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  • 1.
    Divaris, K.
    et al.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, NC, Chapel Hill, United States; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, Chapel Hill, United States.
    Haworth, S.
    Medical Research Council Integrative Epidemiology United, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Bristol Dental School, University of Bristol, Bristol, United Kingdom.
    Shaffer, J.R.
    Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, PA, Pittsburgh, United States; Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, PA, Pittsburgh, United States.
    Anttonen, V.
    Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
    Beck, J.D.
    Division of Comprehensive Oral Health–Periodontology, Adams School of Dentistry, University of North Carolina at Chapel Hill, NC, Chapel Hill, United States.
    Furuichi, Y.
    Division of Endodontology and Periodontology, Department of Oral Rehabilitation, Graduate School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan.
    Holtfreter, B.
    Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.
    Jönsson, D.
    Public Dental Service of Skåne, Lund, Sweden; Hypertension and Cardiovascular Disease, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden.
    Kocher, T.
    Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.
    Levy, S.M.
    Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, IA, Iowa City, United States.
    Magnusson, P.K.E.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    McNeil, D.W.
    Center for Oral Health Research in Appalachia, NY, Appalachia, United States; Department of Psychology, West Virginia University, WV, Morgantown, United States; Department of Dental Public Health & Professional Practice, West Virginia University, WV, Morgantown, United States.
    Michaëlsson, K.
    Department of Surgical Sciences, Unit of Medical Epidemiology, Uppsala University, Uppsala, Sweden.
    North, K.E.
    Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, Chapel Hill, United States; Carolina Population Center, University of North Carolina at Chapel Hill, NC, Chapel Hill, United States.
    Palotie, U.
    Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
    Papapanou, P.N.
    Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, NY, New York, United States.
    Pussinen, P.J.
    Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Institute of Dentistry, School on Medicine, University of Eastern Finland, Kuopio, Finland.
    Porteous, D.
    Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom.
    Reis, K.
    Institute of Genomics, University of Tartu, Tartu, Estonia.
    Salminen, A.
    Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
    Schaefer, A.S.
    Department of Periodontology, Oral Medicine and Oral Surgery, Institute for Dental and Craniofacial Sciences, Charité–Universitätsmedizin Berlin, Berlin, Germany.
    Sudo, T.
    Institute of Education, Tokyo Medical and Dental University, Tokyo, Japan.
    Sun, Y.Q.
    Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
    Suominen, A.L.
    Institute of Dentistry, School on Medicine, University of Eastern Finland, Kuopio, Finland; Institute of Dentistry, School on Medicine, University of Eastern Finland, Kuopio, Finland; Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland; Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
    Tamahara, T.
    Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
    Weinberg, S.M.
    Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, PA, Pittsburgh, United States; Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, PA, Pittsburgh, United States.
    Lundberg, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Marazita, M.L.
    Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, PA, Pittsburgh, United States; Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, PA, Pittsburgh, United States.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Phenotype Harmonization in the GLIDE2 Oral Health Genomics Consortium2022Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 101, nr 11, s. 1408-1416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Genetic risk factors play important roles in the etiology of oral, dental, and craniofacial diseases. Identifying the relevant risk loci and understanding their molecular biology could highlight new prevention and management avenues. Our current understanding of oral health genomics suggests that dental caries and periodontitis are polygenic diseases, and very large sample sizes and informative phenotypic measures are required to discover signals and adequately map associations across the human genome. In this article, we introduce the second wave of the Gene-Lifestyle Interactions and Dental Endpoints consortium (GLIDE2) and discuss relevant data analytics challenges, opportunities, and applications. In this phase, the consortium comprises a diverse, multiethnic sample of over 700,000 participants from 21 studies contributing clinical data on dental caries experience and periodontitis. We outline the methodological challenges of combining data from heterogeneous populations, as well as the data reduction problem in resolving detailed clinical examination records into tractable phenotypes, and describe a strategy that addresses this. Specifically, we propose a 3-tiered phenotyping approach aimed at leveraging both the large sample size in the consortium and the detailed clinical information available in some studies, wherein binary, severity-encompassing, and “precision,” data-driven clinical traits are employed. As an illustration of the use of data-driven traits across multiple cohorts, we present an application of dental caries experience data harmonization in 8 participating studies (N = 55,143) using previously developed permanent dentition tooth surface–level dental caries pattern traits. We demonstrate that these clinical patterns are transferable across multiple cohorts, have similar relative contributions within each study, and thus are prime targets for genetic interrogation in the expanded and diverse multiethnic sample of GLIDE2. We anticipate that results from GLIDE2 will decisively advance the knowledge base of mechanisms at play in oral, dental, and craniofacial health and disease and further catalyze international collaboration and data and resource sharing in genomics research.

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  • 2.
    Eriksson, Linda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lif Holgerson, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Esberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Microbial complexes and caries in 17-year-olds with and without Streptococcus mutans2018Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 97, nr 3, s. 275-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 3.
    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.2000Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 79, nr 6, s. 1378-1384Artikel i tidskrift (Refereegranskat)
    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.

  • 4.
    Fries, Niklas
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Haworth, S.
    University of Bristol, Bristol, United Kingdom.
    Shaffer, J.R.
    University of Pittsburgh, PA, Pittsburgh, United States.
    Esberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Divaris, K.
    University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
    Marazita, M.L.
    University of Pittsburgh, PA, Pittsburgh, United States.
    Johansson, I.
    Umeå universitet.
    A polygenic score predicts caries experience in elderly Swedish adults2024Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 103, nr 5, s. 502-508Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Caries is a partially heritable disease, raising the possibility that a polygenic score (PS, a summary of an individual’s genetic propensity for disease) might be a useful tool for risk assessment. To date, PS for some diseases have shown clinical utility, although no PS for caries has been evaluated. The objective of the study was to test whether a PS for caries is associated with disease experience or increment in a cohort of Swedish adults. A genome-wide PS for caries was trained using the results of a published genome-wide association meta-analysis and constructed in an independent cohort of 15,460 Swedish adults. Electronic dental records from the Swedish Quality Registry for Caries and Periodontitis (SKaPa) were used to compute the decayed, missing, and filled tooth surfaces (DMFS) index and the number of remaining teeth. The performance of the PS was evaluated by testing the association between the PS and DMFS at a single dental examination, as well as between the PS and the rate of change in DMFS. Participants in the highest and lowest deciles of PS had a mean DMFS of 63.5 and 46.3, respectively. A regression analysis confirmed this association where a 1 standard deviation increase in PS was associated with approximately 4-unit higher DMFS (P < 2 × 10−16). Participants with the highest decile of PS also had greater change in DMFS during follow-up. Results were robust to sensitivity analysis, which adjusted for age, age squared, sex, and the first 20 genetic principal components. Mediation analysis suggested that tooth loss was a strong mediating factor in the association between PS and DMFS but also supported a direct genetic effect on caries. In this cohort, there are clinically meaningful differences in DMFS between participants with high and low PS for caries. The results highlight the potential role of genomic data in improving caries risk assessment.

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  • 5.
    Gustafsson, Nils
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ahlqvist, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Buhlin, K.
    Gustafsson, A.
    Kjellström, B.
    Klinge, B.
    Rydén, L.
    Levring Jäghagen, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Associations among Periodontitis, Calcified Carotid Artery Atheromas, and Risk of Myocardial Infarction2020Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 99, nr 1, s. 60-68Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cardiovascular disease is a common cause of morbidity and premature mortality. Cardiovascular disease can be prevented when risk factors are identified early. Calcified carotid artery atheromas (CCAAs), detected in panoramic radiographs, and periodontitis have both been associated with increased risk of cardiovascular disease. This case-control study aimed to 1) investigate associations between periodontitis and CCAA detected in panoramic radiographs and 2) determine the risk of future myocardial infarctions due to CCAA combined with periodontitis. We evaluated 1,482 participants (738 cases and 744 controls) with periodontitis and CCAAs recruited from the PAROKRANK study (Periodontitis and Its Relation to Coronary Artery Disease). Participants were examined with panoramic radiographs, including the carotid regions. Associations between myocardial infarction and periodontitis combined with CCAA were evaluated in 696 cases and 696 age-, sex-, and residential area-matched controls. Periodontitis was evaluated radiographically (as degree of bone loss) and with a clinical periodontal disease index score (from clinical and radiographic assessments). We found associations between CCAA and clinical periodontal disease index score among cases (odds ratio [OR], 1.51; 95% CI, 1.09 to 2.10; P = 0.02) and controls (OR, 1.70; 95% CI, 1.22 to 2.38; P < 0.01), although not between CCAA and the degree of bone loss. In a multivariable model, myocardial infarction was associated with CCAA combined with periodontitis, as assessed by degree of bone loss (OR, 1.75; 95% CI, 1.11 to 2.74; P = 0.01). When the cohort was stratified by sex, only men showed a significant association between myocardial infarction and CCAA combined with periodontitis. Participants with clinically diagnosed periodontitis exhibited CCAA in panoramic radiographs more often than those without periodontitis, irrespective of the presence of a recent myocardial infarction. Participants with combined periodontitis and CCAA had a higher risk of having had myocardial infarction as compared with participants with either condition alone. These findings implied that patients in dental care might benefit from dentists assessing panoramic radiographs for CCAA-particularly, patients with periodontitis who have not received any preventive measures for cardiovascular disease.

  • 6. Hasegawa, Y.
    et al.
    Iijima, Y.
    Persson, Karina
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Nagano, K.
    Yoshida, Y.
    Lamont, RJ.
    Kikuchi, T.
    Mitani, A.
    Yoshimura, F.
    Role of Mfa5 in Expression of Mfa1 Fimbriae in Porphyromonas gingivalis2016Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, nr 11, s. 1291-1297Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fimbriae are protein-based filamentous appendages that protrude from the bacterial cell surface and facilitate host adhesion. Two types of fimbriae, FimA and Mfa1, of the periodontal pathogen Porphyromonas gingivalis are responsible for adherence to other bacteria and to host cells in the oral cavity. Both fimbrial forms are composed of 5 proteins, but there is limited information about their polymerization mechanisms. Here, the authors evaluated the function of Mfa5, one of the Mfa1 fimbrial accessory proteins. Using mfa5 gene disruption and complementation studies, the authors revealed that Mfa5 affects the incorporation of other accessory proteins, Mfa3 and Mfa4, into fibers and the expression of fimbriae on the cell surface. Mfa5 is predicted to have a C-terminal domain (CTD) that uses the type IX secretion system (T9SS), which is limited to this organism and related Bacteroidetes species, for translocation across the outer membrane. To determine the relationship between the putative Mfa5 CTD and the T9SS, mutants were constructed with in-frame deletion of the CTD and deletion of porU, a C-terminal signal peptidase linked to T9SS-mediated secretion. The ∆CTD-expressing strain presented a similar phenotype to the mfa5 disruption mutant with reduced expression of fimbriae lacking all accessory proteins. The ∆porU mutants and the ∆CTD-expressing strain showed intracellular accumulation of Mfa5. These results indicate that Mfa5 function requires T9SS-mediated translocation across the outer membrane, which is dependent on the CTD, and subsequent incorporation into fibers. These findings suggest the presence of a novel polymerization mechanism of the P. gingivalis fimbriae.

  • 7. Haworth, S.
    et al.
    Esberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lif Holgerson, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Kuja-Halkola, R.
    Timpson, N. J.
    Magnusson, P. K. E.
    Franks, P. W.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Heritability of Caries Scores, Trajectories, and Disease Subtypes2020Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 99, nr 3, s. 264-270Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Previous studies report that dental caries is partially heritable, but there is uncertainty in the magnitude of genetic effects and little understanding of how genetic factors might influence caries progression or caries subtypes. This study aimed to estimate the relative importance of genetic and environmental factors in the etiology of different caries outcomes using a twin-based design. Analysis included up to 41,678 twins in the Swedish Twin Register aged 7 to 97 y, and dental data were obtained from preexisting dental records. The outcome measures were 1) summary indices of caries experience, 2) parameters representing trajectory in caries progression derived from longitudinal modeling, and 3) caries scores in groups of biologically similar tooth surfaces derived from hierarchical clustering of tooth surfaces (termed caries clusters). Additive genetic factors explained between 49.1% and 62.7% of variation in caries scores and between 50.0% and 60.5% of variation in caries trajectories. Seven caries clusters were identified, which had estimates of heritability lying between 41.9% and 54.3%. Shared environmental factors were important for only some of these clusters and explained 16% of variation in fissure caries in molar teeth but little variation in other clusters of caries presentation. The genetic factors influencing these clusters were only partially overlapping, suggesting that different biological processes are important in different groups of tooth surfaces and that innate liability to some patterns of caries presentation may partially explain why groups of tooth surfaces form clusters within the mouth. These results provide 1) improved quantification of genetic factors in the etiology of caries and 2) new data about the role of genetics in terms of longitudinal changes in caries status and specific patterns of disease presentation, and they may help lay the foundations for personalized interventions in the future.

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  • 8.
    Heimisdottir, L.H.
    et al.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Lin, B.M.
    Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, NC, Chapel Hill, United States.
    Cho, H.
    Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, NC, Chapel Hill, United States.
    Orlenko, A.
    Department of Biostatistics, Epidemiology and Informatics, Institute for Biomedical Informatics, University of Pennsylvania, PA, Philadelphia, United States.
    Ribeiro, A.A.
    Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Simon-Soro, A.
    Biofilm Research Labs, Center for Innovation and Precision Dentistry, School of Dental Medicine and School of Engineering and Applied Sciences, University of Pennsylvania, PA, Philadelphia, United States; Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, PA, Philadelphia, United States; Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain.
    Roach, J.
    Research Computing, University of North Carolina, NC, Chapel Hill, United States.
    Shungin, Dmitry
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, MA, Cambridge, United States.
    Ginnis, J.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Simancas-Pallares, M.A.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Spangler, H.D.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Zandoná, A.G. Ferreira
    Department of Comprehensive Care, School of Dental Medicine, Tufts University, MA, Boston, United States.
    Wright, J.T.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Ramamoorthy, P.
    Metabolon, Inc, NC, Durham, United States.
    Moore, J.H.
    Department of Biostatistics, Epidemiology and Informatics, Institute for Biomedical Informatics, University of Pennsylvania, PA, Philadelphia, United States.
    Koo, H.
    Biofilm Research Labs, Center for Innovation and Precision Dentistry, School of Dental Medicine and School of Engineering and Applied Sciences, University of Pennsylvania, PA, Philadelphia, United States; Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health, School of Dental Medicine, University of Pennsylvania, PA, Philadelphia, United States.
    Wu, D.
    Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, NC, Chapel Hill, United States; Division of Oral Craniofacial Health Sciences, School of Dentistry, University of North Carolina, NC, Chapel Hill, United States.
    Divaris, K.
    Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, NC, Chapel Hill, United States; Department of Epidemiology, Gillings School of Public Health, University of North Carolina, NC, Chapel Hill, United States.
    Metabolomics Insights in Early Childhood Caries2021Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 100, nr 6, s. 615-622Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dental caries is characterized by a dysbiotic shift at the biofilm–tooth surface interface, yet comprehensive biochemical characterizations of the biofilm are scant. We used metabolomics to identify biochemical features of the supragingival biofilm associated with early childhood caries (ECC) prevalence and severity. The study’s analytical sample comprised 289 children ages 3 to 5 (51% with ECC) who attended public preschools in North Carolina and were enrolled in a community-based cross-sectional study of early childhood oral health. Clinical examinations were conducted by calibrated examiners in community locations using International Caries Detection and Classification System (ICDAS) criteria. Supragingival plaque collected from the facial/buccal surfaces of all primary teeth in the upper-left quadrant was analyzed using ultra-performance liquid chromatography–tandem mass spectrometry. Associations between individual metabolites and 18 clinical traits (based on different ECC definitions and sets of tooth surfaces) were quantified using Brownian distance correlations (dCor) and linear regression modeling of log2-transformed values, applying a false discovery rate multiple testing correction. A tree-based pipeline optimization tool (TPOT)–machine learning process was used to identify the best-fitting ECC classification metabolite model. There were 503 named metabolites identified, including microbial, host, and exogenous biochemicals. Most significant ECC-metabolite associations were positive (i.e., upregulations/enrichments). The localized ECC case definition (ICDAS ≥1 caries experience within the surfaces from which plaque was collected) had the strongest correlation with the metabolome (dCor P = 8 × 10−3). Sixteen metabolites were significantly associated with ECC after multiple testing correction, including fucose (P = 3.0 × 10−6) and N-acetylneuraminate (p = 6.8 × 10−6) with higher ECC prevalence, as well as catechin (P = 4.7 × 10−6) and epicatechin (P = 2.9 × 10−6) with lower. Catechin, epicatechin, imidazole propionate, fucose, 9,10-DiHOME, and N-acetylneuraminate were among the top 15 metabolites in terms of ECC classification importance in the automated TPOT model. These supragingival biofilm metabolite findings provide novel insights in ECC biology and can serve as the basis for the development of measures of disease activity or risk assessment.

  • 9.
    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 bolus2004Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 83, nr 11, s. 864-868Artikel i tidskrift (Refereegranskat)
    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.

  • 10.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Lampa, Ewa
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Marklund, Susanna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wänman, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Pain and Disability in the Jaw and Neck Region following Whiplash Trauma2016Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, nr 10, s. 1155-1160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain.

  • 11.
    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 Function2006Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, nr 11, s. 1001-1005Artikel i tidskrift (Refereegranskat)
    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.

  • 12.
    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.2002Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 81, nr 11, s. 747-751Artikel i tidskrift (Refereegranskat)
    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.

  • 13.
    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 TMD2004Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 83, nr 12, s. 946-950Artikel i tidskrift (Refereegranskat)
    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.

  • 14.
    Ilgunas, Aurelia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Häggman-Henrikson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Visscher, C.M.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Lobbezoo, F.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Durham, J.
    School of Dental Sciences, Newcastle University, Newcastle, UK;Newcastle Hospitals’ NHS Foundation Trust, Newcastle, UK.
    Liv, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lövgren, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    The longitudinal relationship between jaw catching/locking and pain2023Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 102, nr 4, s. 383-390Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Orofacial pain and joint-related dysfunction can negatively affect daily jaw function. A common cause for limitations in jaw movements is joint-related dysfunction such as various forms of catching and locking. However, knowledge is limited regarding the development and natural course of joint-related jaw dysfunction and its relationship to the onset and course of orofacial pain. Therefore, the aim was to evaluate the incidence, prevalence, and gender differences in jaw catching/locking over time and in relation to orofacial pain in the general population. Data from 3 validated screening questions on orofacial pain and jaw catching/locking were collected from all routine dental checkups in the Public Dental Health Services in Västerbotten, Sweden, from 2010 to 2017. Logistic generalized estimating equation was used to account for repeated observations and Poisson regression for incidence analysis. In total, 180,308 individuals (aged 5–104 y) were screened in 525,707 dental checkups. In 2010, based on 37,647 individuals, the prevalence of self-reported catching/locking was higher in women than in men (3.2% vs. 1.5%; odds ratio, 2.11; 95% confidence interval [CI], 1.83–2.43), and this relationship and magnitude remained similar throughout the study period. The annual incidence rate was 1.1% in women and 0.5% in men. Women were at a higher risk than men for reporting both first onset (incidence rate ratio [IRR], 2.29; 95% CI, 2.11–2.49) and persistent (IRR, 2.31; 95% CI, 2.04–2.63) catching/locking. For the onset subcohort (n = 135,801), an independent onset of orofacial pain or jaw catching/locking exclusively was reported by 84.1%, whereas a concurrent onset was reported by 13.4%. Our findings of higher incidence, prevalence, and persistence in women than in men indicate that the gender differences seen for orofacial pain are evident also for jaw catching/locking. The findings also suggest independent onset of self-reported catching/locking and orofacial pain, which reinforces the pathophysiological differences between these conditions.

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  • 15.
    Johansson, Ingegerd
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Lenander-Lumikari, M
    Saellström, AK
    Saliva composition in Indian children with chronic protein-energy malnutrition1994Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 73, nr 1, s. 11-19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The composition of paraffin-stimulated and unstimulated whole saliva was compared between two groups of 8-12-year-old Indian children-one group with severe to moderate chronic protein-energy malnutrition (PEM group) and an age- and sex-matched control group with normal protein status or mild PEM. The classification of PEM was based on anthropometric measurements compared with Indian standards. Stimulated saliva was analyzed for the following variables: electrolytes (Na+, K+, Ca2+, Cl-, and PO4(3-)), total protein, hexosamines, fucose, sialic acid, and amylase. Unstimulated saliva samples were analyzed for total protein, salivary and myeloperoxidase, thiocyanate, lactoferrin, lysozyme, a bacteria-agglutinating protein (BAGP), total IgG, total IgA, and specific anti-S. mutans IgA. The results show that the PEM group had a reduced secretion rate of stimulated but not unstimulated saliva. Further, the Ca2+ and Cl- concentrations in stimulated saliva were significantly lower in the PEM group compared with the control group, but the other electrolyte levels were similar. No differences were found in total protein concentration or glycoprotein bound carbohydrates in stimulated saliva between the two groups, but the quantity of total protein secreted per min was reduced by 20% in the PEM group. Significantly lower levels of lactoferrin, BAGP, and anti-S mutans IgA were found in unstimulated saliva from children in the PEM group, but significantly higher levels of total IgG. We conclude that children with severe or moderate PEM, who have reduced secretion rate, buffer capacity, lower Ca2+, and protein secretion in stimulated saliva, also have impaired immunological and agglutinating defense factors in unstimulated saliva.

  • 16.
    Johansson, Ingegerd
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Witkowska, Emilia
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Kaveh, Babak
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Lif Holgerson, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Tanner, A. C. R.
    The Microbiome in Populations with a Low and High Prevalence of Caries2016Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, nr 1, s. 80-86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The oral microbiota was compared between Romanian adolescents with a high prevalence of caries and no dental care and Swedish caries-active and caries-free adolescents in caries prevention programs and with a low prevalence of caries. Biofilm samples were analyzed by FLX+ pyrosequencing of the V1 to V4 hypervariable regions of the 16S rRNA gene and polymerase chain reaction (PCR)/quantitative PCR (qPCR) for Streptococcus mutans and Streptococcus sobrinus. Sequences obtained blasted to 9 phyla, 66 genera, and 401 human oral taxa (HOT) in the 16S rRNA Human Oral Microbiome Database, of which 295 were represented by >= 20 sequences. The Romanian adolescents had more sequences in Firmicutes and fewer in Actinobacteria phyla and more sequences in the genera Bacteroidetes [G-3], Porphyromonas, Abiotrophia, Filifactor, Peptostreptococcaceae [11][G-4], Pseudoramibacter, Streptococcus, and Neisseria and fewer in Actinomyces, Selenomonas, Veillonella, Campylobacter, and TM7 [G-1] than the Swedish groups. Multivariate modeling employing HOT, S. sobrinus and S. mutans (PCR/qPCR), and sugar snacks separated Romanian from Swedish adolescents. The Romanian adolescents' microbiota was characterized by a panel of streptococci, including S. mutans, S. sobrinus, and Streptococcus australis, and Alloprevotella, Leptotrichia, Neisseria, Porphyromonas, and Prevotella. The Swedish adolescents were characterized by sweet snacks, and those with caries activity were also characterized by Prevotella, Actinomyces, and Capnocytophaga species and those free of caries by Actinomyces, Prevotella, Selenomonas, Streptococcus, and Mycoplasma. Eight species including Streptococcus mitis and Streptococcus species HOT070 were prevalent in Romanian and Swedish caries-active subjects but not caries-free subjects. In conclusion, S. mutans and S. sobrinus correlated with Romanian adolescents with caries and with limited access to dental care, whereas S. mutans and S. sobrinus were detected infrequently in Swedish adolescents in dental care programs. Swedish caries-active adolescents were typically colonized by Actinomyces, Selenomonas, Prevotella, and Capnocytophaga. Hence, the role of mutans streptococci as a primary caries pathogen appears less pronounced in populations with prevention programs compared to populations lacking caries treatment and prevention strategies.

  • 17. Kanasi, E
    et al.
    Dogan, B
    Karched, M
    Thay, B
    Oscarsson, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    Asikainen, Sirkka
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    Lack of Serotype Antigen in A. actinomycetemcomitans2010Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 89, nr 3, s. 292-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aggregatibacter actinomycetemcomitans is divided into 6 serotypes. Occurrence of non-serotypeable strains is known, but background reasons are unclear. We hypothesized that non-serotypeable strains represent new serotypes or have altered expression of serotype-specific polysaccharide antigen (S-PA). We first characterized 311 strains from 189 individuals using both immunoassay- and PCR-based serotyping. Next, using natural human infection and rabbit immunization approaches, we clarified whether the phenotypically non-serotypeable strains expressed S-PA. Immunoassay identified serotypes a-f among 216 strains from 159 individuals. The remaining 95 strains from 30 individuals were phenotypically non-serotypeable. Yet, all these strains were identified by PCR-typing as serotype a-, b-, c-, or f. Non-serotypeability was confirmed by Western immunoblot with respective rabbit antisera. Patient sera remained non-reactive with autologous non-serotypeable strains at the serotype-specific region. Rabbit immunization with a phenotypically non-serotypeable strain induced no antibody production against S-PA. Thus, phenotypically non-serotypeable strains did not include novel serotypes, but lacked S-PA expression.

  • 18.
    Kanasi, Eleni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral mikrobiologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Lu, Shulin Charles
    Kressin, Nancy R
    Nunn, Martha E
    Kent, Ralph Jr
    Tanner, Anne CR
    Microbial Risk Markers for Childhood Caries in Pediatricians’ Offices2010Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 89, nr 4, s. 378-383Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dental caries in pre-school children has significant public health and health disparity implications. To determine microbial risk markers for this infection, this study aimed to compare the microbiota of children with early childhood caries with that of caries-free children. Plaque samples from incisors, molars, and the tongue from 195 children attending pediatricians’ offices were assayed by 74 DNA probes and by PCR to Streptococcus mutans. Caries-associated factors included visible plaque, child age, race, and snacking habits. Species were detected more frequently from tooth than tongue samples. Lactobacillus gasseri (p < 0.01), Lactobacillus fermentum, Lactobacillus vaginalis, and S. mutans with Streptococcus sobrinus (all p < 0.05) were positively associated with caries. By multifactorial analysis, the probiotic Lactobacillus acidophilus was negatively associated with caries. Prevotella nigrescens was the only species (p < 0.05) significantly associated with caries by the ‘false discovery’ rate. Analysis of the data suggests that selected Lactobacillus species, in addition to mutans streptococci, are risk markers for early childhood caries.

  • 19. Karjalainen, S
    et al.
    Sewón, L
    Söderling, E
    Larsson, B
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi.
    Simell, O
    Lapinleimu, H
    Seppänen, R
    Salivary cholesterol of healthy adults in relation to serum cholesterol concentration and oral health1997Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 76, nr 10, s. 1637-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Salivary lipids are mostly glandular in origin, but some are believed to diffuse directly from serum. This diffusion and the role of salivary lipids in oral health have scarcely been studied. Therefore, the serum and saliva cholesterol concentrations and oral health were analyzed in a group of healthy adults (n = 139; 64 men and 75 women; 34.2 +/- 5.2 yrs). Paraffin-stimulated whole saliva was collected, centrifuged (10,000 x g; 30 min, 4 degrees C), and lyophilized, and the cholesterol and other neutral lipids were extracted, separated by thin-layer chromatography, and quantified. The mean +/- SD (range) of saliva cholesterol concentration was 1.20 +/- 0.75 (0.02-5.46) mumol/L, and the saliva cholesterol level of men (1.36 +/- 0.85 mumol/L) was significantly higher than that of women (1.06 +/- 0.64 mumol/L; p < 0.05). Weak positive correlations between saliva and serum cholesterol concentrations and saliva cholesterol and serum non-high-density lipoprotein cholesterol concentrations were found (r = 0.22, p < 0.05; r = 0.28, p < 0.005, respectively). The saliva cholesterol assay detected subjects with high (> or = 6.5 mmol/L) serum cholesterol values, with sensitivity and specificity values of 100% and 29%, respectively. A positive correlation between the body mass index and the level of saliva cholesterol concentration was also found (r = 0.31 p < 0.01). Oral health, microbial counts, or saliva flow rate revealed no differences in subjects with low and high salivary cholesterol level. We conclude that, in healthy adults, saliva cholesterol concentration reflects serum concentration to some extent and can be used to select individuals with high serum cholesterol levels.

  • 20. Karjalainen, S
    et al.
    Söderling, E
    Saarinen, M
    Larsson, B
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Simell, O
    Niinikoski, H
    Effect of infancy-onset dietary intervention on salivary cholesterol of children: a randomized controlled trial2011Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 90, nr 7, s. 868-873Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigated salivary cholesterol of children from 6 to 16 years of age in response to dietary intervention. One thousand sixty-two infants started in the prospective, randomized project. At 3 years of age, every fifth child was invited into the study (n=178). Of these, 148 enrolled, and 86 completed the oral sub-study at 16 years of age. The intervention aimed at restricting the child's saturated fat and cholesterol intake. Control children received no special recommendations. Every third year, paraffin-stimulated saliva samples (10.0 mL) were collected for cholesterol assays. Nutrient intakes and serum total cholesterol concentrations were regularly followed up by means of 4-day food records and blood samples. Intake of saturated fatty acids (SAFA) was lower in the intervention than in the control group (p<0.001). Salivary cholesterol concentration increased from 1.9 (±1.1) µmol/L at 6 years of age to 16.0 (±9.0) µmol/L at 16 years of age. The increase was smaller in the intervention than in the control group (p<0.001). The ratios of salivary to serum cholesterol concentrations tended to be higher in boys than in girls (p=0.07). Thus, dietary intervention was reflected in children's salivary cholesterol values more sensitively than in serum cholesterol values. (clinicaltrials.gov NCT00223600).

  • 21.
    Kreiner, Marcelo
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostisk radiologi.
    Falace, D
    Michelis, V
    Okeson, JP
    Isberg, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Quality difference in craniofacial pain of cardiac vs. dental origin2010Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 89, nr 9, s. 965-969Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Craniofacial pain, whether odontogenic or caused by cardiac ischemia, is commonly referred to the same locations, posing a diagnostic challenge. We hypothesized that the validity of pain characteristics would be high in assessment of differential diagnosis. Pain quality, intensity, and gender characteristics were assessed for referred craniofacial pain from dental (n = 359) vs. cardiac (n = 115) origin. The pain descriptors "pressure" and "burning" were statistically associated with pain from cardiac origin, while "throbbing" and "aching" indicated an odontogenic cause. No gender differences were found. These data should now be added to those craniofacial pain characteristics already known to point to acute cardiac disease rather than dental pathology, i.e., pain provocation/aggravation by physical activity, pain relief at rest, and bilateralism. To initiate prompt and appropriate treatment, dental and medical clinicians as well as the public should be alert to those clinical characteristics of craniofacial pain of cardiac origin.

  • 22.
    Lerner, Ulf
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    Bone Remodeling in Post-menopausal Osteoporosis.2006Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, nr 7, s. 584-595Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Bone mass in the skeleton is dependent on the coordinated activities of bone-forming osteoblasts and bone-resorbing osteoclasts in discrete bone multi-cellular units. Remodeling of bone in these units is important not only for maintaining bone mass, but also to repair microdamage, to prevent accumulation of too much old bone, and for mineral homeostasis. The activities of osteoblasts and osteoclasts are controlled by a variety of hormones and cytokines, as well as by mechanical loading. Most importantly, sex hormones are very crucial for keeping bone mass in balance, and the lack of either estrogen or testosterone leads to decreased bone mass and increased risk for osteoporosis. The prevalence of osteoporotic fractures is increasing dramatically in the Western part of the world and is a major health problem in many countries. In the present review, the cellular and molecular mechanisms controlling bone remodeling and the influence of sex hormones on these processes are summarized. In a separate paper in this issue, the pathogenesis of post-menopausal osteoporosis will be compared with that of inflammation-induced bone remodeling, including the evidence for and against the hypothesis that concomitant post-menopausal osteoporotic disease influences the progression of periodontal disease.

  • 23.
    Lerner, Ulf
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    Inflammation-induced Bone Remodeling in Periodontal Disease and the Influence of Post-menopausal Osteoporosis.2006Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, nr 7, s. 596-607Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During physiological conditions, the skeleton is remodeled in so-called bone multi-cellular units. Such units have been estimated to exist at 1-2 x 10(6) sites in the adult skeleton. The number and activities of these units are regulated by a variety of hormones and cytokines. In post-menopausal osteoporosis, lack of estrogen leads to increased numbers of bone multi-cellular units and to uncoupling of bone formation and bone resorption, resulting in too little bone laid down by osteoblasts compared with the amount of bone resorbed by osteoclasts. Inflammatory processes in the vicinity of the skeleton, e.g., marginal and apical periodontitis, will affect the remodeling of the nearby bone tissue in such a way that, in most patients, the amount of bone resorbed exceeds that being formed, resulting in net bone loss (inflammation-induced osteolysis). In some patients, however, inflammation-induced bone formation exceeds resorption, and a sclerotic lesion will develop. The cellular and molecular pathogenetic mechanisms in inflammation-induced osteolysis and sclerosis are discussed in the present review. The cytokines believed to be involved in inflammation-induced remodeling are very similar to those suggested to play crucial roles in post-menopausal osteoporosis. In patients with periodontal disease and concomitant post-menopausal osteoporosis, the possibility exists that the lack of estrogen influences the activities of bone cells and immune cells in such a way that the progression of alveolar bone loss will be enhanced. In the present paper, the evidence for and against this hypothesis is presented.

  • 24.
    Lif Holgerson, Pernilla
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Harnevik, L
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Hernell, Olle
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Pediatrik.
    Tanner, ACR
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Mode of birth delivery affects oral microbiota in infants2011Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 90, nr 10, s. 1183-1188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Establishment of the microbiota of the gut has been shown to differ between infants delivered by Caesarian section (C-section) and those delivered vaginally. The aim of the present study was to compare the oral microbiota in infants delivered by these different routes. The oral biofilm was assayed by the Human Oral Microbe Identification Microarray (HOMIM) in healthy three-month-old infants, 38 infants born by C-section, and 25 infants delivered vaginally. Among over 300 bacterial taxa targeted by the HOMIM microarray, Slackia exigua was detected only in infants delivered by C-section. Further, significantly more bacterial taxa were detected in the infants delivered vaginally (79 species/species clusters) compared with infants delivered by C-section (54 species/species clusters). Multivariate modeling revealed a strong model that separated the microbiota of C-section and vaginally delivered infants into two distinct colonization patterns. In conclusion, our study indicated differences in the oral microbiota in infants due to mode of delivery, with vaginally delivered infants having a higher number of taxa detected by the HOMIM microarray.

  • 25. Opdam, N J M
    et al.
    van de Sande, F H
    Bronkhorst, E
    Cenci, M S
    Bottenberg, P
    Pallesen, U
    Gaengler, P
    Lindberg, A
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Huysmans, M C D N J M
    van Dijken, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Longevity of posterior composite restorations: a systematic review and meta-analysis2014Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 93, nr 10, s. 943-949Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years' follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces.

  • 26.
    Palmqvist, Py
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    Lundberg, Pernilla
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    Lundgren, Inger
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    Hänström, Lennart
    Umeå universitet, Medicinsk fakultet, Odontologi, Parodontologi.
    Lerner, Ulf
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral cellbiologi.
    IL-1beta and TNF-alpha regulate IL-6-type cytokines in gingival fibroblasts.2008Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 87, nr 6, s. 558-563Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Interleukin-6 (IL-6)-type cytokines are pleiotropic molecules capable of stimulating bone resorption and expressed by numerous cell types. In the present study, we tested the hypothesis that gingival fibroblasts may exert local osteotropic effects through production of IL-6 and related cytokines. IL-6-type cytokine expression and regulation by IL-1beta and tumor necrosis factor-alpha (TNF-alpha) were studied in fibroblasts from the non-inflamed gingiva of healthy individuals. Constitutive mRNA expression of IL-6, IL-11, and leukemia inhibitory factor (LIF), but not of oncostatin M (OSM), was demonstrated, as was concentration-dependent stimulation of IL-6 and LIF mRNA and of protein by IL-1beta and TNF-alpha. IL-11 mRNA and protein were concentration-dependently stimulated by IL-1beta. The signaling pathway involved in IL-6 and LIF mRNA stimulation involved MAP kinases, but not NF-kappaB. The findings support the view that resident cells may influence the pathogenesis of periodontal disease through osteotropic IL-6-type cytokine production mediated by activation of MAP kinases. Abbreviations: IL-1alpha (interleukin-1alpha); IL-1beta (interleukin-1beta); IL-6 (interleukin-6); IL-11 (interleukin-11); LIF (leukemia inhibitory factor); OSM (oncostatin M); alpha(1)-coll. I (alpha(1)-collagen I); ALP (alkaline phosphatase); BMP-2 (bone morphogenetic protein-2); OC (osteocalcin); BSP (bone sialoprotein); TNFR I (tumor necrosis factor receptor I); TNFR II (tumor necrosis factor receptor II); IL-1R1 (interleukin-1 receptor 1); GAPDH (glyceraldehyde-3-phosphate dehydrogenase); RPL13A (ribosomal protein L13A); mRNA (messenger ribonucleic acid); cDNA (complementary deoxyribonucleic acid); PCR (polymerase chain-reaction); BCA (bicinchoninic acid); ELISA (enzyme-linked immunosorbent assay); alpha-MEM (alpha modification of Minimum Essential Medium); and FCS (fetal calf serum).

  • 27.
    Souza, PPC
    et al.
    University of Sao Paulo.
    Palmqvist, Py
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Lundgren, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Lie, Anita
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Costa-Neto, CM
    Lundberg, Pernilla
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Lerner, Ulf H
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral cellbiologi.
    Stimulation of IL-6 cytokines in fibroblasts by toll-like receptors 22010Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 89, nr 8, s. 802-807Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The osteotropic interleukin-6 (IL-6) types of cytokines IL-6, IL-11, and leukemia inhibitory factor (LIF), but not oncostatin M, are expressed by human gingival fibroblasts, and their expressions are regulated by IL-1 and tumor necrosis factor-alpha (TNF-alpha). In the present study, we investigated whether signaling through Toll-like receptor 2 (TLR2) can affect the expression of these cytokines in human gingival fibroblasts. Lipopolysac-charide (LPS) from P. gingivalis was found to stimulate IL-6 and LIF mRNA and protein, but not IL-11 or OSM mRNA. Using two synthetic ligands acting specifically at TLR2 and siRNA knockdown of TLR2, we demonstrated the important role of TLR2 in the stimulation of IL-6 and LIF in gingival fibroblasts. Analysis of these data suggests that signaling through the innate immune system controls the expression of osteotropic cytokines in human gingival fibroblasts.

  • 28.
    Sundström, Anna
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Bergdahl, Jan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nyberg, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Bergdahl, M
    Public Dental Service Competence Centre of Northern Norway (TkNN), PB 2406, N-9271, Norway .
    Nilsson, Lars-Göran
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Cognitive status in persons with amalgam-related complaints2010Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 89, nr 11, s. 1236-1240Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Self-reported cognitive symptoms are frequent in persons with amalgam-related complaints, but few studies have focused on their cognitive function. The aim was to examine a symptom profile and whether participants with amalgam-related complaints have cognitive deficits in comparison with control individuals. We drew 342 participants with amalgam-related complaints and 342 one-to-one matched control individuals from a longitudinal population-based study. For 81 of the participants with amalgam-related complaints and controls, data were available approximately five years before the onset of complaints, making a longitudinal analysis possible. All participants were assessed by a self-reported health questionnaire and a comprehensive cognitive test battery. The participants with amalgam-related complaints reported more symptoms, mainly musculoskeletal and neuropsychological, compared with control individuals (p < 0.001). The results revealed no significant difference between the amalgam and control group, either cross-sectionally or longitudinally, for any of the cognitive tests. These results suggest that cognitive decline is not associated with amalgam-related complaints.

  • 29. Tanner, A. C. R.
    et al.
    Sonis, A. L.
    Holgerson, Pernilla Lif
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Starr, J. R.
    Nunez, Y.
    Kressirer, C. A.
    Paster, B. J.
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    White-spot Lesions and Gingivitis Microbiotas in Orthodontic Patients2012Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 91, nr 9, s. 853-858Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    White-spot lesions (WSL) associated with orthodontic appliances are a cosmetic problem and increase risk for cavities. We characterized the microbiota of WSL, accounting for confounding due to gingivitis. Participants were 60 children with fixed appliances, aged between 10 and 19 yrs, half with WSL. Plaque samples were assayed by a 16S rRNA-based microarray (HOMIM) and by PCR. Mean gingival index was positively associated with WSL (p = 0.018). Taxa associated with WSL by microarray included Granulicatella elegans (p = 0.01), Veillonellaceae sp. HOT 155 (p < 0.01), and Bifidobacterium Cluster 1 (p = 0.11), and by qPCR, Streptococcus mutans (p = 0.008) and Scardovia wiggsiae (p = 0.04) Taxa associated with gingivitis by microarray included: Gemella sanguinis (p = 0.002), Actinomyces sp. HOT 448 (p = 0.003), Prevotella cluster IV (p = 0.021), and Streptococcus sp. HOT 071/070 (p = 0.023); and levels of S. mutans (p = 0.02) and Bifidobacteriaceae (p = 0.012) by qPCR. Species' associations with WSL were minimally changed with adjustment for gingivitis level. Partial least-squares discriminant analysis yielded good discrimination between children with and those without WSL. Granulicatella, Veillonellaceae and Bifidobacteriaceae, in addition to S. mutans and S. wiggsiae, were associated with the presence of WSL in adolescents undergoing orthodontic treatment. Many taxa showed a stronger association with gingivitis than with WSL.

  • 30. Tanner, ACR
    et al.
    Kent, RL Jr
    Holgersson, Pernilla Lif
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Hughes, CV
    Loo, CY
    Kanasi, E
    Chalmers, NI
    Johansson, Ingegerd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Kariologi.
    Microbiota of severe early childhood caries before and after therapy2011Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 90, nr 11, s. 1298-1305Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Severe early childhood caries (ECC) is difficult to treat successfully. This study aimed to characterize the microbiota of severe ECC and evaluate whether baseline or follow-up microbiotas are associated with new lesions post-treatment. Plaque samples from 2- to 6-year-old children were analyzed by a 16S rRNA-based microarray and by PCR for selected taxa. Severe-ECC children were monitored for 12 months post-therapy. By microarray, species associated with severe-ECC (n = 53) compared with caries-free (n = 32) children included Slackia exigua (p = 0.002), Streptococcus parasanguinis (p = 0.013), and Prevotella species (p < 0.02). By PCR, severe-ECC-associated taxa included Bifidobacteriaceae (p < 0.001), Scardovia wiggsiae (p = 0.003), Streptococcus mutans with bifidobacteria (p < 0.001), and S. mutans with S. wiggsiae (p = 0.001). In follow-up, children without new lesions (n = 36) showed lower detection of taxa including S. mutans, changes not observed in children with follow-up lesions (n = 17). Partial least-squares modeling separated the children into caries-free and two severe-ECC groups with either a stronger bacterial or a stronger dietary component. We conclude that several species, including S. wiggsiae and S. exigua, are associated with the ecology of advanced caries, that successful treatment is accompanied by a change in the microbiota, and that severe ECC is diverse, with influences from selected bacteria or from diet.

  • 31. Tanner, Anne C R
    et al.
    Paster, Bruce J
    Lu, Shulin Charles
    Kanasi, Eleni
    Umeå universitet, Medicinsk fakultet, Odontologi.
    Kent, Ralph Jr
    Van Dyke, Thomas
    Sonis, Steven T
    Subgingival and tongue microbiota during early periodontitis.2006Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, nr 4, s. 318-323Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Periodontal infections have a microbial etiology. Association of species with early disease would be useful in determining which microbes initiate periodontitis. We hypothesized that the microbiota of subgingival and tongue samples would differ between early periodontitis and health. A cross-sectional evaluation of 141 healthy and early periodontitis adults was performed with the use of oligonucleotide probes and PCR. Most species differed in associations with sample sites; most subgingival species were associated with subgingival samples. Few species were detected more frequently in early periodontitis by DNA probes. Porphyromonas gingivalis and Tannerella forsythia (Tannerella forsythensis) were associated with early periodontitis by direct PCR. In conclusion, the microbiota of tongue samples was less sensitive than that of subgingival samples in detecting periodontal species, and there was overlap in species detected in health and early periodontitis. Detection of periodontal pathogens in early periodontitis suggests an etiology similar to that of more advanced disease.

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