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  • 1. Alghadir, Ahmad
    et al.
    Aly, Farag
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Effect of face veil on ventilatory function among Saudi adult females2012Inngår i: Pakistan journal of medical sciences print, ISSN 1682-024X, Vol. 28, nr 1, 71-74 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The use of face veil called "niqab" by women to cover their faces at public places is a common practice in some Muslim communities. The long-term effect of niqab use on ventilatory function (VF) has not previously been reported. The aim of this cross-sectional study was to compare VF between niqab wearing and non-niqab wearing healthy Saudi females. Methodology: Thirty eight healthy adult Saudi females participated in this study. Nineteen subjects were regular niqab users and the other nineteen were either not using niqab at all or used it for less than one hour per day. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC (%), and maximal voluntary ventilation (MVV) were recorded using a digital spirometer. Results: Mean values of FVC, FEV1, FEV1/FVC (%) and MVV for niqab wearers were significantly lower than the corresponding values for non-niqab wearers. Significant negative correlation was found between the FVC and FEV1 values and the number of hours of the use of face veil per day. Conclusions: Long-term use of traditional niqab use can affect VF.

  • 2. Alghadir, Ahmad
    et al.
    Aly, Farag
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Sex-Based Differences in Lung Functions of Saudi Adults2012Inngår i: Journal of Physical Therapy Science, ISSN 0915-5287, Vol. 24, nr 1, 5-9 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    [Background] Sex-based differences in lung function are known. [Purpose] To investigate sex-based differences in ventilatory function among Saudi adults, anti to relate it to their level of physical activity. [Subjects and Methods] Seventy healthy Saudi adult subjects (35 males and 35 females) participated in this study. Measurements of forced vital capacity (FVC), forced expiratory volume in one second (FEVI). FEVI/FVC%, and maximal voluntary ventilation (MVV) were made. In addition, physical activity scores (MET-minutes/week) were measured using the International Physical Activity Questionnaire (IPAQ). [Results] The studied parameters were significantly higher for males than for females. The female values were significantly lower even after the male values were adjusted to compensate for gender-based anatomical and physiological differences in lung capacity. The MET-minutes/week was significantly higher for males than for females, but it was not significantly correlated with the pulmonary function parameters of either gender. [Conclusions] There are sex-based differences in lung function parameters of Saudi adults, with higher values for males. This difference in lung function tests between the genders is greater than the known anatomical and physiological differences in the respiratory systems of males and females. Saudi males are more physically active than females but no significant correlation between pulmonary function parameters and physical activity score was found for either gender.

  • 3.
    Engström, Anna-Lena
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi.
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Johansson, Anders
    Keshishian, Patrik
    Forsberg, Mona
    Juvenile Arthritis and Development of Symptoms of Temporomandibular Disorders: A 15-year Prospective Cohort Study2007Inngår i: Journal of Orofacial Pain, ISSN 1064-6655, Vol. 21, nr 2, 120-126 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To compare the development of symptoms of temporomandibular disorders (TMD) in a sample of patients with juvenile arthritis (JA) and a matched control sample.

    Methods: In 1986, 40 patients with JA (28 girls and 12 boys; mean age ± SD, 18 ± 4.5 years) and an ag- and sex-matched control sample were examined for signs and symptoms of TMD. Fifteen years later in 2001, a questionnaire concerning symptoms of TMD was sent to these subjects. Twenty-eight individuals (68%) in the JA sample (20 women and 8 men; mean age ± SD, 35 ± 5.2 years) and 26 controls (19 women and 7 men; 34 ± 4.0 years) were available for the follow-up.

    Results: The overall prevalence of symptoms of TMD increasead between the 2 examinations in both groups. The prevalence of reported TMD symptoms, such as jaw pain, fatigue in the jaws, and difficulty opening the jaws wide, as well as awareness of tooth clenching, headaches, neck and shoulder pains, was significantly greater among the JA sample than among the controls at the follow-up.

    Conclusion: The study indicates that prevalence of pain and dysfunction in the craniofacial or cervical regions of JA patients is increased more than 20 years after the onset of JA compared to healthy individuals.

  • 4.
    Eriksson, P O
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, E
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Zafar, H
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man.2000Inngår i: Journal of Dental Research, ISSN 0022-0345, Vol. 79, nr 6, 1378-1384 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Recent observations in man of concomitant mandibular and head movements during single maximal jaw-opening/-closing tasks suggest a close functional relationship between the mandibular and the head-neck motor systems. This study was aimed at further testing of the hypothesis of a functional integration between the human jaw and neck regions. Spatiotemporal characteristics of mandibular and associated head movements were evaluated for 3 different modes of rhythmic jaw activities: self-paced continuous maximal jaw-opening/-closing movements, paced continuous maximal jaw-opening/-closing movements at 50 cycles/minute, and unilateral chewing. Mandibular and head-neck movements were simultaneously recorded in 12 healthy young adults, by means of a wireless opto-electronic system for 3-D movement recordings, with retro-reflective markers attached to the lower (mandible) and upper (head) incisors. The results showed that rhythmic mandibular movements were paralleled by head movements. An initial change in head position (head extension) was seen at the start of the first jaw-movement cycle, and this adjusted head position was retained during the following cycles. In addition to this prevailing head extension, the maximal jaw-opening/-closing cycles were paralleled by head extension-flexion movements, and in general the start of these head movements preceded the start of the mandibular movements. The results support the idea of a functional relationship between the temporomandibular and the cranio-cervical neuromuscular systems. We therefore suggest a new concept for human jaw function, in which "functional jaw movements" are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints.

  • 5.
    Eriksson, Per-Olof
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Zafar, Hamayun
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Jaw-neck dysfunction in whiplash-associated disorders2007Inngår i: Archives of Oral Biology, ISSN 0003-9969, Vol. 52, nr 4, 404-408 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This paper reports data from recent studies on integrative jaw-neck motor control in healthy subjects and disturbed jaw-neck behaviour in whiplash-associated disorders (WAD). The results show that neck function is an integral part of natural jaw behaviour, and that neck injury can impair jaw function and therefore disturb eating behaviour. We also show preliminary results from implementation of a new approach for rehabilitation of jaw-neck dysfunction and pain in WAD.

  • 6.
    Eriksson, Per-Olof
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Zafar, Hamayun
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Musculoskeletal Disordes in the Jaw-Face and Neck2005Inngår i: Conn´s Current Therapy: Musculoskeletal Disorders in the Jaw-Face and Neck, Saunders Elsevier , 2005, 1128-1133 s.Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Because different diseases in the jaw-orofacial region may give rise to similar symptoms, proper examination and diagnosis must precede treatment. Musculoskeletal disorders in the jaw-face region, generally termed craniomandbular disorders (CMD), are as prevalent as the two major dental diseases, caries and periodontitis, and constitute a signifiant health problem. There is a strong female preponderance among patients seeking care for CMD, and symptoms and signs are more frequent, severe, and longer-lasting in women than in men. Between 65% and 95% of CMD patients who seek care for the first time are reported to improve. A new concept for natural jaw function suggests that ”functional jaw movements” are the result of jointly activated jaw and neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints, and that these jaw and head-neck movements have neural commands in common, are preprogammed, and are innate. Accordingly, natural jaw function, by definition, includes integrative jaw-neck behavior. A new explanatory model for the development of pain and dysfunction in the jaw-face in subjects with whiplash-associated disorders (WAD) proposes because natural jaw actions require a healthy state of the temporomandibular. atlanto-occipital, and cervical spine joints, it can be assumed that an injury to or disease of any of these three joint systems might derange natural jaw motor control. Based on findings of disturbed jaw-neck function in WAD, a new treatment model is suggested for patients with jaw-face pain and dysfunction and WAD. The rationale behind this approach is that intervention of jaw function by definition includes neck function. Results from implementation of this treatment model, showing improvement of magnitude and speed for both mandibular and head-neck movements, are reported. Finally, an appropriate term for the clinical condition comprising both jaw-face and head-neck pain and dysfunction is cervicocraniomandibular disorders (CCMD).

  • 7.
    Eriksson, Per-Olof
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Zafar, Hamayun
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Musculoskeletal disorders in the jaw-face and neck: Temporomandibular Disorders2006Inngår i: Conn´s Current Therapy, Saunders Elsevier , 2006, 1197-1202 s.Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 8.
    Eriksson, Per-Olof
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Zafar, Hamayun
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Deranged jaw-neck motor control in whiplash-associated disorders2004Inngår i: European Journal of Oral Sciences, ISSN 0909-8836, Vol. 112, nr 1, 25-32 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Recent findings of simultaneous and well coordinated head-neck movements during single as well as rhythmic jaw opening-closing tasks has led to the conclusion that functional jaw movements´are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. It can therefore be assumed that disease or injury to any of these joint systems would disturb natural jaw function. To test this hypothesis, amplitudes, temporal coordination, and spatiotemporal consistency of concomitant mandibular and head-neck movements during single maximal jaw opening-closing tasks were analysed in 25 individuals suffering from whiplash-associated disorders (WAD) using optoelectronic movement recording technique. In addition, the relative durations for which the head position was equal to, leading ahead of, or lagging behind the mandibular position during the entire jaw opening-closing cycle were determined. Compared with healthy individuals, the WAD group showed smaller amplitudes, and changed temporal coordination between mandibular and head-neck movements. No divergence from healthy individuals was found for the spatiotemporal consistency or for the analysis during the entire jaw opening-closing cycle. These findings in the WAD group of a ´faulty, but yet consistent, jaw-neck behaviour may reflect a basic importance of linked control of the jaw and neck sensory-motor systems. In conclusion, the present results suggest that neck injury is associated with deranged control of mandibular and head-neck movements during jaw opening-closing tasks, and therefore might compromise natural jaw function.

  • 9. Forsberg, Hans
    et al.
    Sjödin, Lars
    Lundgren, Per
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Oral health in the adult population of Västerbotten, Sweden - a comparison between an epidemiological survery and data obtained from digital dental records2008Inngår i: Swedish Dental Journal: Oral health in the adult population of Västerbotten, Sweden - a comparison between an epidemiological survey and data obtained from digital records., Vol. 32, 17-25 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this study was to analyse the possibilities and limitations of using data drawn from electronic dental patient records (EDPRs) in monitoring dental health among adults in a northern Swedish county. Material and Methods: The study population comprised all 35-, 50-, 65- and 75-year-old patients who were examined and, where required, received treatment at the Public Dental Service (PDS) in Västerbotten, Sweden, in 2003 and in 2004. In total 2,497 patients in 2003, and 2,546 patients in 2004 met the inclusion criteria. As controls, 779 subjects randomly drawn from the adult population in the same age groups and from the same county were used. They participated in an oral health survey and were examined clinically between October 2002 and March 2003. Results: When oral health was estimated based on EDPRs the prevalence of edentulous subject was significantly underestimated, while the mean numbers of teeth and the mean values of sound teeth were significantly overestimated. No statistically significant difference was found in prevalence of primary decayed tooth surfaces (DS). The prevalence of filled teeth (FT) was fairly similar between the study samples. Registrations of periodontal status were mainly missing in the EDPRs. Since registrations related to temporomandibular disorders are not included in the T4 system its prevalence could no be assessed and accordingly not compared with the epidemiological sample. Conclusion: The study shows that clinical registration based on EDPRs is at present not accurate enough to be used as indicators of oral health status among adults in a community.The objective of this study was to analyse the possibilities and limitations of using data drawn from electronic dental patient records (EDPRs) in monitoring dental health among adults in a northern Swedish county. Material and Methods: The study population comprised all 35-, 50-, 65- and 75-year-old patients who were examined and, where required, received treatment at the Public Dental Service (PDS) in Västerbotten, Sweden, in 2003 and in 2004. In total 2,497 patients in 2003, and 2,546 patients in 2004 met the inclusion criteria. As controls, 779 subjects randomly drawn from the adult population in the same age groups and from the same county were used. They participated in an oral health survey and were examined clinically between October 2002 and March 2003. Results: When oral health was estimated based on EDPRs the prevalence of edentulous subject was significantly underestimated, while the mean numbers of teeth and the mean values of sound teeth were significantly overestimated. No statistically significant difference was found in prevalence of primary decayed tooth surfaces (DS). The prevalence of filled teeth (FT) was fairly similar between the study samples. Registrations of periodontal status were mainly missing in the EDPRs. Since registrations related to temporomandibular disorders are not included in the T4 system its prevalence could no be assessed and accordingly not compared with the epidemiological sample. Conclusion: The study shows that clinical registration based on EDPRs is at present not accurate enough to be used as indicators of oral health status among adults in a community.

  • 10.
    Granberg, I
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Lindell, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Pedrosa-Domellöf, Fatima
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Oftalmiatrik.
    Stål, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Capillary supply in relation to myosin heavy chain fibre composition of human intrinsic tongue muscles2010Inngår i: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 192, nr 5, 303-313 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The capillary supply and myosin heavy chain (MyHC) composition of three different intrinsic tongue muscles was analysed in the anterior and posterior regions of the human tongue with biochemical and immunohistochemical techniques. Mean capillary density for the whole tongue was 796 ± 82 cap/mm², without regional differences. The overall number of capillaries around each fibre (CAF) was higher in the posterior than in the anterior region (2.5 vs. 2.1, p = 0.009). However, correcting for regional differences in fibre size, CAF per fibre area was higher in the anterior region (4.3 vs. 3.0, p < 0.001). Muscle fibres containing fast MyHCs predominated in the anterior region (78.7%), consisting of MyHCIIa (58.5%), MyHCIIx (1.0%), MyHCIIa+MyHCIIx (11.3%) and MyHCI+MyHCIIa (7.9%). Fibres containing slow MyHC predominated in the posterior region (65.2%), consisting of MyHCI (45.5%) and MyHCI+MyHCIIa (19.7%). A minor fibre population (<2%) contained unusual MyHC isoforms, namely MyHC foetal, MyHC slow-tonic, MyHC α-cardiac or MyHC embryonic. The microvascularization of the human tongue was twice as high as in human limb muscles. Regional similarities in capillary supply, but differences in fibre phenotype composition, suggest that human tongue muscle fibres are fatigue resistant independently of MyHC content. High frequency of hybrid fibres, that is fibres co-expressing two or more MyHC isoforms, indicates a wider spectrum of fibre contractile properties than in limb muscles. In conclusion, human intrinsic tongue muscles showed internal specialization in distribution of MyHC isoforms and capillary supply, but not in the expression of unusual MyHCs.

  • 11.
    Grönqvist, Johan
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Impaired jaw function and eating difficulties in Whiplash-associated disorders2008Inngår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, nr 4, 171-177 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Eating requires mouth opening, biting, chewing and swallowing and should be performed without dysfunction or pain. Previous studies have shown that jaw opening-closing movements are the result of coordinated activation of both jaw and neck muscles, with simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. Consequently, it can be assumed that pain or dysfunction in any of the three joint systems involved could impair jaw activities. In fact, recent findings support this hypothesis by showing an association between neck injury and reduced amplitudes, speed and coordination of integrated jaw-neck movements. This study investigated the possible association between neck injury and disturbed eating behaviour. Fifty Whiplash-associated disorders (WAD) patients with pain and dysfunction in the jaw-face region and 50 healthy age- and sex-matched controls without any history of neck injury participated in the study. All participants were assessed by a questionnaire, which contained 26 items about eating behaviour, jaw pain and dysfunction.

    For the WAD group there were significant differences in jaw pain and dysfunction and eating behaviour before and after the accident, but no significant differences between WAD before and healthy. The healthy and the WAD group before the accident reported no or few symptoms. The WAD patients after the accident reported pain and dysfunction during mouth opening, biting, chewing, swallowing and yawning and felt fatigue, stiffness and numbness in the jaw-face region. In addition, a majority also reported avoiding tough food, big pieces of food, and taking breaks during meals. Altogether, these observations suggest an association between neck injury and disturbed jaw function and therefore impaired eating behaviour. A clinical implication is that examination of jaw function should be recommended as part of the assessment and rehabilitation of WAD patients.

  • 12.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nackens roll i käkfunktionen2006Inngår i: Tandläkartidningen, Vol. 98, nr 3, 56-57 s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Functional jaw movements are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. This study tested the hypothesis of a functional integration between the human jaw and neck motor systems in rhythmic jaw activities in healthy and in individuals with pain and dysfunction in the jaw and neck region following neck trauma. Whiplash Associated Disorders (WAD). Compared with healthy subjects, the WAD groups showed smaller amplitudes and disturbed coordination of head and mandibular movements, and reduced endurance during chewing. The results suggest that optimal jaw function requires free unrestricted head-neck movements and support the hypothesis of a close functional relationship between the jaw and the neck regions in rhythmic jaw activities.

    [Article in Swedish]

  • 13.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Neck function in rhythmic jaw activities2004Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Previous studies in animals and humans show anatomic and physiological connections between the trigeminal and cervical regions. This investigation tested the hypothesis of a functional integration between the human jaw and neck motor systems in rhythmic jaw activities. By means of a wireless optoelectronic 3-D movement recording system, spatiotemporal characteristics of mandibular and head-neck movements were studied during rhythmic jaw opening-closing and chewing tasks, in healthy and in individuals with pain and dysfunction in the jaw and neck region following neck trauma, Whiplash-associated Disorders (WAD). As a basis, a methodological study evaluated the applicability of skin and teeth attached reflex markers fixed to the lower jaw and to the head in optoelectronic recording of chewing movements.

    The results showed concomitant and coordinated mandibular and head movements during rhythmic jaw tasks. The start of the head movement generally preceded the start of the mandibular movement. For chewing, larger size and harder texture of bolus were associated with larger head extension and larger amplitude of both mandibular and head movements. Immobilization of the head by mechanical fixation deranged jaw motor behaviour with regard to speed and amplitude of mandibular movements. Even with head fixation, muscle activity was present in neck muscles during activities. Compared to healthy subjects, WAD individuals showed smaller amplitudes and disturbed coordination of mandibular and head movements. Furthermore, a dynamic load test showed a reduced endurance during chewing in the WAD group.

    In conclusion, the results suggest that optimal jaw function requires free unrestricted head-neck movements and support the hypothesis of a close functional relationship between the jaw and the neck regions in rhythmic jaw activities. A new concept for human jaw function is proposed, in which "functional jaw movements" are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. The finding of an association between neck injury and disturbed jaw behaviour suggest that assessment and management of neck injured patients should include jaw function.

  • 14.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Head movements during chewing: relation to size and texture of bolus2004Inngår i: Journal of Dental Research, ISSN 0022-0345, Vol. 83, nr 11, 864-868 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Coordinated mandibular and head-neck movements during jaw opening-closing activities suggest a close functional linkage between the jaw and the neck regions. The present study investigated whether size and texture of bolus can influene head-neck behaviour during chewing. Using an optoelectronic 3-D recording technique, we analyzed concomitant mandibular and head-neck movements in 12 healthy adults chewing small (3 g) and large (9 g) boluses of chewing gum and Optosil®. The main finding was a head extension during chewing, the amount of which was related mainly to bolus size. Furthermore, each chewing cycle was accompanied not only by mandibular movements, but also by head extension-flexion movements. Larger head movement amplitudes were correlated with larger size and, to some extent, also with harder texture of the bolus. The results suggest that head-neck behaviour during chewing is modulated in response to changes in jaw sensory-motor input.

  • 15.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, P-O
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, E
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Zafar, H
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Evaluation of skin- versus teeth-attached markers in wireless optoelectronic recordings of chewing movements in man1998Inngår i: Journal of Oral Rehabilitation, ISSN 0305-182X, Vol. 25, nr 7, 527-534 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 16.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nordh, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Increased sternocleidomastoid, but not trapezius, muscle activity in response to increased chewing load2013Inngår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 121, nr 5, 443-449 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previous findings, during chewing, that boluses of larger size and harder texture result in larger amplitudes of both mandibular and head-neck movements suggest a relationship between increased chewing load and incremental recruitment of jaw and neck muscles. The present report evaluated jaw (masseter and digastric) and neck [sternocleidomastoid (SCM) and trapezius] muscle activity during the chewing of test foods of different sizes and textures by 10 healthy subjects. Muscle activity was recorded by surface electromyography and simultaneous mandibular and head movements were recorded using an optoelectronic technique. Each subject performed continuous jaw-opening/jaw-closing movements whilst chewing small and large boluses of chewing gum and rubber silicone (Optosil). For jaw opening/jaw closing without a bolus, SCM activity was recorded for jaw opening concomitantly with digastric activity. During chewing, SCM activity was recorded for jaw closing concomitantly with masseter activity. Trapezius activity was present in some, but not all, cycles. For the masseter and SCM muscles, higher activity was seen with larger test foods, suggesting increased demand and recruitment of these muscles in response to an increased chewing load. This result reinforces the previous notion of a close functional connection between the jaw and the neck motor systems in jaw actions and has scientific and clinical significance for studying jaw function and dysfunction.

  • 17.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Nordh, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Head Immobilization can Impair Jaw Function2006Inngår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, nr 11, 1001-1005 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Findings that jaw-opening/-closing relies on both mandibular and head movements suggest that jaw and neck muscles are jointly activated in jaw function. This study tested the hypothesis that rhythmic jaw activities involve an active repositioning of the head, and that head fixation can impair jaw function. Concomitant mandiular and head-neck movements were recorded during rhythmic jaw activities in 12 healthy adults, with and without fixation of the head. In four participants, the movement recording was combined with simultaneous registration of myoelectric activity in jaw and neck muscles. The results showed neck muscle activity during jaw opening with and without head fixation. Notably, head fixation led to reduced mandibular movements and shorter duration of jaw-opening/-closing cycles. The findings suggest recruitment of neck muscles in jaw activities, and that head fixation can impair jaw function. The results underline the jaw and neck neuromuscular relationship in jaw function.

  • 18.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Zafar, H
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, P-O
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Disturbed jaw behavior in whiplash-associated disorders during rhythmic jaw movements.2002Inngår i: Journal of Dental Research, ISSN 0022-0345, Vol. 81, nr 11, 747-751 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    As shown previously, "functional jaw movements" are the result of coordinated activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints. In this study, the effect of neck trauma on natural jaw function was evaluated in 12 individuals suffering from whiplash-associated disorders (WAD). Spatiotemporal characteristics of mandibular and concomitant head movements were evaluated for three different modes of rhythmic jaw activities: self-paced continuous maximal jaw-opening/-closing movements, paced continuous maximal jaw-opening/-closing movements at 50 cycles/minute, and unilateral chewing. Compared with healthy subjects, the WAD group showed smaller magnitude and altered coordination pattern (a change in temporal relations) of mandibular and head movements. In conclusion, these results show that neck trauma can derange integrated jaw and neck behavior, and underline the functional coupling between the jaw and head-neck motor systems.

  • 19.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Österlund, Caatharina
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Endurance during chewing in whiplash-associated disorders and TMD2004Inngår i: Journal of Dental Research, ISSN 0022-0345, Vol. 83, nr 12, 946-950 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We have previously shown an association between neck injury and disturbed jaw function. This stydy tested the hypothesis of a relationship between neck injury and impaired endurance during chewing. Fifty patients with whiplash-associated disorders (WAD) were compared with 50 temporomandibular disorders (TMD) patients and 50 healthy subjects. Endurance was evaluated during unilateral chewing of gum for 5 min when participants reported fatigue and pain. Whereas all healthy subjects completed the task, ¼ of the TMD and a majority of the WAD patients discontinued the task. A majority of the WAD patients also reported fatigue and pain. These findings suggest an association between neck injury and reduced functional capacity of the jaw motor system. From the results, we propose that routine examination of WAD patients should include jaw function and that an endurance test as described in this study could also be a useful tool for non-dental professionals.

  • 20. Jung, TTK
    et al.
    Alper, CM
    Roberts, JE
    Casselbrant, ML
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Gravel, JS
    Hellström, Sten O
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
    Hunter, LL
    Paradise, JL
    Park, SK
    Spratley, J
    Tos, M
    Wallace, I
    Complications and sequelae2005Konferansepaper (Fagfellevurdert)
  • 21.
    Karlsson, Fredrik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Unger, Elin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Wahlgren, Sofia
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Blomstedt, Patric
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Linder, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Nordh, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Doorn, Jan van
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Deep brain stimulation of caudal zona incerta and subthalamic nucleus in patients with Parkinson’s disease: effects on diadochokinetic rate2011Inngår i: Parkinson’s Disease, ISSN 2042-0080, Vol. 2011, 605607- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The hypokinetic dysarthria observed in Parkinson's disease (PD) affects the range, speed, and accuracy of articulatory gestures in patients, reducing the perceived quality of speech acoustic output in continuous speech. Deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) and of the caudal zona incerta (cZi-DBS) are current surgical treatment options for PD. This study aimed at investigating the outcome of STN-DBS (7 patients) and cZi-DBS (7 patients) in two articulatory diadochokinesis tasks (AMR and SMR) using measurements of articulation rate and quality of the plosive consonants (using the percent measurable VOT metric). The results indicate that patients receiving STN-DBS increased in articulation rate in the Stim-ON condition in the AMR task only, with no effect on production quality. Patients receiving cZi-DBS decreased in articulation rate in the Stim-ON condition and further showed a reduction in production quality. The data therefore suggest that cZi-DBS is more detrimental for extended articulatory movements than STN-DBS.

  • 22.
    Lampa, Ewa
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Brechter, Anna
    Umeå universitet, Medicinsk fakultet, Odontologi.
    van Dijken, Jan
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandhygienistprogrammet.
    Effect of a Nonrinse Conditioner on the Durability of a Polyacid-modified Resin Composite Fissure Sealant2004Inngår i: Journal of Dentistry for Children, ISSN 0022-0353, Vol. 71, nr 2, 152-157 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to evaluate the effect of the simplified conditioning on durability of polyacid-modified resin composite (PMRC; Dyract Seal) fissure sealants. The effectiveness of a nonrinsing conditioner (NRC) on retention of PMRC sealants (92) was studied in a split-mouth design.

    Methods: The enamel of 1 molar was pretreated with NRC and coated with Prime & Bond NT (Dentsply DeTrey, Konstanz, Germany)/PMRC. The contralateral molar was conditioned with 36% phosphoric acid and sealed with Delton. The sealant retention was evaluated during 2 years. In addition 49 pairs were sealed with Prime & BondNT/PMRC after conditioning with 36% phosphoric acid and evaluated after 1 year.

    Results: Significantly higher loss rates at 1 and 2 years were observed for the NRC/Prime &

    Bond NT/PMRC sealants. At 2 years, partial and total loss rates for Delton were 23% and 11%, and for NRC/Prime & Bond NT/PRMC sealants were 44% and 40%, respectively. At

    1 year, phosphoric acid-conditioned Prime & Bond NT/PMRC sealants showed significantly better retention than the NRC-conditioned PMRC sealants and the phosphoric acid- conditioned Delton sealants.

    Conclusions: Conditioning with NRC prior to sealant application cannot be recommended.

  • 23.
    Liu, Jing-Xia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Thornell, Lars-Eric
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Pedrosa-Domellöf, Fatima
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Fiber content and myosin heavy chain composition of muscle spindles in aged human biceps brachii2005Inngår i: Journal of Histochemistry and Cytochemistry, ISSN 0022-1554, E-ISSN 1551-5044, Vol. 53, nr 4, 445-454 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present study investigated potential age-related changes in human muscle spindles with respect to the intrafusal fiber-type content and myosin heavy chain (MyHC) composition in biceps brachii muscle. The total number of intrafusal fibers per spindle decreased significantly with aging, due to a significant reduction in the number of nuclear chain fibers. Nuclear chain fibers in old spindles were short and some showed novel expression of MyHC alpha-cardiac. The expression of MyHC alpha-cardiac in bag1 and bag2 fibers was greatly decreased in the A region. The expression of slow MyHC was increased in nuclear bag1 fibers and that of fetal MyHC decreased in bag2 fibers whereas the patterns of distribution of the remaining MyHC isoforms were generally not affected by aging. We conclude that aging appears to have an important impact on muscle spindle composition. These changes in muscle spindle phenotype may reflect an age-related deterioration in sensory and motor innervation and are likely to have an impact in motor control in the elderly.

  • 24.
    Lundgren, Sofie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Saeys, Thomas
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Karlsson, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Olofsson, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
    Blomstedt, Patric
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Linder, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Nordh, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Doorn, Jan van
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Deep brain stimulation of caudal zona incerta and subthalamic nucleus in patients with Parkinson’s disease: effects on voice intensity2011Inngår i: Parkinson’s Disease, ISSN 2042-0080, Vol. 2011, 658956- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson’s disease (PD) affects speech in small, inconsistent ways. However, voice intensity generally increases. Recently the caudal zona inserta (cZi) has been investigated as an alternate target in DBS treatment of PD. The effects of cZi-DBS on voice intensity have not yet been investigated. The aim of this study was to compare the voice intensity effects of cZi-DBS and STN-DBS in PD patients. Voice intensity during reading and intensity decay during rapid syllable repetition were measured for eight STN-DBS and eight cZi-DBS patients in a pre-surgical baseline and then on- and off-stimulation 12 months after surgery. Voice intensity on-stimulation was larger than off-stimulation for the STN-DBS patients, but smaller for the cZi-DBS patients. There were no significant changes in intensity decay. The results suggest that cZi and STN are involved differently in neuromuscular control of the speech respiratory subsystem.

  • 25.
    Marklund, Susanna
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Temporomandibular disorders: incidence, course, and risk factors2009Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Temporomandibular disorders (TMD) embrace pain and dysfunction in the temporomandibular joint (TMJ) and jaw muscles. TMD is a prevalent condition in the population and constitutes a significant health problem. Knowledge of factors influencing the onset and course of TMD is important in preventive care and development of treatment strategies as well as in clinical decision making. The aim of this thesis was to gain knowledge of whether variations in dental occlusion, bruxism, spinal pain and gender predicted the development and course of TMD.

    The study population comprised 371 undergraduate dental students. A questionnaire was used to obtain case histories. Clinical examination included the function of the TMJ, jaw muscles, maximal jaw mobility, the morphological occlusion, and contact patterns in centric and eccentric positions. The examinations were performed at start, and after 12 and 24 months. In total, 280 subjects were examined at all three occasions.

    The incidence of TMJ pain and dysfunction was high among both males and females. The course composed onset, recovery and maintenance resulting in a fluctuating pattern. Females were more likely to have persistent TMJ pain and dysfunction than males. The incidence and persistence of jaw muscle signs and symptoms was high and significantly more common in females. A similar fluctuating pattern as for TMJ pain and dysfunction was found. Crossbite predicted onset and persistence of TMJ pain and dysfunction; mandibular instability in centric positions predicted persistent TMJ pain and dysfunction, as well as persistent jaw muscle signs or symptoms. Reported bruxism increased the risk for TMJ pain and dysfunction but did not significantly affect the course of jaw muscle signs and symptoms. Spinal pain at baseline predicted the onset of jaw pain, headaches, and TMD pain. Signs of TMD at baseline predicted the onset of non-pain symptoms of TMD, jaw pain, headaches, and spinal pain.

    In conclusion, the results in this thesis show high incidence rates for TMD, headaches, and spinal pain among dental students. Crossbite, mandibular instability, reported bruxism, as well as female gender were identified as contributing risk factors. Spinal pain and TMD mutually predicted each other, indicating common pathophysiological mechanisms and individual vulnerability. The findings support a multidisciplinary approach, and it is recommended that the status and function of the jaw system be considered in patients with spinal pain.

  • 26.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Bergman, Bo
    Hedlund, Sven-Olof
    Nilson, Hans
    An intraindividual clinical comparison of two metal-ceramic systems: a 5-year prospective study.2003Inngår i: International Journal of Prosthodontics, ISSN 0893-2174, Vol. 16, nr 1, 70-3 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]
    PURPOSE: Earlier studies on low-fusing ceramics have shown the occurrence of changes over time regarding surface and color. The present prospective study is an ongoing follow-up of an intraindividual comparison between two metal-ceramic systems, the Procera system (titanium copings veneered with a low-fusing ceramic) and noble-alloy copings veneered with a medium-fusing ceramic. MATERIALS AND METHODS: Twenty-one crown pairs were fabricated for 18 patients. After 5 years, 18 crown pairs in 15 patients were available for comparison. The crowns were examined shortly after cementation (baseline), and after 1, 2, and 5 years. The crowns were rated according to the CDA system. Bleeding index and margin index were also evaluated. RESULTS: Obvious changes regarding surface and color were noted for the titanium-ceramic crowns. The difference between the two types of crowns was statistically significant at 5 years (P = .004). The differences between the two systems regarding anatomic form, margin integrity, bleeding index, and margin index were small. CONCLUSION: Within the limitations of this study, it is concluded that low-fusing ceramic-veneered titanium copings are inferior to medium-fusing ceramic-veneered conventional copings regarding surface and color of the ceramic. Therefore, conventional ceramic-veneered crowns seem to be preferable, at least in the anterior area, where the esthetic requirements are greater than in premolar and molar regions. Whether possible changes in the properties of low-fusing ceramics will reduce the differences between the two types of metal-ceramic crowns remains to be proven.
  • 27.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Wiesinger, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Reciprocal influence on the incidence of symptoms in trigeminally and spinally innervated areas2010Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 14, nr 4, 366-371 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Temporomandibular disorders (TMD), headaches, and spinal pain show co-morbidity and may therefore influence each other. The hypothesis tested is that the presence of any of these conditions will increase the risk of onset of new symptoms within a 2-year period. The study population comprised 280 dental students, who were examined three times at 12-month intervals. The incidence was calculated for a 2-year period, based on subjects without the defined symptom at baseline. Each participant was classified into five different case-control groups, representing incidence cases or no incidence (controls) of: (1) nonpain TMD symptoms; (2) jaw pain; (3) headaches; (4) spinal pain; and (5) TMD pain. Presence of headaches and of spinal pain and signs and symptoms of TMD at baseline were used as independent variables in logistic regression analyses, controlling for age and sex. Incidence cases with TMD pain reported spinal pain at baseline significantly more often than the controls, and were mostly women. Incidence cases with headaches and incidence cases with jaw pain significantly more often had signs of TMD and reported spinal pain at baseline, compared to controls. Incidence cases with nonpain TMD symptoms or spinal pain significantly more often presented with signs of TMD at baseline. Our findings show that pain and dysfunction in trigeminally innervated areas and pain in spinally innervated areas mutually predict the onset of new symptoms in dental students, indicating common pathophysiological mechanisms and individual vulnerability. This may be of importance in risk assessment and treatment planning of individuals with musculoskeletal pain.

  • 28.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wänman, A
    A century of controversy regarding the benefit or detriment of occlusal contacts on the mediotrusive side.2000Inngår i: Journal of Oral Rehabilitation, ISSN 0305-182X, Vol. 27, nr 7, 553-562 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 29.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Incidence and prevalence of myofascial pain in the jaw-face region: a one-year prospective study on dental students2008Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 66, nr 2, 113-121 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The aims of this study were to examine the 1-year period prevalence, incidence, and course of myofascial pain in the jaw-face region, and to analyze whether female gender, dental occlusion, and oral parafunctions have any influence on these signs and symptoms. Material aad methods. The study population comprised 308 dental students examined at the start of their dentistry course and re-examined after 1 year. Case histories were collected using a questionnaire. The clinical examination included palpation sites of muscles, a submaximal clenching test, measurements of maximal mandibular mobility, and classification of morphological and functional dental occlusion. Results. The 1-year period prevalence of frequent myofascial symptoms was 19%. The incidence of myofascial pain, according to the Research Diagnostic Criteria for TemporoMandibular Disorders (RDC/TMD), was 4%. The female students presented an almost 4-fold incidence rate of myofascial symptoms compared to the male students. Non-symptomatic subjects were found among those without awareness of bruxism and with simultanious bilateral contact in the retruded contact position (RCP), and among those with a stable intercuspal position (ICP). Variations in morphological occlusion did not show any relation to myofascial symptoms, nor did contact patterns in eccentric positions. Conclusions. Female dental students were more prone to developing frequent myofascial pain and to perceiving local muscle soreness than were male students during a 1-year period. Both self-reported bruxism and registered mandibular instability in ICP showed association with the 1-year period prevalence of myofascial signs and symptoms in the jaw-face region.

  • 30.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Incidence and prevalence of temporomandibular joint pain and dysfunction: a one-year prospective study of university students2007Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 65, nr 2, 119-127 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The aims of this study were to investigate the incidence and recovery of temporomandibular joint (TMJ) pain and dysfunction during a 1-year period, and to examine factors associated with TMJ signs and symptoms.

    Material and Methods. The study population comprised 371 dental students examined at the start of education, out of which 308 were re-examined after 1 year. Case histories were collected with the aid of a questionnaire.

    The cinical examination involved TMJ mobility, TMJ pain, TMJ sounds, morhological and functional dental occlusion.

    Results. The 1-year incidence of TMJ signs and/or symptoms was 12%, with no statistically significant difference between men and women. Reported TMJ sounds (10%) and clinically registered TMJ pain (8%) reached the highest incidence rates. Approximately a quarter of those who had TMJ signs and/or symptoms at baseline had recovered at follow-up. Subjects with a non-symptomatic TMJ were significantly more often found among men and among those with bilateral contacts in centric relation, a normal transverse inter-maxillary relationship, and a stabile manadibular position in centric occlusion.

    Conclusion. The 1-year incidence of TMJ pain and/or dysfunction was high among 1st-year univerisity students. The persistence of signs and symptoms during the observation period was related to gender, while incidence and disappearance of symptoms were not. Dental occlusion was not rejected as a possible concurrent factor in relation to TMJ pain and/or dysfunction among university students.

  • 31.
    Marklund, Susanna
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Risk factors associated with incidence and persistence of temporomandibular disordersManuskript (Annet vitenskapelig)
    Abstract [en]

    Aims: The aim of this study was to analyze whether gender, reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorders (TMD) during a 2 year period.

    Methods: The study population comprised 280 dental students at Umeå University, Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment, and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at start. Cases with persistent TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses.

    Results: The analyses revealed that reported bruxism and crossbite, respectively, increased the risk of incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk to develop and maintain myofascial pain. Signs of mandibular instability increased the risk of long-standing signs and/or symptoms of TMD.

    Conclusion: This 2-year prospective observational study indicated that reported bruxism and variations in dental occlusion were linked to incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

  • 32. Omar, Mohammed Taher Ahmed
    et al.
    Shaheen, Afaf Ahmed Mohamed
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    A systematic review of the effect of low-level laser therapy in the management of breast cancer-related lymphedema2012Inngår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, nr 11, 2977-2984 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to review the effect of low-level laser therapy (LLLT) in the management of breast cancer-related lymphedema (BCRL). A systematic review of seven databases for clinical trials for LLLT in the management of BCRL published between 1990 and 2011 was performed. A total of eight studies on 230 patients were found. The methodological qualities of the selected studies were assessed with the Physiotherapy Evidence Database scale, and the studies were categorized according to Sackett's levels of evidence. Five studies were graded at evidence level II. Two studies were graded at evidence level III, and the remaining study was graded at evidence level V. There is moderate to strong evidence for the effectiveness of LLLT for the management of BCRL from five small studies of acceptable methodological quality. A dose of 1-2 J/cm(2) per point applied to several points covering the fibrotic area can reduce limb volume following BCRL. Further well-designed, large-scale studies are required to determine more precisely how effective LLLT may be in BCRL.

  • 33. Selander, John
    et al.
    Marnetoft, Sven-Uno
    Åsell, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Predictors for successful vocational rehabilitation for clients with back pain problems2007Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, nr 3, 215-220 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: The aim of this study was to identify predicting factors for successful vocational rehabilitation for people with back pain problems.

    METHOD: The study was based on data from 347 long-term sick-listed clients collected at the onset of vocational rehabilitation. The outcome was measured 6 months after the conclusion of rehabilitation.

    RESULTS: In a first bi-variate analysis, a considerable number of variables were associated with the rehabilitation outcome. In a second multivariate analysis, only four associations remained. These were age, general health, vitality and internal locus of control. Young vital clients in good general health, with a high internal locus of control were more likely than others to return to work.

    CONCLUSION: The findings regarding age, general health and vitality are well in line with previous studies. The findings regarding internal locus of control are more unique.

  • 34.
    Storm Mienna, Christina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    A two-year follow-up study of temporomandibular disorders in a female Sami population: validation of cases and controls as predicted by questionnaire2007Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, nr 6, 341-347 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The first aim of this study was to validate persistent, severe symptoms of temporomandibular disorders (TMD) among Sami females, as predicted by questionnaire. The second aim was to establish diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis 1 among predicted cases and controls. The third aim was to compare subjects with severe TMD to controls in regard to dental occlusion, general health, and parafunctions.

    MATERIAL AND METHODS: The subjects, Sami females living in the Arctic region of northern Sweden, all with long-standing (>or=1 year), intense (>or=5 on NS), and frequent (>or=once a week) symptoms of pain and dysfunction in the jaw-face region, were invited for clinical examination; 22 (63%) agreed to participate. Forty-six subjects with no symptoms in the jaw-face region were matched to these cases in accordance with five age groups. The examiner was blind to subject affiliation.

    RESULTS: The positive predictive value of presenting with signs and symptoms of TMD at follow-up was 0.82; the negative value was 0.87. Cases reported impaired general health and awareness of parafunctions significantly more frequently than did controls. Registered dental occlusion factors did not distinguish cases from controls.

    CONCLUSIONS: Long-standing, intense, and frequent TMD symptoms remained essentially unchanged over the 2-year follow-up of females in a Sami population. Presence of severe TMD was related to impaired general health and awareness of oral parafunctions.

  • 35.
    Storm Mienna, Christina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Self-reported impact on daily life activities related to temporomandibular disorders, headaches, and neck-shoulder pain among women in a Sami population living in Northern Sweden2012Inngår i: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 26, nr 3, 215-224 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To analyze the influence of frequency, intensity, and duration of temporomandibular disorders (TMD), headaches, and neck-shoulder pain (NSP) on Sami women's daily life. A further aim was to analyze the relationship between these symptoms and age.

    Methods: All 751 Sami women 21 to 70 years old registered in either the Swedish Sami Parliament's electoral register or registered as reindeer owners or herders and living north of the Arctic Circle in Sweden were sent a questionnaire regarding TMD symptoms, NSP, and headaches. In total, 487 women (65%) participated. The questionnaire focused on symptom frequency, duration, and intensity and whether these symptoms influenced activities of daily life. The symptom's interference with daily life activities was measured, respectively, with a numerical rating scale (NRS). The statistical analyses included multiple logistic regression analysis and Chi-square test. A P value < .05 was considered statistically significant.

    Results: Seventeen percent of the women reported that symptoms in the jaw-face region to some degree disturbed their daily life, and for 6%, the interference was significant (>= 5 on NRS). Duration of jaw pain, troublesome impaired jaw opening, and neck pain, together with a low education level, affected reports of whether symptoms of TMD influenced daily life. Almost half of the study population reported that headaches had a negative impact on their life. A similar pattern was reported for NSP. The prevalence of frequent and troublesome symptoms of TMD and headaches, but not NSP, showed a declining trend with age.

    Conclusion: TMD symptoms, headaches, and NSP negatively influence many Sami women's daily life. Factors related to pain had the greatest influence when these Sami women rated the related impairment.

  • 36.
    Storm Mienna, Christina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Temporomandiular disorders, headaches, and cervical pain among females in a Sami population2006Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, nr 5, 319-325 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. The aim of this study was to examine the prevalence and co-morbidity of long-standing, intense, and frequent symptoms of pain and dysfunction in the jaw-face, head, and cervical region among adult females drawn from the Sami population in northern Sweden.

    Methods. A total of 487 females, taken from the register of the Swedish Sami Parliament or registered as reindeer owners or reindeer herders in the Swedish Board of Agriculture and living in the Arctic region of northern Sweden, participated in a questionnaire study.

    Results. The prevalence of pain and/or dysfunction in the jaw-face region was 32%, of headaches 61%, and of pain in the cervical region 56%. When the criterion of frequent symptoms (once a week or more often) was used, prevalence dropped to 17%, 19%, and 30%, respectively, and when that of intense symptoms, defined as 5 or more on an 11-point numerical rating scale, was added, prevalence dropped further to 8%, 11%, and 20%, respectively. The majority reported long-standing symptoms (67-98% depending on symptom). A high statistically significant relationship was found between frequent symptoms of pain and/or dysfunction in the jaw-face, frequent headaches, and frequent cervical pain (p <0.0001).

    Conclusions. Symptoms in the jaw-face, headaches, and cervical pain were frequently reported among a sample of Sami females living in the Swedish Arctic region. The prevalence of symptoms was strongly dependent on criteria of frequency and intensity.

  • 37.
    Stål, Per
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Marklund, Susanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Thornell, Lars-Eric
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    De Paul, R
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Fibre composition of human intrinsic tongue muscles.2003Inngår i: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 173, nr 3, 147-161 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The muscle fibre composition of three human intrinsic tongue muscles, the longitudinalis, verticalis and transversus, was investigated in four anterior to posterior regions of the tongue using morphological and enzyme- and immunohistochemical techniques. All three muscles typically contained type I, IIA and IM/IIC fibres. Type I fibres expressed slow myosin heavy chain (MyHC), type II fibres fast MyHC, mainly fast A MyHC, whereas type IM/IIC coexpressed slow and fast MyHCs. Type II fibres were in the majority (60%), but regional differences in proportion and diameter of fibre types were obvious. The anterior region of the tongue contained a predominance of relatively small type II fibres (71%), in contrast to the posterior region which instead showed a majority of larger type I and type IM/IIC fibres (66%). In general, the fibre diameter was larger in the posterior region. This muscle fibre composition of the tongue differs from those of limb, orofacial and masticatory muscles, probably reflecting genotypic as well as phenotypic functional specialization in oral function. The predominance of type II fibres and the regional differences in fibre composition, together with intricate muscle structure, suggest generally fast and flexible actions in positioning and shaping the tongue, during vital tasks such as mastication, swallowing, respiration and speech. Copyright 2003 S. Karger AG, Basel

  • 38.
    Thornell, Lars-Eric
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Carlsson, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Liu, Jing-Xia
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Österlund, Catharina
    Stål, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Pedrosa-Domellöf, Fatima
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Fibre typing of intrafusal fibres2015Inngår i: Journal of Anatomy, ISSN 0021-8782, E-ISSN 1469-7580, Vol. 227, nr 2, 136-156 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The first descriptions of muscle spindles with intrafusal fibres containing striated myofibrils and nervous elements were given approximately 150years ago. It took, however, another 100years to establish the presence of two types of intrafusal muscle fibres: nuclear bag and nuclear chain fibres. The present paper highlights primarily the contribution of Robert Banks in fibre typing of intrafusal fibres: the confirmation of the principle of two types of nuclear bag fibres in mammalian spindles and the variation in occurrence of a dense M-band along the fibres. Furthermore, this paper summarizes how studies from the Umea University group (Laboratory of Muscle Biology in the Department of Integrative Medical Biology) on fibre typing and the structure and composition of M-bands have contributed to the current understanding of muscle spindle complexity in adult humans as well as to muscle spindle development and effects of ageing. The variable molecular composition of the intrafusal sarcomeres with respect to myosin heavy chains and M-band proteins gives new perspectives on the role of the intrafusal myofibrils as stretch-activated sensors influencing tension/stiffness and signalling to nuclei.

  • 39.
    Wiesinger, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    On the relationship between spinal pain and temporomandibular disorders2010Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Both spinal pain and temporomandibular disorders (TMD) commonly occur in the general population. Previous studies demonstrate neurophysiologic and biomechanical couplings between the trigeminal and cervical regions. This investigation tested the null hypothesis of no relationship between spinal pain (neck, shoulder and/or low back) and TMD, by using questionnaires and clinical examinations of the jaw function.

    In an age- and sex-matched case-control study, the specific aim was to compare the prevalence of signs and symptoms of TMD among cases with long-term spinal pain and controls without spinal pain. The results showed that subjects with spinal pain had signs and symptoms of TMD significantly more often than did controls. The associations remained after excluding all participants with jaw pain. Furthermore, the comorbidity pattern was similar, regardless of location of spinal pain.

    In a cross-sectional study, the specific aim was to test whether there is a reciprocal cross-sectional dose-response-like relationship between spinal pain and TMD. Two different designs were used, one with frequency/severity of spinal pain as independent variable, and the other, with frequency/severity of TMD symptoms as independent variable. The analysis showed increasing odds for presence of TMD symptoms with increasing frequency/severity of spinal pain, and increasing odds for presence of spinal pain with increasing frequency/severity of TMD symptoms.

    In a case-control study within a 2-year prospective cohort, the specific aim was to test whether there is a reciprocal temporal relationship between signs and symptoms in trigeminally, and symptoms in spinally, innervated areas. Incidence of symptoms in these areas was analyzed in relation to presence of spinal pain, headaches, and signs and symptoms of TMD at baseline. The main findings were that presence of signs of TMD at baseline increased the onset of spinal pain and symptoms in the trigeminal area, and that spinal pain increased the onset of symptoms in the trigeminal area. An augmentation effect between the significant baseline variables was observed for the incidence of headaches and jaw pain.

    In conclusion, the investigation demonstrated a cross-sectional and temporal relationship between spinal pain and TMD; thus, the null hypothesis was rejected. The results indicate common pathophysiological mechanisms in the development of spinal pain and TMD. The comorbidity and reciprocal influence that were found call for an integrated and multidimensional approach in the management of individuals with long-term spinal pain and TMD.

  • 40.
    Wiesinger, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Malker, Hans
    Englund, Erling
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Back pain in relation to musculoskeletal disorders in the jaw-face: a matched case-control study2007Inngår i: Pain, ISSN 0304-3959, Vol. 131, nr 3, 311-319 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Back pain and temporomandibular disorders are both common conditions in the population with influence on the human motor system, but a possible co-morbidity between these conditions has not been fully investigated. The aim of this study was to test the hypothesis of an association between long-term back pain and pain and/or dysfunction in the jaw-face region. Back pain was defined as pain in the neck, shoulders and/or low back. The study-population comprised 96 cases with long-term back pain and 192 controls without back pain. We used a screening procedure, a questionnaire and a clinical examination of the jaw function. The questionnaire focused on location, frequency, duration, intensity and impact on daily life of symptoms in the jaw-face and back regions. The analysis was conducted on 16 strata, matched by age and sex for case vs. control, using Mantel-Haenszel estimates of matched odds ratio (OR) and 95% confidence interval (CI) as well as the corrected Mantel-Haenszel chi(2) test. The overall prevalence of frequent symptoms in the jaw-face region, as reported in the questionnaire, was 47% among cases and 12% among controls. The difference was statistically significant (P<0.0001) with a sevenfold odds ratio (CI: 3.9-13.7). Moderate to severe signs from the jaw region were clinically registered among 49% of the cases and 17% of the controls (P<0.0001, OR: 5.2, CI: 2.9-9.2). The results showed statistically significant associations between long-term back pain and musculoskeletal disorders in the jaw-face and indicate co-morbidity between these two conditions.

  • 41.
    Wiesinger, Birgitta
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Malker, Hans
    Englund, Erling
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Does a dose-response relation exist between spinal pain and temporomandibular disorders?2009Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, Vol. 10, 28- s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The aim of this study was to test whether a reciprocal dose-response relation exists between frequency/severity of spinal pain and temporomandibular disorders (TMD). METHODS: A total of 616 subjects with varying severity of spinal pain or no spinal pain completed a questionnaire focusing on symptoms in the jaw, head and spinal region. A subset of the population (n = 266) were sampled regardless of presence or absence of spinal pain. We used two different designs, one with frequency/severity of spinal pain, and the other, with frequency/severity of TMD symptoms as independent variable. All 616 participants were allocated to four groups, one control group without spinal pain and three spinal pain groups. The subjects in the subset were allocated to one control group without TMD symptoms and three TMD groups. Odds ratios (ORs) were calculated for presence of frequent TMD symptoms in the separate spinal pain groups as well as for frequent spinal pain in the separate TMD groups. RESULTS: The analysis showed increasing ORs for TMD with increasing frequency/severity of spinal pain. We also found increasing ORs for spinal pain with increasing frequency/severity of TMD symptoms. CONCLUSION: This study shows a reciprocal dose-response-like relationship between spinal pain and TMD. The results indicate that these two conditions may share common risk factors or that they may influence each other. Studies on the temporal sequence between spinal pain and TMD are warranted.

  • 42.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Endurance to physical strain in patients with temporomandibular disorders: a case-control study2012Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, ISSN 1502-3850, Vol. 70, nr 6, 455-462 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract Objective. The hypothesis tested was whether patients with temporomandibular disorders (TMD) have an impaired endurance to motor tasks, under physical strain. Material and methods. The study population included 81 cases with TMD and 75 controls. After giving their informed consent, the participants filled out a questionnaire and performed five endurance trials. Each trial was measured in seconds from start to termination. The tests included: (a) holding the arm in a straight out position with a 2 kg weight in the hand, (b) lifting and lowering the arm with a 2 kg weight in the hand, (c) opening and closing the mandible repeatedly against a resistance of 1.6 kg during the jaw-opening phase, (d) protruding and retracting the mandible repeatedly against a resistance of 1.6 kg during the protruding phase and (e) unilateral chewing of three pieces of chewing gum. Analysis of differences between cases and controls for endurance were evaluated with Mann-Whitney U-test. A p-value < 0.05 was considered statistically significant. Results. The cases had statistically significantly (p < 0.0001) lower endurance time than controls for all tests. Conclusions. Patients with TMD compared to those without signs and symptoms of TMD have an impaired capacity to endure motor tasks that involve physical demand of the jaw muscles and shoulder girdle muscles.

  • 43.
    Wänman, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Temporomandibular disorders among smokers and nonsmokers: a longitudinal cohort study2005Inngår i: Journal of Orofacial Pain, ISSN 1064-6655, Vol. 19, nr 3, 209-217 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To evaluate whether smoking influences the presence and/or development of signs and symptoms of temporomandibular disorders(TMD) among adults.

    Methods: A random sample of subjects 35, 50 and 65 years of age was drawn from the general population and examined with the aid of a questionnaire and a clinical examination. Within the sample,. smokers were identified based on reported current smoking and nonsmokers were matched to the smokers based on age, gender, educational level, area of residence, and number of teeth. In total, 268 subjects were matched (134 pairs). Six years after the baseline examination, 122 matched pairs were re-examined.

    Results: Mild symptoms of TMD were reported by approximately 30% of the sample both at baseline and at the folllow-up examaination 6 years later. Pain in the jaws and/or more severe symptoms of TMD were reported by approximately 15% on both occasions. No significant differences between smokers and nonsmokers were found regarding symptoms of TMD. In both examinations, mild signs (dysfuntion index I) were found in approcimately 40% of the sample and moderate to severe signs (dysfunction index II to III) in approximately 20%; no statistically significant differences were found between smokers and nonsmokers. No significant differences were found between smokers and nonsmokers regarding the course of symptoms or signs of TMD during the study period.

    Conclusion: Smoking is not a factor related to the presence or development of signs and symptoms of TMD.

  • 44.
    Zafar, H
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Eriksson, P O
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, E
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Wireless optoelectronic recordings of mandibular and associated head-neck movements in man: a methodological study.2000Inngår i: Journal of Oral Rehabilitation, ISSN 0305-182X, Vol. 27, nr 3, 227-238 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 45.
    Zafar, Hamayun
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Nordh, Erik
    Umeå universitet, Medicinsk fakultet, Farmakologi och klinisk neurovetenskap, Klinisk neurofysiologi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinsk fakultet, Odontologi, Klinisk oral fysiologi.
    Impaired positioning of the gape in whiplash-associated disorders.2006Inngår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 30, nr 1, 9-15 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We have previously introduced a new concept for natural jaw function suggesting that "functional jaw movements" are the result of coordinated jaw and neck muscle activation, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. Thus, jaw function requires a healthy state of both the jaw and the neck motor systems. The aim of this study was to examine the positioning of the gape in space during maximal jaw opening at fast and slow speed in healthy as well as whiplash-associated disorders (WAD) individuals. A wireless optoelectronic technique for three-dimensional movement recording was used. Subjects were seated in an upright position, with back support up to the mid-scapular level without headrest. The position of the gape in space was defined as the vertical midpoint position of the gape at maximal jaw opening (MP). In healthy, the MP generally coincided with the reference position at the start of jaw opening. In the WAD group, the MP was significantly lower than the reference position. No sex or speed related differences were found. The results suggest that both the width and orientation of the gape in space relies on coordinated jaw and neck muscle activation and mandibular and head-neck movements. This study also suggests an association between neck pain and dysfunction following trauma, and reduced width and impaired positioning of the gape in space. Finally, the MP seems to be a useful marker in evaluation of the functional state of the jaw-neck motor system

  • 46.
    Zafar, Hamayun
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi. King Saud University, Saudi Arabia .
    Oluseye, Kamaldeen
    King Saud University, Saudi Arabia.
    Alghadir, Ahmad
    King Saud University, Saudi Arabia.
    Iqbal, Zaheen A.
    King Saud University, Saudi Arabia.
    Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia2015Inngår i: Journal of Physical Therapy Science, ISSN 0915-5287, Vol. 27, nr 6, 1827-1831 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    [Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy.

  • 47.
    Åsell, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Sjölander, Per
    Kerschbaumer, Helmut
    Djupsjöbacka, Mats
    Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects?2006Inngår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 87, nr 9, 1170-6 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN: A single-blinded, controlled, multigroup comparative study. SETTING: Vocational rehabilitation center. PARTICIPANTS: Ninety-two patients with CLBP, divided into subgroups based on severity of symptoms and diagnostic characteristics. An age- and sex-matched group (n=31) of healthy subjects were the control. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We measured repositioning errors (variable, constant) at 3 positions of the lumbar spine. Subjects were guided to a sitting target posture and asked to perform lumbar flexion before reproducing the target posture. Self-assessed pain, self-efficacy, and functional ability were addressed through questionnaires. RESULTS: There were no differences in repositioning errors between the patients with CLBP or the subgroups of patients and the control group. We found only weak correlations between the repositioning errors and the self-reported data on functional disability, self-efficacy, and pain. CONCLUSIONS: We suggest that sensorimotor dysfunctions in CLBP should be evaluated with methods other than repositioning tests in order to generate data relevant to the development of rational diagnostic methods and rehabilitation programs.

  • 48.
    Österlund, Catharina
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Extra- and intrafusal muscle fibre type compositions of the human masseter at young age.: In perspective of growth and functional maturation of the jaw-face motor system.2011Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Muscles control body posture and movement by extrafusal and intrafusal (muscle spindle) fibres. The purpose of this thesis was to provide insight into the muscular basis for human jaw function at young age. Extrafusal and intrafusal fibres in the young masseter, and for comparison young biceps, were examined for composition of fibre types and myosin heavy chain (MyHC) isoforms by means of morphological, enzyme-histochemical, biochemical and immuno-histochemical techniques. For evaluation of plasticity during life span the data for young muscles were compared with previous reported data for adult and elderly muscles.

    The results showed significant differences in extrafusal fibre types and MyHC expression between young masseter and young biceps and between young masseter and masseter in adults and elderly. Compared with young biceps, young masseter was more intricate in composition of extrafusal MyHC expression. Muscle spindles were larger and more frequent in the masseter than in the biceps. Masseter and biceps muscle spindles showed fundamental similarities but also marked differences in MyHC expression.

    The results suggest that the young masseter is specialized in fibre types already at young age and shows a unique fibre type growth pattern. Whereas masseter extrafusal fibres display marked plasticity in fibre types and MyHC isoforms during life span muscle spindles/intrafusal fibres are morphologically mature already at young age and precede extrafusal fibres in growth and maturation. Results showed similarities in intrafusal MyHC expression between young masseter and biceps, but also differences implying muscle specific proprioceptive control. Differences in fibre types and MyHC expression between young masseter and young biceps extrafusal fibres are proposed to reflect diverse evolutionary and developmental origins and accord with the masseter and biceps being separate allotypes of muscle.

  • 49.
    Österlund, Catharina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Lindström, Mona
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Thornell, Lars-Eric
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Remarkable heterogeneity in myosin heavy-chain composition of the human young masseter compared with young biceps brachii2012Inngår i: Histochemistry and Cell Biology, ISSN 0948-6143, E-ISSN 1432-119X, Vol. 138, nr 4, 669-682 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Adult human jaw muscles differ from limb and trunk muscles in enzyme-histochemical fibre type composition. Recently, we showed that the human masseter and biceps differ in fibre type pattern already at childhood. The present study explored the myosin heavy-chain (MyHC) expression in the young masseter and biceps muscles by means of gel electrophoresis (GE) and immuno-histochemical (IHC) techniques. Plasticity in MyHC expression during life was evaluated by comparing the results with the previously reported data for adult muscles. In young masseter, GE identified MyHC-I, MyHC-IIa MyHC-IIx and small proportions of MyHC-fetal and MyHC-alpha cardiac. Western blots confirmed the presence of MyHC-I, MyHC-IIa and MyHC-IIx. IHC revealed in the masseter six isomyosins, MyHC-I, MyHC-IIa, MyHC-IIx, MyHC-fetal, MyHC alpha-cardiac and a previously not reported isoform, termed MyHC-IIx'. The majority of the masseter fibres co-expressed two to four isoforms. In the young biceps, both GE and IHC identified MyHC-I, MyHC-IIa and MyHC-IIx. MyHC-I predominated in both muscles. Young masseter showed more slow and less-fast and fetal MyHC than the adult and elderly masseter. These results provide evidence that the young masseter muscle is unique in MyHC composition, expressing MyHC-alpha cardiac and MyHC-fetal isoforms as well as hitherto unrecognized potential spliced isoforms of MyHC-fetal and MyHC-IIx. Differences in masseter MyHC expression between young adult and elderly suggest a shift from childhood to adulthood towards more fast contractile properties. Differences between masseter and biceps are proposed to reflect diverse evolutionary and developmental origins and confirm that the masseter and biceps present separate allotypes of muscle.

  • 50.
    Österlund, Catharina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Liu, Jing-Xia
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Thornell, Lars-Eric
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Eriksson, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Intrafusal myosin heavy chain expression of human masseter and biceps muscles at young age shows fundamental similarities but also marked differences2013Inngår i: Histochemistry and Cell Biology, ISSN 0948-6143, E-ISSN 1432-119X, Vol. 139, nr 6, 895-907 s.Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Muscle spindles are skeletal muscle mechanoreceptors that provide proprioceptive information to the central nervous system. The human adult masseter muscle has greater number, larger and more complex muscle spindles than the adult biceps. For a better knowledge of muscle diversity and physiological properties, this study examined the myosin heavy chain (MyHC) expression of muscle spindle intrafusal fibres in the human young masseter and young biceps muscles by using a panel of monoclonal antibodies (mAbs) against different MyHC isoforms. Eight MyHC isoforms were detected in both muscles-slow-tonic, I, IIa, IIx, foetal, embryonic, α-cardiac and an isoform not previously reported in intrafusal fibres, termed IIx'. Individual fibres co-expressed 2-6 isoforms. MyHC-slow tonic separated bag(1), AS-bag(1) and bag(2) fibres from chain fibres. Typically, bag fibres also expressed MyHC-I and α-cardiac, whereas chain fibres expressed IIa and foetal. In the young masseter 98 % of bag(1) showed MyHC-α cardiac versus 30 % in the young biceps, 35 % of bag(2) showed MyHC-IIx' versus none in biceps, 17 % of the chain fibres showed MyHC-I versus 61 % in the biceps. In conclusion, the result showed fundamental similarities in intrafusal MyHC expression between young masseter and biceps, but also marked differences implying muscle-specific proprioceptive control, probably related to diverse evolutionary and developmental origins. Finding of similarities in MyHC expression between young and adult masseter and biceps muscle spindles, respectively, in accordance with previously reported similarities in mATPase fibre type composition suggest early maturation of muscle spindles, preceding extrafusal fibres in growth and maturation.

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