup.

  • 9. Bhoo-Pathy, Nirmala
    et al.
    Peeters, Petra H. M.
    Uiterwaal, Cuno S. P. M.
    Bueno-de-Mesquita, H. Bas
    Bulgiba, Awang M.
    Bech, Bodil Hammer
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Perquier, Florence
    Teucher, Birgit
    Kaaks, Rudolf
    Schuetze, Madlen
    Boeing, Heiner
    Lagiou, Pagona
    Orfanos, Philippos
    Trichopoulou, Antonia
    Agnoli, Claudia
    Mattiello, Amalia
    Palli, Domenico
    Tumino, Rosario
    Sacerdote, Carlotta
    van Duijnhoven, Franzel J. B.
    Braaten, Tonje
    Lund, Eiliv
    Skeie, Guri
    Redondo, Maria-Luisa
    Buckland, Genevieve
    Sanchez Perez, Maria Jose
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Amiano, Pilar
    Wirfalt, Elisabet
    Wallstrom, Peter
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Nilsson, Lena Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Khaw, Kay-Tee
    Wareham, Nick
    Allen, Naomi E.
    Key, Timothy J.
    Rinaldi, Sabina
    Romieu, Isabelle
    Gallo, Valentina
    Riboli, Elio
    van Gils, Carla H.
    Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study2015Inngår i: Breast Cancer Research, ISSN 1465-542X, Vol. 17, 15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Specific coffee subtypes and tea may impact risk of pre- and post-menopausal breast cancer differently. We investigated the association between coffee (total, caffeinated, decaffeinated) and tea intake and risk of breast cancer. Methods: A total of 335,060 women participating in the European Prospective Investigation into Nutrition and Cancer (EPIC) Study, completed a dietary questionnaire from 1992 to 2000, and were followed-up until 2010 for incidence of breast cancer. Hazard ratios (HR) of breast cancer by country-specific, as well as cohort-wide categories of beverage intake were estimated. Results: During an average follow-up of 11 years, 1064 premenopausal, and 9134 postmenopausal breast cancers were diagnosed. Caffeinated coffee intake was associated with lower risk of postmenopausal breast cancer: adjusted HR = 0.90, 95% confidence interval (CI): 0.82 to 0.98, for high versus low consumption; P-trend = 0.029. While there was no significant effect modification by hormone receptor status (P = 0.711), linear trend for lower risk of breast cancer with increasing caffeinated coffee intake was clearest for estrogen and progesterone receptor negative (ER-PR-), postmenopausal breast cancer (P = 0.008). For every 100 ml increase in caffeinated coffee intake, the risk of ER-PR- breast cancer was lower by 4% (adjusted HR: 0.96, 95% CI: 0.93 to 1.00). Non-consumers of decaffeinated coffee had lower risk of postmenopausal breast cancer (adjusted HR = 0.89; 95% CI: 0.80 to 0.99) compared to low consumers, without evidence of dose-response relationship (P-trend = 0.128). Exclusive decaffeinated coffee consumption was not related to postmenopausal breast cancer risk, compared to any decaffeinated-low caffeinated intake (adjusted HR = 0.97; 95% CI: 0.82 to 1.14), or to no intake of any coffee (HR: 0.96; 95%: 0.82 to 1.14). Caffeinated and decaffeinated coffee were not associated with premenopausal breast cancer. Tea intake was neither associated with pre- nor post-menopausal breast cancer. Conclusions: Higher caffeinated coffee intake may be associated with lower risk of postmenopausal breast cancer. Decaffeinated coffee intake does not seem to be associated with breast cancer.

  • 10.
    Boman, Andreas
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Selvin, Jakob
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Softening Efficacy of Various Solvents on Gutta-percha and Root Canal Sealer2016Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    Solvents have been used in endodontic retreatment for a long time and the dissolving effect is well proven. Latterly chloroform has come in a bad light due to its possible carcinogenicity. Despite the negative health effect it is still used in dental environment. Other more biocompatible solvents have now reached the market and tests should be performed to evaluate the softening efficacy. The purpose of this in-vitro study was to evaluate the softening efficacy of four different solvents used in endodontics; chloroform, eucalyptol, tetrachloroethylene, orange-oil and a control group. 100 simulated canals filled with gutta-percha, epoxy amine resin based sealer, zinc oxide eugenol based sealer and non eugenolcalcium hydroxide based sealer were tested with hardness measurement before and after two minutes exposure time of medicament. Non-eugenol calcium hydroxide failed to set and was excluded from the test. A Shore A durometer was used to evaluate the hardness of the materials and all data was first analyzed with Kruskal-Wallis test and then Mann-Whitney test to compare with control group. With a digital camera connected to a microscope we also took pictures to compare the impressions with the different medicaments. The result showed that chloroform and tetrachloroethylene is significant better to soften gutta-percha than control group (p < 0.05) but only chloroform significant better than control group to soften epoxy amine resin based sealer and zinc oxide eugenol based sealer (p < 0.05). Even if the result was significant, we cannot draw any conclusions due to small sample size.

  • 11.
    Borys, Jennifer
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Higher Voltage Influence on Optimal Caries Diagnosis in Digital Radiography2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    It has previously been shown that caries diagnostics is improved when performed on radiographs exposed with a voltage of 60 kV compared to 70 kV. This is because low voltage provides higher subject contrast.

    The aim of the present study was to investigate whether the tube voltage used when exposing bitewings, influence the possibility to diagnose caries when using a new digital system with CMOS-sensors.

    Extracted teeth were mounted and bitewings exposed with both 60 and 70 kV and varying exposure times, using a digital system with CMOS-sensors. Observers with different experience in dentistry evaluated the radiographs for caries. CBCT of each single tooth was used as golden standard.

    There was no significant difference between the results of diagnosing caries between radiographs exposed with 60 kV compared to 70 kV. All radiographs that were exposed to an acceptable level of brightness gave similar result, independent on voltage.

    In conclusion; there was no significant difference between radiographic caries diagnosis performed with radiographs exposed with 60 compared to 70 kV, given that the exposure time was optimized. This indicates that 70 kV can be used for all intraoral examination if a correct decreased exposure time is used and that lowering to 60 kV is not necessary when intraoral examinations for caries evaluation are performed.

  • 12. Brown, J
    et al.
    Jacobs, R
    Levring Jäghagen, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lindh, C
    Baksi, G
    Schulze, D
    Schulze, R
    Basic training requirements for the use of dental CBCT by dentists: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology2014Inngår i: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 43, nr 1, 20130291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cone beam CT (CBCT) is a relatively new imaging modality, which is now widely available to dentists for examining hard tissues in the dental and maxillofacial regions. CBCT gives a three-dimensional depiction of anatomy and pathology, which is similar to medical CT and uses doses generally higher than those used in conventional dental imaging. The European Academy of DentoMaxilloFacial Radiology recognizes that dentists receive training in two-dimensional dental imaging as undergraduates, but most of them have received little or no training in the application and interpretation of cross-sectional three-dimensional imaging. This document identifies the roles of dentists involved in the use of CBCT, examines the training requirements for the justification, acquisition and interpretation of CBCT imaging and makes recommendations for further training of dentists in Europe who intend to be involved in any aspect of CBCT imaging. Two levels of training are recognized. Level 1 is intended to train dentists who prescribe CBCT imaging, such that they may request appropriately and understand the resultant reported images. Level 2 is intended to train to a more advanced level and covers the understanding and skills needed to justify, carry out and interpret a CBCT examination. These recommendations are not intended to create specialists in CBCT imaging but to offer guidance on the training of all dentists to enable the safe use of CBCT in the dentoalveolar region.

  • 13. Buckland, G
    et al.
    Travier, N
    Cottet, V
    Gonzalez, CA
    Lujan-Barroso, L
    Agudo, A
    Trichopoulou, A
    Lagiou, P
    Trichopoulos, D
    Peeters, PH
    May, A
    Bueno-de-Mesquita, HB
    Duijnhoven, FJ Bvan
    Key, TJ
    Allen, N
    Khaw, KT
    Wareham, N
    Romieu, I
    McCormack, V
    Boutron-Ruault, M
    Clavel-Chapelon, F
    Panico, S
    Agnoli, C
    Palli, D
    Tumino, R
    Vineis, P
    Amiano, P
    Barricarte, A
    Rodriguez, L
    Sanchez, MJ
    Chirlaque, MD
    Kaaks, R
    Teucher, B
    Boeing, H
    Bergmann, MM
    Overvad, K
    Dahm, CC
    Tjonneland, A
    Olsen, A
    Manjer, J
    Wirfalt, E
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lund, E
    Hjartaker, A
    Skeie, G
    Vergnaud, AC
    Norat, T
    Romaguera, D
    Riboli, E
    Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study2013Inngår i: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 132, nr 12, 2918-2927 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Epidemiological evidence suggests that the Mediterranean diet (MD) could reduce the risk of breast cancer (BC). As evidence from the prospective studies remains scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992 to 2000, in ten European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive [ER+/PR+] and 1,018 estrogen and progesterone receptor negative [ER/PR]). The arMED was inversely associated with the risk of BC overall and in postmenopausal women (high vs. low arMED score; hazard ratio [HR] = 0.94 [95% confidence interval [CI]: 0.88, 1.00] ptrend = 0.048, and HR = 0.93 [95% CI: 0.87, 0.99] ptrend = 0.037, respectively). The association was more pronounced in ER/PR tumors (HR = 0.80 [95% CI: 0.65, 0.99] ptrend = 0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor-negative tumors. The results support the potential scope for BC prevention through dietary modification.

  • 14.
    Buiyan, Salmah
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Sheng, Nongfei
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Experience of Oral Care among Elderly in Nursing Homes2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Life expectancy among the elderly has been improving for decades and edentulousness is constantly decreasing among the senior citizens. The steady decrease of tooth loss among the elderly is a challenge to the dental profession due to the increased demand of oral care. This study aims to explore the perspectives regarding oral health and oral care among the elderly living in nursing homes.

    Ten subjects from two nursing homes in Umeå were interviewed based on a defined interview guide. The interview guide contained open-ended questions regarding oral health and oral care. The subjects were interviewed, all the interviews were recorded and transcribed verbatim. Categories, subcategories and codes were created using qualitative content analysis.

    Two categories and six subcategories were established based on qualitative content analysis. The two categories revealed opposing attitudes, the first promoted oral care and the second disfavored oral health. The oral care promoted factors included general satisfaction with the elderly’s’ present oral status, positive experiences associated with oral care and strong desire to maintain their own oral hygiene. The most notable negative factors for good oral health was the lack of thorough oral examinations and individually adapted assistance with daily oral hygiene. The informants took oral hygiene as a part of their integrity and expressed wishes to be independent.

    In general, the informants held positive attitudes toward their current oral status and understood that proper oral care is a prerequisite to good oral health. However, it should be noted that assistance with oral hygiene is not practiced in either of the two nursing homes on a regular basis. This may be attributed to staff shortages and the residents desire to maintain their independence.

  • 15. Campmans-Kuijpers, Marjo J. E.
    et al.
    Sluijs, Ivonne
    Noethlings, Ute
    Freisling, Heinz
    Overvad, Kim
    Weiderpass, Elisabete
    Fagherazzi, Guy
    Kuehn, Tilman
    Katzke, Verena A.
    Mattiello, Amalia
    Sonestedt, Emily
    Masala, Giovanna
    Agnoli, Claudia
    Tumino, Rosario
    Spijkerman, Annemieke M. W.
    Barricarte, Aurelio
    Ricceri, Fulvio
    Chamosa, Saioa
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Winkvist, Anna
    Tjonneland, Anne
    Sluik, Diewertje
    Boeing, Heiner
    Beulens, Joline W. J.
    Isocaloric substitution of carbohydrates with protein: the association with weight change and mortality among patients with type 2 diabetes2015Inngår i: Cardiovascular Diabetology, ISSN 1475-2840, Vol. 14, 39Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The health impact of dietary replacement of carbohydrates with protein for patients with type 2 diabetes is still debated. This study aimed to investigate the association between dietary substitution of carbohydrates with (animal and plant) protein and 5-year weight change, and all-cause and cardiovascular (CVD) mortality risk in patients with type 2 diabetes.

    Methods: The study included 6,107 diabetes patients from 15 European cohorts. Patients with type 1 diabetes were excluded. At recruitment, validated country-specific food-frequency questionnaires were used to estimate dietary intake. Multivariable adjusted linear regression was used to examine the associations between dietary carbohydrate substitution with protein and 5-year weight change, and Cox regression to estimate hazard ratios (HRs) for (CVD) mortality.

    Results: Annual weight loss of patients with type 2 diabetes was 0.17 (SD 1.24) kg. After a mean follow-up of 9.2 (SD 2.3)y, 787 (13%) participants had died, of which 266 (4%) deaths were due to CVD. Substitution of 10 gram dietary carbohydrate with total (ß = 187 [75;299]g) and animal (ß = 196 [137;254]g) protein was associated with mean 5-year weight gain. Substitution for plant protein was not significantly associated with weight change (β = 82 [−421;584]g). Substitution with plant protein was associated with lower all-cause mortality risk (HR = 0.79 [0.64;0.97]), whereas substitution with total or animal protein was not associated with (CVD) mortality risk.

    Conclusions: In diabetes patients, substitution with plant protein was beneficial with respect to weight change and all-cause mortality as opposed to substitution with animal protein. Therefore, future research is needed whether dietary guidelines should not actively promote substitution of carbohydrates by total protein, but rather focus on substitution of carbohydrates with plant protein.

  • 16.
    Dahlén, Gunnar
    et al.
    Göteborgs Universitet.
    Claesson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Höglund Åberg, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Haubek, Dorte
    Aarhus University Denmark.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Kwamin, Francis
    Ghana University, Ghana.
    Subgingival bacteria in Ghanaian adolescents with or without progression of attachment loss2014Inngår i: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 6, 23977Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: This study describes subgingival bacterial profiles associated with clinical periodontal status in Ghanaian adolescents with or without progression of attachment loss.

    MATERIALS AND METHODS: Among 500 adolescents included in a cohort study, 397 returned 2 years later for a periodontal re-examination, including full-mouth CAL measurements. At follow-up, a subgroup of 98 adolescents was also subjected to bacterial sampling with paper points at four periodontal sites (mesial aspect of 11, 26, 31, and 46) and analyzed with the checkerboard DNA-DNA hybridization technique against DNA-probes from nine periodontitis-associated bacterial species.

    RESULTS: The 98 Ghanaian adolescents examined in the present study were similar to the entire group examined at the 2-year follow-up with respect to age, gender, and CAL ≥3 mm. A high detection frequency of Fusobacterium nucleatum and Prevotella intermedia (>99%) using checkerboard analysis was found, while for Aggregatibacter actinomycetemcomitans the detection frequency was <50%. A strong correlation was found at the individual level between the presence of P. intermedia and the total CAL change, and P. intermedia and Porphyromonas gingivalis were strongly correlated with a change in CAL and probing pocket depth (PPD) at the sampled sites. In a linear regression model, a significant discriminating factor for the total CAL change in the dentition during the 2-year follow-up period was obtained for P. intermedia and public school.

    CONCLUSION: This study indicates that subgingival bacterial species other than A. actinomycetemcomitans, for example, P. intermedia, have a significant association with periodontal breakdown (change in CAL) in Ghanaian adolescents with progression of periodontal attachment loss.

  • 17.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Coates, Philip J
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Nylander, Elisabet
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Genes Involved in Epithelial Differentiation and Development are Differentially Expressed in Oral and Genital Lichen Planus Epithelium Compared to Normal Epithelium2014Inngår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 94, nr 5, 526-530 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Lichen planus (LP) is a chronic mucocutaneous disease with unknown cause. Patients with LP often have both oral and genital lesions, but these conditions are often considered as separate diseases and treated accordingly. To find out which genes are differently expressed in mucosal LP compared to normal mucosa and establish whether oral and genital LP are in fact the same disease, whole genome expression analysis was performed on epithelium from 13 patients diagnosed with oral and/or genital LP and normal controls. For confirmation of keratin 4 and corneodesmosin expression, quantitative reverse-transcription PCR and immunohistochemistry were used. Many genes involved in epithelial development and differentiation are differently expressed in epithelium from LP compared to normal epithelium. Several of the differentially expressed genes are common for oral and genital LP and the same biological processes are altered which supports the fact that oral and genital LP are manifestations of the same disease. The change in gene expression indicates that differentiation is altered leading to changes in the epithelial barrier.

  • 18.
    Domäng, Markus
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Nasiri, Nargis
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Fluoride Levels in Saliva after Tea Intake2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Tea contains fluoride but its effect as a caries-preventive measure is not fully understood. The aim of this study was to evaluate the fluoride levels in saliva after tea-intake.

    Part one of the study analyzed the fluoride content of teas and one black and one green tea was thereafter selected for the clinical part of the study (part two). Ten healthy adults participated in part two which was designed as a prospective, crossover study where the salivary fluoride levels were analyzed after tea-intake at designated follow-ups.

    The fluoride level in saliva increased after tea-intake (0.04 ± 0.2 vs 0.97 ± 0.32 mg/L, (p < 0.01)). After intake of the black tea fluoride levels remained elevated compared to baseline at 5 minutes (0.04 ± 0.02 vs 0.12 ± 0.08 mg/L, ( p < 0.01)) and 10 minutes (0.04 ± 0.02 vs 0.09 ± 0.07 mg/L, (p < 0.05) but not at 20 minutes (0.04 ± 0.02 vs 0.05 ± 0.03 mg/L, (p = 0.056)). The green tea had elevated fluoride levels up to 5 minutes (0.05 ± 0.03 vs 0.14 ± 0.09 mg/L, (p < 0.01)) but not at 10 minutes (0.05 ± 0.03 vs 0.09 ± 0.08 mg/L, (p > 0.05)).

    The fluoride level in saliva is elevated after tea-intake which may suggest a caries-preventive effect, but not for a long period of time due to its rapid clearance in saliva.

  • 19.
    Eriksson, Linda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lif Holgerson, Pernilla
    Esberg, Anders
    Johansson, Ingegerd
    Microbial Complexes and Caries in 17-Year-Olds with and without Streptococcus mutans.2017Inngår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, 22034517731758Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Streptococcus mutans is a key bacterial species in the caries process, which affects >90% of the population worldwide. However, other acidogenic and aciduric/acidophilic species may contribute to disease development. In Sweden, a country with low prevalences of caries and S. mutans, a significant portion of caries-affected adolescents lack detectable levels of S. mutans. The objectives of the present study were 1) to characterize the tooth biofilm and saliva microbiota of adolescents with caries disease, with or without detectable S. mutans, from tooth biofilm and saliva samples and 2) to assess taxa clustering in the tooth biofilm and saliva samples and relate this information to caries status. For 17-y-old participants ( N = 154), enamel and dentin caries (the total number of present carious surfaces in the enamel and dentin) and caries experience (the number of decayed and filled tooth surfaces) were recorded, dental biofilm and saliva samples obtained, and information on medical and lifestyle habits collected. Multiplex 16S rDNA (V3-V4) sequencing of bacterial DNA was performed with the Illumina MiSeq platform. The Human Oral Microbiome Database and the ProbeSeq pipeline were used in the HOMI NGS procedure. In subjects with caries experience, high levels of S. mutans were associated with a few species and low levels with a panel of saccharolytic species. Present caries was similarly associated with a panel of saccharolytic species in subjects without S. mutans. Furthermore, tooth biofilm microbiota could be used to establish 4 clusters of subjects with different caries experiences. In particular, high levels of S. mutans were associated with the presence of a few influential species in multivariate modeling, including Scardovia wiggsiae. By contrast, a panel of less avid lactic acid-producing species was influential in patients with undetectable or low S. mutans levels in such modeling. These findings support a prominent role of S. mutans in infected adolescents but also the ecologic concept, especially in S. mutans-free subjects.

  • 20.
    Fransson, Oscar
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Malmberg, David
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Enterococcus faecalis Susceptibility to Alkaline Environments – a pilot study2015Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    Enterococcus faecalis has been shown to manifest the oral cavity and may be the cause of persistent infections in already root canal treated teeth. It has the capability of surviving in a high alkaline environment and undergoes starvation in a minimal metabolic state. The aim of the present study is to evaluate the antibacterial effect of pH 7.1, 10.0, 10.7 and 11.2 on Enterococcus faecalis during 7 days (168 hours). The hypothesis is that the stress induced by an alkaline environment will negatively affect the growth and survival of Enterococcus faecalis. The key methods used in this pilot study are cultivation on agar plates and optical density for measuring the bacterial growth and pH to control the experimental environment. The results show that pH 10.0 retards growth of Enterococcus faecalis, whereas no growth could be seen at pH 10.7 and pH 11.2, however pH 7.1 indicated initial growth. The initial growth stopped after 8 h and the reason for that might be due to lack of nutrition. The conclusion of this study is that a high alkaline intra canal pH may kill or retard the growth of Enterococcus faecalis.

  • 21.
    Frostell-Birge, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Skocic, Mia
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Phenotypic Characterization of hns mutants of Aggregatibacter actinomycetemcomitans2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Aggregatibacter actinomycetemcomitans is associated with aggressive forms of periodontitis. The mechanisms that control the expression of virulence factors are essentially unknown. Histone-like nucleoid structuring protein, H-NS, is a DNA binding protein that has been shown to influence hundreds of genes in Gram-negative bacteria. H-NS usually acts as a transcriptional silencer and has a negative influence on gene expression. H-NS has not been studied in A. actinomycetemcomitans before, and its effects on gene expression in this species were lacking. This study aimed to investigate if lack of H-NS expression might result in apparent phenotypical differences regarding gene expression with emphasis on virulence. For this we have used the A. actinomycetemcomitans rough-colony serotype a strain, D7S, its smooth-colony derivative D7SS, and hns mutants of D7S and D7SS. Our results show that smooth colony strain D7SS releases a larger amount of vesicles as compared to the rough D7S. The D7S hns mutant appeared to exhibit pili that were shorter than those of the parental strain, and this was not due to altered expression of RcpA in the hns mutant. As judged by Silver-staining, and Western blot analysis, H-NS may influence the level of several proteins. Taken together, our study supports that H-NS is involved in the regulation of virulence factor expression in A. actinomycetemcomitans.

  • 22.
    Glas, Johan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Rohlin, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Effect of Excessive Chewing on Pain Thresholds2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Pain and dysfunction in the jaw region may be related to fatigue and delayed onset muscle soreness (DOMS) following overstrain. The aim was to investigate development and course of subjective muscle fatigue, pain intensity, together with pressure pain thresholds (PPT) over the masseter and temporalis muscles during a 24-hour period in healthy men and women after an intense chewing task. Twenty healthy subjects (ten males and ten females) chewed seven pieces of hard chewing gum (ELMA) for 10 minutes at the pace of 80 beats per minute on their preferred chewing side. PPT at the temporalis, masseter were measured with an algometer before chewing (baseline), directly after, one hour after and 24 hours after chewing. Subjective fatigue and pain intensity were rated on a numerical rating scale (NRS). All subjects managed to complete the chewing task. The results showed that for both men and women, self-rated fatigue and pain intensity levels peaked directly after chewing and returned close to baseline values after one hour. The masseter PPT levels were significantly reduced one hour after chewing. Directly after chewing, the temporal muscle PPT increased significantly in men but not in women. Compared to women, men had higher PPT directly after chewing in both the masseter and temporal muscle sites. The results indicate that that intense chewing induces transient subjective local fatigue and pain but not DOMS in healthy subjects. Pressure pain thresholds remained fairly stable among women whereas a tendency for increased thresholds directly after the exercise was observed in men.

  • 23.
    Granholm, Susanne
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Henning, Petra
    Lindholm, Catharina
    Lerner, Ulf H.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Osteoclast progenitor cells present in significant amounts in mouse calvarial osteoblast isolations and osteoclastogenesis increased by BMP-22013Inngår i: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 52, nr 1, 83-92 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Enzymatically released cells from neonatal mouse calvarial bones are frequently used as primary mouse osteoblasts for in vitro studies. We, here, report that although these cells lack mRNA expression of the osteoclastic genes Calcr, Acp5 and Mmp-9 at early time points after their isolation, these transcripts are gradually upregulated when the calvarial osteoblast cultures are differentiated to more mature osteoblasts in long term cultures. Similarly, Calcr, Acp5, Mmp-9, as well as Rank and Nfatc1 mRNA expressions are robustly increased when the osteoblast cultures were induced to differentiate by treatment with bone morphogenetic protein (BMP-2). The increased Calcr mRNA resulted in functionally active calcitonin receptors. Enhanced osteoblastic differentiation was associated with increased Rankl mRNA expression and decreased Opg and Cfs1 mRNA expression. Treatment of the osteoblastic cells with BMP-2 or RANKL, either on plastic dishes or bone slices, resulted in the formation of multinucleated tartrate-resistant acid phosphatase positive cells, which were able to excavate resorption pits and release CTX from the bones. In contrast, increased osteoblastic differentiation induced by BMP-2 in the mouse calvarial osteoblastic cell line MC3T3-E1 was not associated with increased mRNA expression of Calcr, Acp5, Rank, c-Fms or Oscar. Interestingly, Ctsk mRNA was increased during osteoblastic differentiation in both mouse calvarial osteoblast cultures and in MC3T3-E1 cultures. Also osteoblasts isolated from mouse long bones by outgrowth from explant cultures were contaminated with osteoclast progenitors able to differentiate into bone resorbing osteoclasts. These data indicate that mouse calvarial osteoblast cultures contain osteoclast progenitor cells, which will be differentiated along the osteoclastic lineage during osteoblastic differentiation. Moreover, the data show that BMP-2 not only stimulates osteoblastic differentiation but can also induce osteoclastogenesis through increased RANKL.

  • 24.
    Habib, Ali
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Al-Khateeb, Zaid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Effect of Veneering Dental Zirconia on Bond Strength. A pilot study2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The objective of the study was to evaluate the effect of veneering zirconia surfaces with feldspar-based ceramics or glass ceramics on bond strength when using a resin composite cement. Forty-eight ytteria tetragonal zirconia polycrystal (Y-TZP) specimens were randomly divided into four groups. Six pairs were created in each group by bonding two of the specimens to each other after having the bonded surfaces treated differently as the following: I) polished and heat-treated (served as control), II) veneered with Vita VM9, III) veneered with e.max CAD Glaze and, IV) polished and heat-treated. The luting agent used in Group I - III was RelyX Unicem and in Group IV Charisma. Using a universal testing machine, the load at debonding (Newton) was recorded and the bond strength (MPa) was then calculated. Group I exhibited statistical significantly superior bond strength compared to all other groups. A statistical significantly superior bond strength was seen for the specimens in Group II compared to Group III and IV. Group IV presented the lowest bond strength but there was no significant difference to Group III. The present paper show no promotion in bond strength when zirconia was veneered with feldspar-based ceramic or glass ceramic.

  • 25.
    Hall, Michael
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Nylander, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Jenkinson, H
    University of Bristol.
    Persson, Karina
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Structure of the C-terminal domain of AspA (antigen I/II-family) protein from Streptococcus pyogenes2014Inngår i: FEBS open Bio, ISSN 2211-5463, Vol. 4, 283-289 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The pathogenic bacteria Streptococcus pyogenes can cause an array of diseases in humans, including moderate infections such as pharyngitis (strep throat) as well as life threatening conditions such as necrotizing fasciitis and puerperal fever. The antigen I/II family proteins are cell wall anchored adhesin proteins found on the surfaces of most oral streptococci and are involved in host colonization and biofilm formation. In the present study we have determined the crystal structure of the C2–3-domain of the antigen I/II type protein AspA from S. pyogenes M type 28. The structure was solved to 1.8 Å resolution and shows that the C2–3-domain is comprised of two structurally similar DEv-IgG motifs, designated C2 and C3, both containing a stabilizing covalent isopeptide bond. Furthermore a metal binding site is identified, containing a bound calcium ion. Despite relatively low sequence identity, interestingly, the overall structure shares high similarity to the C2–3-domains of antigen I/II proteins from Streptococcus gordonii and Streptococcus mutans, although certain parts of the structure exhibit distinct features. In summary this work constitutes the first step in the full structure determination of the AspA protein from S. pyogenes.

  • 26.
    Hayat, Ayesha
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Rashid, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Neuromuscular and Microvascular Changes in Intrinsic Tongue Muscles of Patients with Various Forms of ALS2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The study objective was to investigate whether amyotrophic lateral sclerosis (ALS) affects the intrinsic tongue muscles differently when the symptoms begin in cranial or lower limb muscles. Muscle fiber area, myosin heavy chain (MyHC) composition and vascularization were analyzed in the anterior and posterior region of the tongue with immunohistochemistry and morphometric techniques in 7 patients with classical ALS (limb onset) and 5 patients with progressive bulbar ALS (cranial onset). Samples from 5 previously healthy subjects were used as controls. The morphological results were correlated to the clinical data for each patient.

    The results showed that the ALS samples had various degrees of pathological changes in both the anterior and posterior region of the tongue. The fiber area and number of capillaries around fibers was decreased by approximately 50% compared to controls. In both anterior and posterior regions, there was a shift against fibers co-expressing slow and fast MyHC isoforms. Although both classical and bulbar forms of ALS affected the muscles, there were also important differences between the two. In the bulbar form of ALS, the proportion of MyHCI fibers were decreased, a finding in contrast with classical ALS where MyHCII fibers have been reported to be affected preferentially. The slow contracting MyHCI fibers in the bulbar form of ALS differed also by being better supplied by capillaries. Conclusively, ALS had a large impact on the tongue muscle morphology, but both the form of the ALS and inherent factors seem to influence the disease process.

  • 27. Hruby, Adela
    et al.
    Ngwa, Julius S.
    Renström, Frida
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Wojczynski, Mary K.
    Ganna, Andrea
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Houston, Denise K.
    Jacques, Paul F.
    Kanoni, Stavroula
    Lehtimaki, Terho
    Lemaitre, Rozenn N.
    Manichaikul, Ani
    North, Kari E.
    Ntalla, Ioanna
    Sonestedt, Emily
    Tanaka, Toshiko
    van Rooij, Frank J. A.
    Bandinelli, Stefania
    Djousse, Luc
    Grigoriou, Efi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lohman, Kurt K.
    Pankow, James S.
    Raitakari, Olli T.
    Riserus, Ulf
    Yannakoulia, Mary
    Zillikens, M. Carola
    Hassanali, Neelam
    Liu, Yongmei
    Mozaffarian, Dariush
    Papoutsakis, Constantina
    Syvanen, Ann-Christine
    Uitterlinden, Andre G.
    Viikari, Jorma
    Groves, Christopher J.
    Hofman, Albert
    Lind, Lars
    McCarthy, Mark I.
    Mikkila, Vera
    Mukamal, Kenneth
    Franco, Oscar H.
    Borecki, Ingrid B.
    Cupples, L. Adrienne
    Dedoussis, George V.
    Ferrucci, Luigi
    Hu, Frank B.
    Ingelsson, Erik
    Kahonen, Mika
    Kao, W. H. Linda
    Kritchevsky, Stephen B.
    Orho-Melander, Marju
    Prokopenko, Inga
    Rotter, Jerome I.
    Siscovick, David S.
    Witteman, Jacqueline C. M.
    Franks, Paul W.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Meigs, James B.
    McKeown, Nicola M.
    Nettleton, Jennifer A.
    Higher Magnesium Intake Is Associated with Lower Fasting Glucose and Insulin, with No Evidence of Interaction with Select Genetic Loci, in a Meta-Analysis of 15 CHARGE Consortium Studies2013Inngår i: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 143, nr 3, 345-353 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Favorable associations between magnesium intake and glycemic traits, such as fasting glucose and insulin, are observed in observational and clinical studies, but whether genetic variation affects these associations is largely unknown. We hypothesized that single nucleotide polymorphisms (SNPs) associated with either glycemic traits or magnesium metabolism affect the association between magnesium intake and fasting glucose and insulin. Fifteen studies from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided data from up to 52,684 participants of European descent without known diabetes. In fixed-effects meta-analyses, we quantified 1) cross-sectional associations of dietary magnesium intake with fasting glucose (mmol/L) and insulin (In-pmol/L) and 2) interactions between magnesium intake and SNPs related to fasting glucose (16 SNPs), insulin (2 SNPs), or magnesium (8 SNPs) on fasting glucose and insulin. After adjustment for age, sex, energy intake, BMI, and behavioral risk factors, magnesium (per 50-mg/d increment) was inversely associated with fasting glucose [beta = -0.009 mmol/L (95% CI: -0.013, -0.005), P< 0.0001] and insulin (-0.020 In-pmo/L (95% CI: -0.024, -0.017), P< 0.0001]. No magnesium-related SNP or interaction between any SNP and magnesium reached significance after correction for multiple testing. However, rs2274924 in magnesium transporter-encoding TRPM6 showed a nominal association (uncorrected P= 0.03) with glucose, and rs11558471 in SLC30A8and rs3740393 near CNNM2showed a nominal interaction (uncorrected, both P = 0.02) with magnesium on glucose. Consistent with other studies, a higher magnesium intake was associated with lower fasting glucose and insulin. Nominal evidence of TRPM6 influence and magnesium interaction with select loci suggests that further investigation is warranted. J. Nutr. 143: 345-353, 2013.

  • 28.
    Hussein, Bejyan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Tamali, Ali
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The Effect of Aggregatibacter actinomycetemcomitans Leukotoxin on Cell-to-Cell Communication in Human Monocytes2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Periodontitis is a complex and multifactorial dental disease and without proper treatment it eventually leads to the loss of teeth. Individuals with a higher number of Aggregatibacter actinomycetemcomitans in their micro-flora have a greater risk of developing periodontitis and the bacterium is associated with local aggressive periodontitis that affects younger populations. Aa produces a toxic virulent factor named Leukotoxin-A that can activate monocytes by a cellular chain reaction resulting in activation and secretion of IL-1β. This cytokine is an important pro-inflammatory key player for maintaining the metabolic balance in tissue homeostasis, which is also of great importance for the pathogenicity of periodontitis. The aim of this study is to investigate if the effect of LtxA on human monocytes involves activation of cell-to-cell (gap-junction) communication trough opening of the Connexin-43 channels (i.e. Connexons) on the target cell membrane. A human monocyte cell line, THP-1, were exposed to LtxA in combination with and without Carbenoxalone, which is an inhibitor of gap junction communication. The activity of GJC was studied by using FACS (fluorescence activated cell scanner) with the Parachute-technique. The results showed that the THP-1 cells do express Cx43 on their membrane both with and without exposure to lipopolysaccharide. LtxA induces a dose and time dependent increased activity of GJC, which was significantly reduced in presence of Cbx. These effects of LtxA and Cbx indicate a specific induction of GJC through Cx43 channels by LtxA. In conclusion, our results show that the activation of human monocytes by LtxA involves stimulation of increased GJC through connexon channels.

  • 29.
    Ibrahimi, Pranvera
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Jashari, Fisnik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Ahlqvist, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Arnerlöv, Conny
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Garoff, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Johansson, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Levring Jäghagen, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wester, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Henein, Michael Y
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Carotid ultrasound accurately detects arterial calcification quantified by cone beam computed tomography2014Inngår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, nr Supplement 1, Meeting abstract P3519, 636-636 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 30.
    Isackson, Andréa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Magnusson, Matilda
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Oral Care Assistance at Private and Municipal Swedish Geriatric homes - A Questionnaire survey2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Oral health among elderly people is commonly debated, and correlations between oral and general health are shown. The increase of life expectancy in our population causes changes in the need of oral health care. The requirements of performing the oral hygiene increase and cause higher demands on the staff working at the geriatric homes.

    Both private and communal geriatric homes were included in this study. Two different questionnaires were distributed, one to nursing staff and one to staff managers. A geographical distribution to four big city’s; Umeå, Stockholm, Göteborg and Malmö were selected.

    The hypothesis is that the knowledge of the daily needs of oral care for elderly people among geriatric nursing staff and the manager, are insufficient and more education are needed. Results do not differ when comparing private and municipal management.

    Nursing assistants indicated that their basic education included none or minor theoretical knowledge (61 %) and practical training in oral care (67 %). Part of the staff (30%) felt that they needed more education to help the residents with the daily oral care. Half of the staff members answered that they had not received any in-service education in oral health. The results did not differ comparing private and municipal geriatric homes.

    Conclusions of this study are that it is common that caretakers in geriatric homes are in need of assistance when performing daily oral care. The staffs appear to be well aware of the fact that maintaining a good oral health is of big importance. More education about oral health are both wanted and needed.

  • 31.
    Jerner, Adéle
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Svedberg, Lina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The Effect of Topical Anesthesia on Pain Perception in Patients with Local Myalgia2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Temporomandibular disorders (TMD) is a term used to embrace pain and dysfunction in the jaw-, face- and temple region. Myofascial pain is considered the most common condition included in TMD. The diagnostic criteria for myalgia are based on the patient’s symptoms and clinical signs, where pain to palpation of the jaw muscles is vital. The aim of this experimental trial was to examine whether pain perception is influenced by topical anesthesia in patients with local myalgia of the jaw muscles. Our hypothesis was that the pressure pain thresholds (PPT) at jaw muscle sites are affected after topical application of anesthesia in patients with local myalgia.

    Ten women (median age 36 years) with TMD related to myalgia participated in the study. The PPT at masseter muscle and temporal muscle sites bilaterally and the first dorsal intraossei on the dominant hand were measured using an electronic algometer. After a baseline registration, EMLA or placebo cream was applied on the chosen sites in a randomized order. A new registration was carried out five minutes after the application. The values for each participant before and after the application were compared using Wilcoxon rank sum test. A P-value < 0.05 was considered statistically significant.

    The PPT increased significantly after application of topical anesthesia, but not placebo cream. The results indicate that the superficial nociceptors were sensitized and sensitive to topical anesthesia in patients with TMD related to myalgia. The interpretation of a pain response to pressure thus seems to be complex and warrant further studies.

  • 32.
    Johansson, Mattias
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Immediate loading of splinted implants placed in healed alveolar bone for the rehabilitation of edentulous maxillae2016Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 33.
    Karalli, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Glucocorticosteroid Injection In the Temporomandibular Joint2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Local injection of glucocorticosteroid (GCS) is an effective treatment of painful conditions in the temporomandibular joint (TMJ). GCS can be administered using anatomical landmarks for orientation or by the use of simultaneous radiographic imaging. In the image guided technique the corticosteroid is mixed with a contrast medium and the injection visualized using radiography.

    The aim of this prospective pilot study was to compare the treatment effect of intra-articular GCS injection in the TMJ with- and without the use of simultaneous radiographic imaging.

    13 patients (9 women and 4 men) with TMJ arthralgia received injection either with or without simultaneous radiographic imaging. Treatment effect was evaluated based on changes in clinical signs and symptoms before and 4-6 weeks after treatment. The symptoms included pain at rest and at jaw function, joint locking, pain index and global improvement. Clinical observations involved TMJ pain to palpation, maximal mouth opening, pain at maximal opening and joint sounds.

    The main findings were significant decreases in pain index and relief of familiar pain before and after treatment as well as a positive effect on global improvement regardless of administration technique. There were no significant differences between the two methods in treatment outcome.

    The results suggest that both administration techniques are comparable in treatment effect and should therefore rather be evaluated based on cost-effectiveness and radiation dose. It may be reasonable to apply the image-guided technique mainly when further diagnostic information is needed.

  • 34.
    Kaveh, Babak
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Witkowska, Emilia
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Caries Prevalence and Caries Associated Measures in Children Living in a Rural Romanian Village2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    A cross-sectional study was performed with the aim to investigate the caries prevalence and associated factors in 6 to 15 year old school children living in a village outside Cluj-Napoca, Romania. All children were offered to be included and examined for dental caries according to World Health Organisation (WHO) criteria. Caries was scored at the tooth and surface levels D/d=decayed, M/m=missing, F/f=filled, T/t=tooth, S/s=surface (DMFT/DMFS/dmft/dmfs) for the permanent and deciduous dentition, respectively. Presence of dental plaque was evaluated according to Silness-Löe, infection with the caries associated bacterial species Streptococcus mutans and Streptococcus sobrinus by polymerase chain reaction (PCR), and general information collected with a questionnaire. Totally, 71 children, 69 children were clinically examined. Mean DMFT was 5.7 and DMFS 9.8, and the Significant-Caries-Index (SIC), i.e. the mean (DMFT-value) in the highest tertile based on caries distribution, was 10.8. S. mutans was detected in 86% and S. sobrinus in 49% of the children, and 46% were infected with both species. Five children (7%) were neither infected by S. mutans nor S. sobrinus. Among all children the mean number of reported daily intakes of sweet products was 4.8, and large amounts of dental plaque was generally seen. In conclusion, the caries prevalence among school children in the village was very high, oral hygiene inadequate, daily sugar intake high, and prevalence of S. mutans high, combined with no access to dental care and caries preventive programs.

  • 35.
    Kreidly, Mariam
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    IL-34 Expression in Gingival Fibroblasts, Gingival Crevicular Fluid and Gingival Tissue2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    IL-34 is a protein associated with bone degenerative diseases but the role in periodontal disease is unknown. The aim of this study was to assess the expression of IL-34 in primary human gingival fibroblasts (GF) and investigate if the expression is regulated by the pro-inflammatory cytokines interleukin-1 (IL-1β) and tumor necrosis factor α(TNF-α). We also investigated if IL-34 is detectible in gingival crevicular fluid (GCF) in healthy, gingivitis and periodontitis sites. Furthermore, we examined if healthy and inflamed gingival tissue contains IL-34.

    GF were stimulated by IL-1β300 pg/ml and TNF-α10 ng/ml. IL-34 mRNA was measured by quantitative real-time PCR (qPCR). GCF was collected from 11 healthy, 10 gingivitis, and 21 periodontitis gingival crevices. IL-34 protein was quantified using enzyme-linked immunoabsorbent assays (ELISA). Healthy and inflamed gingival tissue biopsies were collected and examined using immunohistochemistry (IHC).

    IL-34 mRNA was expressed in GF and the expression was enhanced 12x fold-change versus control by TNF-α10 ng/ml and 4x fold-change versus control by IL-1β300 pg/ml. IL-34 was also present in GCF but no significant difference in IL-34 protein was detected between the healthy, gingivitis, and periodontitis groups. Healthy and inflamed gingival tissue showed equal amounts of IL-34 protein in the epithelium while sub-epithelially the inflamed tissue showed higher levels of IL-34 protein.

    Pro-inflammatory cytokines stimulate IL-34 mRNA expression in GF. IL-34 protein is present in GCF and gingival tissue which demands further investigation about the eventual role of IL-34 in the pathogenesis of periodontitis.

  • 36. Leenders, Max
    et al.
    Boshuizen, Hendriek C.
    Ferrari, Pietro
    Siersema, Peter D.
    Overvad, Kim
    Tjonneland, Anne
    Olsen, Anja
    Boutron-Ruault, Marie-Christine
    Dossus, Laure
    Dartois, Laureen
    Kaaks, Rudolf
    Li, Kuanrong
    Boeing, Heiner
    Bergmann, Manuela M.
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Palli, Domenico
    Krogh, Vittorio
    Panico, Salvatore
    Tumino, Rosario
    Vineis, Paolo
    Peeters, Petra H. M.
    Weiderpass, Elisabete
    Engeset, Dagrun
    Braaten, Tonje
    Luisa Redondo, Maria
    Agudo, Antonio
    Sanchez, Maria-Jose
    Amiano, Pilar
    Huerta, Jose-Maria
    Ardanaz, Eva
    Drake, Isabel
    Sonestedt, Emily
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Winkvist, Anna
    Khaw, Kay-Tee
    Wareham, Nick J.
    Key, Timothy J.
    Bradbury, Kathryn E.
    Johansson, Mattias
    Licaj, Idlir
    Gunter, Marc J.
    Murphy, Neil
    Riboli, Elio
    Bueno-de-Mesquita, H. Bas
    Fruit and vegetable intake and cause-specific mortality in the EPIC study2014Inngår i: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 29, nr 9, 639-652 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Consumption of fruits and vegetables is associated with a lower overall mortality. The aim of this study was to identify causes of death through which this association is established. More than 450,000 participants from the European Prospective Investigation into Cancer and Nutrition study were included, of which 25,682 were reported deceased after 13 years of follow-up. Information on lifestyle, diet and vital status was collected through questionnaires and population registries. Hazard ratios (HR) with 95 % confidence intervals (95 % CI) for death from specific causes were calculated from Cox regression models, adjusted for potential confounders. Participants reporting consumption of more than 569 g/day of fruits and vegetables had lower risks of death from diseases of the circulatory (HR for upper fourth 0.85, 95 % CI 0.77-0.93), respiratory (HR for upper fourth 0.73, 95 % CI 0.59-0.91) and digestive system (HR for upper fourth 0.60, 95 % CI 0.46-0.79) when compared with participants consuming less than 249 g/day. In contrast, a positive association with death from diseases of the nervous system was observed. Inverse associations were generally observed for vegetable, but not for fruit consumption. Associations were more pronounced for raw vegetable consumption, when compared with cooked vegetable consumption. Raw vegetable consumption was additionally inversely associated with death from neoplasms and mental and behavioral disorders. The lower risk of death associated with a higher consumption of fruits and vegetables may be derived from inverse associations with diseases of the circulatory, respiratory and digestive system, and may depend on the preparation of vegetables and lifestyle factors.

  • 37.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Osteoblasts, Osteoclasts, and Osteocytes: Unveiling Their Intimate-Associated Responses to Applied Orthodontic Forces2012Inngår i: Seminars in orthodontics, ISSN 1073-8746, Vol. 18, nr 4, 237-248 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Bone is remodeled and modeled by the concerted activities of 3 cell types — osteoblasts, osteocytes, and osteoclasts. Osteoblasts are the cells that produce bone extracellular matrix and are responsible for its mineralization. Osteoblasts also have endocrine activity through secretion of osteocalcin, which regulates fat and energy metabolism. These cells also control the differentiation and activity of osteoclasts. Osteocytes are osteoblasts that have been incorporated into bone matrix and are cells with extensive dendritic processes through which the cells communicate with other osteocytes and with osteoblasts. Mechanical loading is sensitized by the dendritic processes and transferred to biochemical responses involved in control of osteoblast and osteoclast function. Osteocytes also have endocrine activity by releasing fibroblast growth factor 23, which is involved in phosphate secretion in kidneys. Differentiation of osteoclast mononuclear progenitors to mature multinucleated osteoclasts is regulated by macrophage colony-stimulating factor and receptor activator of NF-κB ligand, expressed by stromal cells in bone marrow or osteoblasts in bone, as well as by osteocytes. The integrated endo- and paracrine control of osteoblasts, osteocytes, and osteoclasts is important for maintaining bone mass and for control of remodeling and modeling processes in bone, including during orthodontic-induced tooth movement.

  • 38.
    Lindholm, Mark
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Niklasson, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Optimal Exposure Time for Diagnosis of Approximal Caries Lesions on Digital X-rays2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    In digital radiography the image can be enhanced and thereby an incorrect exposed radiograph can appear to have optimal brightness but with limited information and possibility to diagnose e.g. caries.

    The primary aim of this study was to determine if different exposure times have an impact on the accuracy in diagnosis of approximal caries lesions in bitewing radiographs using a CMOS system. If so, what the optimal exposure time was.

    A total of 40 extracted human teeth were selected and evaluated with a digital CMOS system. The teeth were exposed with different exposure times. CBCT was used to validate the presence and degree of approximal caries lesions on every individual tooth surface. The radiographs were evaluated by 11 general dentists and 4 specialists in oral and maxillofacial radiology.

    The choice of exposure time did affect the diagnostic accuracy. A higher diagnostic accuracy was achieved when a longer exposure time (> 0.1 sec) was used when comparing kappa values and ROC curves among the observers. The radiologists had a higher diagnostic accuracy than the general dentists. A substantial variation in individual diagnostic accuracy between observers was found.

    In conclusion; approximal caries was found to be easier to diagnose when the evaluated longer exposure times were used in the studied digital CMOS system. There was some decline in the longest exposures of the time span. However, when selecting optimal exposure time the patient's age and size should also be taken into consideration.

  • 39.
    Lundqvist, Pontus
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Mathson, Anton
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Oral Health Care in Home Care Service – Personnels’ Perspective2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Elderly nowadays stay longer in their own home. This raises the standards on home care service to contribute to the maintenance of elderly’s general and oral health. Our objective is therefore to explore attitudes about how home care workers view oral health care and the importance of good oral health for elderly clients. 8 subjects (22 to 61 years of age) were selected for the study working in home care service, which all gave their informed consent. Semi-structured interviews were performed, recorded and transcribed verbatim before evaluation, using qualitative content analysis. From the interviews, a result of total 19 categories and 41 subcategories were assigned which were the bases for the 10 evolved themes. The four themes best representing the study’s purpose are more thoroughly described. At a low level of abstraction attitudes such as reminding the clients to brush their teeth and importance of practical help with oral hygiene are expressed as important. Difficulties occur in forms of lack of accessibility to the oral cavity and the client’s unwillingness to co-operate. The participants also require better contact with dental services. On the emotional level, feelings such as alienation, powerlessness and fear of breaking the client’s integrity occur along with feelings of distantness and lack of interest. This leading to a conclusion of a low level of awareness together with lack of knowledge about oral care and oral health is seen among personnel in home care service, while the personnel themselves are requesting more knowledge and better contact with dental health care services.

  • 40.
    Lövgren, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Recognition of Temporomandibular Disorders: validity and outcome of three screening questions (3Q/TMD)2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background

    Pain and dysfunction in the temporomandibular region (Temporomandibular Disorders, TMD) are common conditions in the general population with an estimated treatment need of 5-15% in the general population. However, in Sweden, traceable performed treatments are significantly lower. The reasons for this indicated under-treatment are not known. To easily detect patients with a potential TMD related condition, three screening questions, 3Q/TMD, have been introduced. The aim with this project was to evaluate the validity and outcome of the 3Q/TMD with the objective to recognize individuals with TMD and potential treatment need in the Public Dental Health service (PDHS).

    Methods

    The thesis is based on four study samples; three from the PDHS in the county of Västerbotten, Sweden and one sample from the specialized orofacial pain clinic at the Academic Centre for Dentistry, ACTA, Amsterdam, the Netherlands. The bases for all studies are individuals’ answers to the 3Q/TMD and quantitative approaches were used in the analyses. The prevalence of affirmative answers was evaluated in a large cross-sectional study over the lifespan. The validity of the 3Q/TMD in relation to the Diagnostic Criteria for TMD (DC/TMD) as reference standard was established in two case-control studies. The outcome of the 3Q/TMD on TMD treatment within general practice was evaluated in a cohort study.

    Results

    Affirmative answers to the 3Q/TMD increased during adolescence. Women answered affirmatively to the 3Q/TMD significantly more often compared to men for all age groups expect for the first and last parts of a one hundred-year lifespan. The highest prevalence was reported by women during their fertile period in life. In a general population sample, 74% of individuals with an affirmative answer qualified for a DC/TMD pain or dysfunctional diagnosis, as compared to 64% in a specialist patient sample. In the general population sample, for the individual 3Q/TMD questions, as well as combinations of questions, the negative predictive values were high (0.92-0.99). For the specialist sample, when at least one question was answered affirmatively the negative predictive value was high (0.90). The positive predictive value was high (0.89) when all three questions were positive. There was significantly more treatment performed or recommended for 3Q-positives (21.5%) compared to 3Q-negatives (2.2%) (P<0.001). The odds ratio for TMD-related treatment for 3Q-positives versus 3Q-negatives was 12.1 (95% CI: 6.3-23.4).

    Conclusion

    The 3Q/TMD is a convenient and valid tool to recognize individuals who would benefit from a further TMD examination within an adult, general population. Within specialized orofacial pain clinics, the questions are useful as guidance for further diagnostics. Although the 3Q/TMD was a factor related to TMD treatment, the majority of individuals with self-reported symptoms of TMD still did not receive traceable assessment or treatment. Factors associated with dentists’ clinical decision-making in relation to TMD warrants further research. The utilization of the 3Q/TMD as a part of a decision tree for the clinician can improve the health care for patients with TMD and is therefore recommended within dentistry.

     

  • 41.
    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-making2017Inngår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, nr 8, 573-579 s.Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 42.
    Lövgren, Anna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Parvaneh, Hasti
    Academic Centre for Dentistry Amsterdam (ACTA).
    Lobbezoo, Frank
    Academic Centre for Dentistry Amsterdam (ACTA).
    Häggman-Henrikson, Birgitta
    Malmö Högskola.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Visscher, Corine
    Academic Centre for Dentistry Amsterdam (ACTA).
    Validity of three screening questions in relation to the DC/TMD in a specialized orofacial pain clinicManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Aims: To determine the validity of three screening questions (3Q/TMD) in relation to the

    Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized orofacial pain

    clinic.

    Methods: Consecutive patients, >18 years, referred with a TMD complaint to the Orofacial pain

    clinic, Academic Centre for Dentistry Amsterdam, ACTA, the Netherlands, were included in the

    study. The study sample, (n=449) with mean age 44 years (72% females) answered the

    3Q/TMD and the DC/TMD questionnaire before a clinical DC/TMD examination. The 3Q/TMD

    constitutes of two questions on weekly pain from the jaw, face, and temple region, in rest (Q1)

    and on function (Q2), and one function-related question on weekly catching and/or locking of the

    jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation

    to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.

    Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an

    intraarticular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was

    high (0.83-0.94), whereas specificity was low (0.41-0.55). For the function-related question,

    sensitivity was low (0.48), whereas specificity was high (0.96).

    Conclusions: In most TMD-pain patients, the two pain screening questions are positive. The

    high negative predictive values of the two questions on pain (Q1 and Q2) indicate that in

    patients with negative responses, the presence of pain-related TMD is quite unlikely. For the

    functional screening question (Q3), a positive response is indicative for a subgroup of intra-

    articular DC/TMD diagnoses.

  • 43.
    Lövheim, Hugo
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gilthorpe, Jonathan
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Eriksson, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Elgh, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Herpes simplex infection and the risk of Alzheimer's disease: a nested case-control study2015Inngår i: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 11, nr 6, 587-592 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Herpes simplex virus (HSV) is thought to play an etiological role in the development of Alzheimer's disease (AD).

    METHODS: Plasma samples from 360 AD cases (75.3% women, mean age 61.2 years) and 360 age- and sex-matched dementia-free controls, taken on average 9.6 years before AD diagnosis, were analyzed for anti-HSV antibodies (immunoglobulin G, IgG, and immunoglobulin M, IgM) by enzyme-linked immunosorbent assays.

    RESULTS: In the complete sample group, the presence of anti-HSV IgG and IgM antibodies did not increase the risk of AD significantly (odds ratio (OR) 1.636, P = .069 and OR 1.368, P = .299, respectively). In cases with 6.6 years or more between plasma sampling and AD diagnosis (n = 270), there was a significant association between presence of anti-HSV IgG antibodies and AD (OR 2.250, P = .019).

    CONCLUSION: Among persons with a follow-up time of 6.6 years or more, HSV infection was significantly associated with AD.

  • 44.
    Malmbom, Madeleine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Svahn, Hanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lack of Lipopolysaccharide-induced β-hexosaminidase and TNF-α Release from Human Mast Cells (HMC-1) and Rat Basophilic Cells (RBL-2H3)2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Mast cells are important immune cells that are able to degranulate potent mediators, and participate in infections and inflammatory responses. The process of mast cell degranulation is complex and still partly unknown, especially in bacterial infections caused by endotoxins such as lipopolysaccarides. In this study, we have investigated lipopolysaccharide-induced degranulation of β-hexosaminidase and tumor necrosis factor α in a human mast cell line, HMC-1, and a rat basophilic leukemia cell line, RBL-2H3. We investigated whether the cells expressed the required Toll-like receptor 4 through which lipopolysaccaride activates the mast cell. By using RT-PCR we show that the Toll-like receptor 4 gene is actively transcribed in both cell lines, indicating that the cells could be able to respond to lipopolysaccaride. To analyse the degranulation of β-hexosaminidase, the cells were stimulated with different concentrations of lipopolysaccaride and the extracellular enzyme activity was measured spectrophotometrically. Our results showed that no release could be measured using this method in neither of the cell lines. The release of tumor necrosis factor α was analysed by using enzyme-linked-immunosorbent-assay, and the results indicated that neither lipopolysaccharide, ionomycin, nor 5’-(N-ethylcarboxamido) adenosine had any effect on this process.

    In conclusion, the HMC-1 cell line is not a useful model to study mast cell degranulation in oral infections, and a more reliable in vitro method is needed to investigate the involvement of human mast cells in pathological conditions and to screen for new therapeutic drugs.

  • 45. Mariscal-Munoz, Eduardo
    et al.
    Costa, Carlos A. S.
    Tavares, Hewerson S.
    Bianchi, Jonas
    Hebling, Josimeri
    Machado, João P. B.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning. Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Souza, Pedro P. C.
    Osteoblast differentiation is enhanced by a nano-to-micro hybrid titanium surface created by Yb:YAG laser irradiation2016Inngår i: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 20, nr 3, 503-511 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to analyze the capacity of a new modified laser surface to stimulate calvarial osteoblasts isolated from neonatal mouse bones to differentiate and form mineralized nodules. Titanium discs were subjectezd or not to laser irradiation according to specific parameters and characterized. Osteoblasts isolated from neonatal mouse calvaria were cultured over the discs, and the capacity of these cells to proliferate (MTT assay), form mineralized nodules (Alizarin red assay), and enhance alkaline phosphatase activity (ALPase activity) was analyzed. Real-time PCR was used for quantification of gene expression. Laser-irradiated titanium discs (L) presented a rough nano-to-micrometric oxidized surface contrasting with the smooth pattern on polished discs (P). The R-a on the micrometric level increased from 0.32 +/- 0.01 mu m on P surfaces to 10.57 +/- 0.39 mu m on L surfaces. When compared with P, L promoted changes in osteoblast morphology, increased mineralized nodule formation in osteoblasts cultured on the surfaces for 14 days, and enhanced ALPase activity at days 7 and 14. Transcription factors triggering osteoblast differentiation (Runx2 and Sp7) and genes encoding the bone extracellular matrix proteins collagen type-1 (Col1a1), osteopontin (Spp1), and osteocalcin (Bglap) were upregulated in cells on L surfaces compared with those on P surfaces at days 1-14. Laser treatment of titanium surfaces created a rough surface that stimulated osteoblast differentiation. Laser treatment of titanium generates a reproducible and efficient surface triggering osteoblast differentiation that can be of importance for osteointegration.

  • 46. Mejàre, Ingegerd A.
    et al.
    Klingberg, Gunilla
    Mowafi, Frida K.
    Stecksén-Blicks, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Twetman, Svante H. A.
    Tranaeus, Sofia H.
    A Systematic Map of Systematic Reviews in Pediatric Dentistry: What Do We Really Know?2015Inngår i: PLoS ONE, ISSN 1932-6203, Vol. 10, nr 2, e0117537Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. Methods A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Results Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. Conclusion There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.

  • 47. Michaud, Dominique S
    et al.
    Izard, Jacques
    Rubin, Zachary
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Weiderpass, Elisabete
    Tjønneland, Anne
    Olsen, Anja
    Overvad, Kim
    Boutron-Ruault, Marie Christine
    Clavel-Chapelon, Françoise
    Dossus, Laure
    Kaaks, Rudolf
    Katzke, Verena A
    Boeing, Heiner
    Foerster, Jana
    Trichopoulou, Antonia
    Naska, Androniki
    Ziara, Giana
    Vineis, Paolo
    Grioni, Sara
    Palli, Domenico
    Tumino, Rosario
    Mattiello, Amalia
    Peeters, Petra H M
    Siersema, Peter D
    Barricarte, Aurelio
    Huerta, José-María
    Molina-Montes, Esther
    Dorronsoro, Miren
    Quirós, J Ramón
    Duell, Eric J
    Ohlsson, Bodil
    Jeppsson, Bengt
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Lif, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Khaw, Kay-Tee
    Wareham, Nick
    Travis, Ruth C
    Key, Tim J
    Freisling, Heinz
    Duarte-Salles, Talita
    Stepien, Magdalena
    Riboli, Elio
    Bueno-de-Mesquita, H Bas
    Lifestyle, dietary factors, and antibody levels to oral bacteria in cancer-free participants of a European cohort study2013Inngår i: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 24, nr 11, 1901-1909 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Increasing evidence suggests that oral microbiota play a pivotal role in chronic diseases, in addition to the well-established role in periodontal disease. Moreover, recent studies suggest that oral bacteria may also be involved in carcinogenesis; periodontal disease has been linked to several cancers. In this study, we examined whether lifestyle factors have an impact on antibody levels to oral bacteria.

    METHODS: Data on demographic characteristics, lifestyle factors, and medical conditions were obtained at the time of blood sample collection. For the current analysis, we measured antibody levels to 25 oral bacteria in 395 cancer-free individuals using an immunoblot array. Combined total immunoglobin G (IgG) levels were obtained by summing concentrations for all oral bacteria measured.

    RESULTS: IgG antibody levels were substantially lower among current and former smokers (1,697 and 1,677 ng/mL, respectively) than never smokers (1,960 ng/mL; p trend = 0.01), but did not vary by other factors, including body mass index, diabetes, physical activity, or by dietary factors, after adjusting for age, sex, education, country, and smoking status. The highest levels of total IgG were found among individuals with low education (2,419 ng/mL).

    CONCLUSIONS: Our findings on smoking are consistent with previous studies and support the notion that smokers have a compromised humoral immune response. Moreover, other major factors known to be associated with inflammatory markers, including obesity, were not associated with antibody levels to a large number of oral bacteria.

  • 48.
    Mirzadeh, Sadegh
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    The long-term effect of sinus elevation surgery on the health and thickness of the maxillary sinus membrane. A radiological, retrospective cohort follow up study2015Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 49.
    Mårell, Lena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Tandläkarutbildning.
    Bergdahl, Jan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Tillberg, Anders
    Public Dental Health Competence Centre for Northern Norway, Tromsø, Norway.
    Stenberg, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Berglund, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Psychological symptoms and self-image of patients with complaints attributed to dental restorative materials: Psychological symptoms in patients with environmental intoleranceManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Objectives The aim was to study self-image the level of psychological symptoms in patients with symptoms attributed to their dental restorative materials, one group with local oral symptoms only (LSO) and one group with multi-symptoms (M-S).

    Materials and methods A questionnaire was sent to the 257 participants, 189 women and 68 men, containing questions regarding their dental and medical history.The self-image was assessed with the Structural Analysis of Social Behavior (SASB. Psychological symptomssuch as somatization, depression and anxiety were assessedand the Global Severity Index (GSI) was computed by using the Symptom Check List 90 (SCL-90).

    Results The SASB showed that the M-S group and the LSO-group scored significantly higher on the “spontaneous” and “positive self-image” than the reference group. In the SCL-90, the M-S group scored significantly higher than the LSO-group and the references on the somatization subscales. On depression, anxiety and the GSI scale, the M-S group scored significantly higher than the reference group.

    Conclusions The two subgroups rated significantly higher on the SASB Spontaneous and Positive clusters which indicates that these patients have an excessively positive self-image, are very spontaneous and have an overconfidence in themselves compared to the reference group. In the M-S group  there was a clear tendency to somatization, depression and anxiety and they are more psychologically stressed than the reference group.

    Clinical relevance Clinicians should be aware of that illness attributed to dental restorative materials seems to be multi-factorial and patient with multi-symptoms are more psychologically stressed than patient with local-symptoms only.