Umeå University's logo

umu.sePublications
Change search
Refine search result
12 1 - 50 of 52
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Abrahamsson, Helene
    et al.
    Eriksson, Lars
    Abrahamsson, Peter
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, 205 06 Malmö, Sweden.
    Treatment of temporomandibular joint luxation: a systematic literature review2020In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 24, no 1, p. 61-70Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation.

    Materials and methods: This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018.

    Results: Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients.

    Conclusions: In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods.

    Clinical relevance: Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.

    Download full text (pdf)
    fulltext
  • 2. Bajramaj, Ermira
    et al.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University.
    Dawson, Andreas
    Gerdle, Bjorn
    Ghafouri, Bijar
    The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls2019In: Diagnostics (Basel), ISSN 2075-4418, Vol. 9, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the metabolic milieu and thereby influence the results when comparing healthy subjects to those with TMD. This study aimed to investigate the levels of serotonin and glutamate during the acute tissue trauma period in healthy subjects and in patients with TMD. Microdialysis was carried out in 15 patients with TMD and 15 controls, and samples were collected every 20 min during a period of 140 min. No significant alterations of serotonin or glutamate were observed over the 2 h period for the healthy subjects. For the TMD group, a significant decrease in serotonin was observed over time (p < 0.001), followed by a significant increase between 120 and 140 min (p < 0.001). For glutamate, a significant reduction was observed at 40 min compared to baseline. The results showed that there was a spontaneous increase of serotonin 2 h after the insertion of the catheter in patients with TMD. In conclusion, the results showed that there are differences in the masseter muscle levels of serotonin and glutamate during acute nociception in patients with myofascial TMD compared to healthy subjects.

    Download full text (pdf)
    fulltext
  • 3.
    Böthun, Alicia
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Clinical signs in the jaw and neck region following whiplash trauma: A 2-year follow-up2023In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 27, no 6, p. 699-709Article in journal (Refereed)
    Abstract [en]

    Background: Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective.

    Methods: In total, 84 cases (48 women) diagnosed with neck distortion after a car accident and 116 controls (68 women) were examined within 1 month, and 49 cases (27 women) and 71 controls (41 women) were re-examined 2 years later. Outcome measures were pain on palpation of jaw and neck muscles and maximal jaw opening. Analysis was performed using mixed-models.

    Results: Cases and women were at higher risk for pain on palpation of jaw muscles (OR:7.7; p < 0.001 and OR:3.2; p = 0.010 respectively) and neck muscles (OR:12.7; p < 0.001 and OR:2.9; p = 0.020 respectively) but with no significant effect of time. Cases and women also had lower maximal jaw opening (−3.1; p = 0.001 and −3.3; p = 0.001 respectively). There was no significant time effect, but a significant interaction between cases and time (2.2; p = 0.004).

    Conclusion: Individuals with a whiplash trauma present a higher risk for pain on palpation in jaw and neck muscles both in a short- and long-term perspective, but show normal jaw movements. No time effect suggests that cases do not spontaneously improve nor get worse. Investigating pain on palpation in the jaw and neck muscles after whiplash trauma can identify individuals at risk for developing long-term orofacial pain and dysfunction.

    Significance: Orofacial pain is often reported after whiplash trauma but most previous studies concerning orofacial pain in whiplash populations have been questionnaire studies. Cases with a previous whiplash trauma and women, in general, had higher risk for pain on palpation in the jaw and neck region. Investigating pain on palpation after a whiplash trauma can help to identify individuals at risk of developing long-lasting pain in the orofacial region.

    Download full text (pdf)
    fulltext
  • 4.
    Böthun, Alicia
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Wiesinger, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Research and Development, Umeå University, Sundsvall, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Österlund, Catharina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Jaw–neck motor strategy during jaw‐opening with resistance load2022In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 514-521Article in journal (Refereed)
    Abstract [en]

    Background:  The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known.

    Objectives:  To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions.

    Methods:  Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex® ) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant.

    Results:  The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, p < .001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, p = .018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, p = .025).

    Conclusion:  There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.

    Download full text (pdf)
    fulltext
  • 5.
    Böthun, Alicia
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Österlund, Catharina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Hellström, Fredrik
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Whiplash trauma did not predict jaw pain after 2 years: an explorative study2024In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, article id 165Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore predictive factors for the development and maintenance of jaw pain over a 2-year period.

    Methods: One hundred nineteen cases (73 women) and 104 controls (59 women), mean age 34.9 years (SD 13.9), attended baseline and 2-year follow-up examinations. The whiplash cases visited the emergency department at Umeå University Hospital, Sweden, with neck pain within 72 h following a car accident, and baseline questionnaires were answered within a month after trauma. Controls were recruited via advertising. Inclusion criteria were age 18–70 years, living in Umeå municipality and Swedish speaking. The exclusion criterion was neck fracture for cases and a previous neck trauma for controls. Validated questionnaires recommended in the standardized Research Diagnostic Criteria for temporomandibular disorders were used. Jaw pain was assessed by two validated screening questions answered with “yes” or “no.” A logistic regression analysis was used to predict the outcome variable jaw pain (yes/no) after 2 years.

    Results: Whiplash trauma did not increase the odds of development of jaw pain over a 2-year period (OR 1.97, 95% CI 0.53–7.38). However, non-specific physical symptoms (OR 8.56, 95% CI 1.08–67.67) and female gender (OR 4.89, 95% CI 1.09–22.02) did increase the odds for jaw pain after 2 years.

    Conclusion: The development and maintenance of jaw pain after whiplash trauma are primarily not related to the trauma itself, but more associated with physical symptoms.

    Clinical relevance: The development of jaw pain in connection with a whiplash trauma needs to be seen in a biopsychosocial perspective, and early assessment is recommended.

    Download full text (pdf)
    fulltext
  • 6.
    Eklund, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wiesinger, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Österlund, Catharina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Jaw-neck motor function in the acute stage after whiplash trauma2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 7, p. 834-842Article in journal (Refereed)
    Abstract [en]

    Background: Jaw-neck motor function is affected in the chronic stage following whiplash trauma. It is not known whether motor function is affected also in the early stage after neck trauma.

    Objectives: To determine how jaw and head movement amplitudes and movement cycle times correlate with jaw and neck pain, and neck disability in the acute stage after whiplash trauma. Methods Jaw and head movements during jaw opening-closing were recorded with an optoelectronic system in 23 cases (4 men, 19 women, 18-66 years) within 1 month after whiplash trauma and compared with 27 controls without neck trauma (15 men, 12 women, 20-66 years). Jaw and head movement amplitudes, head/jaw ratio (quotient of head and jaw movement amplitude) and movement cycle times were evaluated in relation to jaw and neck pain (Numeric Rating Scale) and neck disability (Neck Disability Index). Analyses were performed with Mann-Whitney U test and Spearman's correlation.

    Results: Compared with controls, cases showed smaller jaw movement amplitudes (P = .006) but no difference in head movement amplitudes, head/jaw ratios or movement cycle times. There were no significant correlations between movement amplitudes or cycle times and jaw and neck pain, and neck disability. Cases with high neck pain intensity had smaller jaw movement amplitudes compared to cases with low neck pain intensity (P = .024).

    Conclusion: The results suggest that jaw-neck motor function may be affected in the acute stage after whiplash trauma and more so in cases with higher neck pain intensity.

    Download full text (pdf)
    fulltext
  • 7.
    Eriksson, P O
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Nordh, E
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Zafar, H
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man.2000In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 79, no 6, p. 1378-1384Article in journal (Refereed)
    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.

  • 8.
    Eriksson, Per-Olof
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Jaw-neck dysfunction in whiplash-associated disorders2007In: Archives of Oral Biology, ISSN 0003-9969, E-ISSN 1879-1506, Vol. 52, no 4, p. 404-408Article in journal (Refereed)
    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.

  • 9.
    Eriksson, Per-Olof
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Deranged jaw-neck motor control in whiplash-associated disorders2004In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 112, no 1, p. 25-32Article in journal (Refereed)
    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.

  • 10.
    Grönqvist, Johan
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Impaired jaw function and eating difficulties in Whiplash-associated disorders2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 4, p. 171-177Article in journal (Refereed)
    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.

  • 11.
    Häggman Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö; Faculty of Odontology, Health Technology Assessment – Odontology (HTA-O), Malmö.
    Alstergren, P.
    Davidson, T.
    Högestätt, E. D.
    Östlund, P.
    Umeå University, Faculty of Medicine, Department of Odontology. Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm.
    Tranaeus, S.
    Umeå University, Faculty of Medicine, Department of Odontology. Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm.
    Vitols, S.
    List, T.
    Pharmacological treatment of oro-facial pain: health technology assessment including a systematic review with network meta-analysis2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 10, p. 800-826Article, review/survey (Refereed)
    Abstract [en]

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

  • 12.
    Häggman Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Grönqvist, Johan
    Umeå University, Faculty of Medicine, Department of Odontology.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Department of Odontology.
    Frequent jaw-face pain in chronic Whiplash-Associated Disorders2011In: Swedish Dental Journal, ISSN 0347-9994, Vol. 35, no 3, p. 123-131Article in journal (Refereed)
    Abstract [en]

    Chronic Whiplash-Associated Disorders (WAD) present with frequent pain in the neck, head and shoulder regions but the presence of frequent jaw-face pain is unclear. The aim of the study was to investigate the frequency of jaw-face pain in other regions, and general symptoms in chronic WAD patients. Fifty whiplash-patients  and 50 healthy age- and sex-matched controls were examined by qustionnaire for pain in the jaw-face, pain in other regions and other symptoms.

    In contrast to healthy, a majority of the WAD patients (88%) reported frequent pain in the jaw-face, in addition to frequent pain in the neck (100%), shoulders (94%), head (90%) and back (72%). The WAD patients also reported stiffness and numbness in the jaw-face region, and frequent general symptoms such as balance problems, stress and sleep disturbances.

    The result suggests that frequent pain in the jaw-face can be part of the spectrum of symptoms in chronic WAD. The finding of self-reported numbness in the jaw-face indicates disturbed trigeminal nerve function and merits further investigation. We conclude that assessment of WAD should include pain in the jaw-face region. A multidisciplinary rehabilitation program including dentists, preferably specialized in the area of orofacial pain, should be advocated after whiplash injury.

  • 13.
    Häggman Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    List, Thomas
    Westergren, Hans
    Axelsson, Susanna
    Temporomandibular Disorder Pain After Whiplash Trauma: A Systematic Review2013In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 27, no 3, p. 217-226Article, review/survey (Refereed)
    Abstract [en]

    Aims: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. Methods: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Results: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). Conclusion: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.

  • 14.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Neck function in rhythmic jaw activities2004Doctoral thesis, comprehensive summary (Other academic)
    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.

    Download full text (pdf)
    FULLTEXT01
  • 15.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Head movements during chewing: relation to size and texture of bolus2004In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 83, no 11, p. 864-868Article in journal (Refereed)
    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.

  • 16.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Eriksson, P-O
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Nordh, E
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Zafar, H
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Evaluation of skin- versus teeth-attached markers in wireless optoelectronic recordings of chewing movements in man1998In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 25, no 7, p. 527-534Article in journal (Refereed)
    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.

  • 17.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Marklund, Susanna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Pain and Disability in the Jaw and Neck Region following Whiplash Trauma2016In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, no 10, p. 1155-1160Article in journal (Refereed)
    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.

  • 18.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lampa, Ewa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders2013In: International Journal of Oral Science, ISSN 1674-2818, Vol. 5, no 3, p. 150-154Article in journal (Refereed)
    Abstract [en]

    There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

    Download full text (pdf)
    fulltext
  • 19.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Liv, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Ilgunas, Aurelija
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Visscher, Corine M.
    Lobbezoo, Frank
    Durham, Justin
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Increasing gender differences in the prevalence and chronification of orofacial pain in the population2020In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 161, no 8, p. 1768-1775Article in journal (Refereed)
    Abstract [en]

    Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course is lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, two screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010-2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least two consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (OR 2.58, 95% CI 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (IRR 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (IRR 2.56, 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.

    Download full text (pdf)
    fulltext
  • 20.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Increased sternocleidomastoid, but not trapezius, muscle activity in response to increased chewing load2013In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 121, no 5, p. 443-449Article in journal (Refereed)
    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.

  • 21.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Head Immobilization can Impair Jaw Function2006In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, no 11, p. 1001-1005Article in journal (Refereed)
    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.

  • 22.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö.
    Rezvani, M.
    Department of Orofacial Pain and Jaw Function, Malmö University, Malmö.
    List, T.
    Department of Orofacial Pain and Jaw Function, Malmö University, Malmö and Department of Rehabilitation Medicine, Skåne University Hospital, Lund,.
    Prevalence of whiplash trauma in TMD patients: a systematic review2014In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 41, no 1, p. 59-68Article, review/survey (Refereed)
    Abstract [en]

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

  • 23.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Visscher, Corine M.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, Amsterdam, Netherlands.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ljótsson, Brjánn
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
    Peck, Christopher C.
    The University of Sydney Westmead Initiative, The University of Sydney, Sydney, Australia.
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders2021In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 11, p. 1193-1200Article in journal (Refereed)
    Abstract [en]

    Aims: Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations.

    Methods: A community-based sample of 110 individuals (83 women; 20–69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20–69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated.

    Results: Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1–2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294–0.321, p≤0.002), but not to number of pain sites.

    Conclusion: Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.

    Download full text (pdf)
    fulltext
  • 24.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Wiesinger, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Research and Development, Västernorrland County Council, Umeå University, Umeå, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    The effect of supervised exercise on localized TMD pain and TMD pain associated with generalized pain2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 6-12Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate the effect of a supervised exercise program in patients with localized/regional temporomandibular disorder (TMD) pain and with TMD associated with generalized pain.

    Material and methods: Consecutively referred patients with localized/regional TMD pain (n = 56; 46 women and 10 men, mean age 44 years) and TMD associated with generalized pain (n = 21; 21 women, mean age 41 years) participated. Patients underwent a 10-session structured supervised exercise program over 10-20 weeks that included relaxation, and coordination and resistance training of the jaw and neck/shoulders. The outcomes were jaw pain intensity on the Numerical Rating Scale, endurance time for jaw opening and protrusion against resistance and chewing, and effect of pain on daily activities.

    Results: After the exercise program, a reduction in jaw pain was reported by the local (p = .001) and general (p = .011) pain groups. There were no significant differences in jaw pain intensity between the groups, before (p = .062) or after treatment (p =.121). Endurance time increased for both groups for jaw opening/protrusion (both p <. 001) and chewing (both p = .002). The effect of jaw pain on daily activities decreased after exercise compared to baseline for both the local (p < .001) and general (p = .008) pain groups.

    Conclusions: Supervised exercise can reduce TMD pain and increase capacity in patients with TMD. The results suggest that activation of the jaw motor system with exercise has a positive effect in patients with localized/regional TMD pain and TMD associated with generalized pain.

  • 25.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Zafar, H
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Eriksson, P-O
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Disturbed jaw behavior in whiplash-associated disorders during rhythmic jaw movements.2002In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 81, no 11, p. 747-751Article in journal (Refereed)
    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.

  • 26.
    Häggman-Henrikson, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Österlund, Caatharina
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Eriksson, Per-Olof
    Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
    Endurance during chewing in whiplash-associated disorders and TMD2004In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 83, no 12, p. 946-950Article in journal (Refereed)
    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.

  • 27.
    Ilgunas, Aurelia
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. 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 University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    The longitudinal relationship between jaw catching/locking and pain2023In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 102, no 4, p. 383-390Article in journal (Refereed)
    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.

    Download full text (pdf)
    fulltext
  • 28.
    Ilgunas, Aurelija
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Häggman-Henrikson, Birgitta
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Karlsson Wirebring, Linnea
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
    Visscher, Corine M.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
    Durham, Justin
    School of Dental Sciences, Newcastle University, Newcastle, UK and Newcastle Hospitals’ NHS Foundation Trust, Newcastle, UK.
    Conceptualizing the clinical decision-making process in managing temporomandibular disorders: a qualitative study2021In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 129, no 5, article id e12811Article in journal (Refereed)
    Abstract [en]

    Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process forTMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.

    Download full text (pdf)
    fulltext
  • 29.
    Lampa, Ewa
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    List, Thomas
    Häggman-Henrikson, Birgitta
    Relationship Between Psychosocial Factors and Pain in the Jaw and Neck Regions Shortly After Whiplash Trauma2019In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 33, no 2, p. 213-219Article in journal (Refereed)
    Abstract [en]

    Aims: To assess jaw pain shortly after whiplash trauma in relation to neck pain, physical symptoms, depression, and jaw pain-related disability.

    Methods: A total of 181 cases (106 women and 75 men, mean ages 33.7 and 36.8 years, respectively) were examined within 1 month after a whiplash trauma and compared to 117 controls (68 women and 49 men, 34.2 and 30.9 years, respectively). Participants rated current jaw and neck pain intensity on a numeric rating scale and rated nonspecific physical symptoms and depression symptoms on subscales of the Symptom Checklist-90-Revised. The nonspecific physical symptoms were further analyzed with and without pain items. Disability related to jaw pain and neck pain was also assessed. Differences between groups were calculated using Mann-Whitney U test, and correlations were measured using Spearman correlation.

    Results: Compared to controls, cases reported higher current jaw and neck pain intensity (P < .0001), together with higher scores for physical nonpain and pain symptoms, depression, and jaw pain-related disability (P < .0001 for all). For cases, there were moderate correlations between nonspecific physical symptoms and jaw pain and neck pain, as well as between jaw pain-related disability and jaw pain and neck pain (r = 0.43 to 0.77, P < .0001 for all). Low correlations were observed between depression and jaw pain and neck pain (r = 0.34 to 0.39, both P < .0001).

    Conclusion: Shortly after a whiplash trauma, pain in the jaw and neck regions is associated with the severity of psychosocial factors. Thus, psychosocial factors may play a role in the development of pain in the jaw region after whiplash trauma.

  • 30.
    Lampa, Ewa
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Effects on jaw function shortly after whiplash trauma2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 12, p. 941-947Article in journal (Refereed)
    Abstract [en]

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

  • 31.
    Lampa, Ewa
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    The Course of Orofacial Pain and Jaw Disability after Whiplash Trauma: A 2-year Prospective Study2020In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 45, no 3, p. E140-E147Article in journal (Refereed)
    Abstract [en]

    Study Design: Prospective cohort study.

    Objective: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.

    Summary of Background Data: Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma.

    Methods: Within one month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, non-specific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined.

    Results: Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain was correlated to non-specific physical symptoms and to depression.

    Conclusion: Orofacial pain and jaw disability related to neck pain is often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma.

    Level of Evidence: 3

  • 32. Larsson, Johan
    et al.
    Westergren, Hans
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Ilgunas, Aurelija
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Malmström, Eva-Maj
    The feasibility of gym-based exercise therapy for patients with persistent neck pain2020In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 20, no 2, p. 261-272Article in journal (Refereed)
    Abstract [en]

    Background and aims: Persistent neck pain is common and can be detrimental to the health of those who are affected. This is particularly common after neck trauma, where it poses a challenge to health care providers. In this paper, we present the design and results of a study aimed primarily at assessing the feasibility of a supervised exercise intervention for patients with persistent neck pain after trauma. As a secondary aim, we analyzed the results of the intervention.

    Methods: We designed and conducted a feasibility study using a mixed methods design. Ten patients with persistent neck pain (nine with a history of neck trauma and one with sudden onset of neck pain) were recruited from a specialized pain rehabilitation center and underwent a gym-based individual exercise therapy intervention, supervised by a physical therapist. We assessed the feasibility of the exercise therapy intervention based on the experiences of the patients and physical therapists. We analyzed both quantitative and qualitative results using descriptive statistics, content analysis, and questionnaires.

    Results: The study found the exercise therapy to be a feasible alternative for patients with persistent neck pain. Most of the practical aspects of the intervention and study were executed as planned, and the study was well received by the patients, who found it a valuable part of their rehabilitation. In the quantitative analysis, improvements were observed on the Neck Disability Index, numerical rating scale for pain, EuroQol 5D, and physical activity, with scores on the Neck Disability Index showing a statistically significant improvement. Scores on the Disability Rating Index showed a non-significant deterioration. The qualitative analysis uncovered one overarching theme and four themes for the patients and three themes for the physical therapist.

    Conclusions: The exercise therapy intervention seems to be feasible with favorable outcomes for the patients. The quantitative and qualitative analyses demonstrated exercise therapy to be beneficial from several different perspectives. However, although structured, the training needs customization and individual adaption from a clinical reasoning perspective in order to meet each patient’s individual needs.

    Implications: This study shows that supervised gym-based exercise therapy is feasible for patients with severe, persistent neck pain. It facilitates and motivates the execution of a larger, controlled trial, which might then lead to a new and potentially effective addition to the toolbox of all health care providers treating patients with persistent neck pain.

  • 33.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Begic, Arnela
    Umeå University, Faculty of Medicine, Department of Odontology.
    Landgren, Henrik
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lundén, Victor
    Umeå University, Faculty of Medicine, Department of Odontology.
    Svensson, P.
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden; Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
    Österlund, Catharina
    Umeå University, Faculty of Medicine, Department of Odontology.
    The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 3033-3040Article in journal (Refereed)
    Abstract [en]

    Objectives: Pain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner.

    Materials and methods: Healthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0–10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant.

    Results: In total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner.

    Conclusions: The gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual.

    Clinical relevance: In clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

    Download full text (pdf)
    fulltext
  • 34.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, C. M.
    Lobbezoo, F.
    Marklund, Susanna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Temporomandibular pain and jaw dysfunction at different ages covering the lifespan - A population based study2016In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 20, no 4, p. 532-540Article in journal (Refereed)
    Abstract [en]

    Background

    Temporomandibular pain and jaw dysfunction can have a negative effect on daily life, but these conditions are not well recognized in the health care systems. The general aim was to examine the cross-sectional prevalence of frequent temporomandibular pain and jaw dysfunction in men and women across the lifespan.

    Methods

    The analysis was based on data from 137,718 individuals (mean age 35years, SD 22.7) who answered three questions (3Q/TMD) included in the digital health declaration in the Public Dental Health care in the county of Vasterbotten, Sweden; Q1: Do you have pain in your temple, face, jaw or jaw joint once a week or more?'; Q2: Does it hurt once a week or more when you open your mouth or chew?'; and Q3: Does your jaw lock or become stuck once a week or more?'

    Results

    The prevalence of frequent temporomandibular pain (Q1) was 5.2% among women and 1.8% among men (p<0.0001). The prevalence of frequent pain on jaw movement (Q2) was 2.5% among women and 0.9% among men (p<0.0001). The prevalence of frequent locking of the jaw (Q3) was 2.7% among women and 1.2% among men (p<0.0001).

    Conclusions

    The study shows that the cross-sectional prevalence of temporomandibular pain and jaw dysfunction varies during the lifespan. For men and women, respectively, symptoms increase during adolescence, peak in middle age and then gradually diminish. The prevalence of these symptoms is significantly higher among women except from the first and last decades of a 100-year lifespan.

  • 35.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ilgunas, Aurelia
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Elias, B.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Roudini, O. A.L.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, C.M.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Lobbezoo, F.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Liv, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors2023In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 23, no 3, article id 101888Article in journal (Refereed)
    Abstract [en]

    Objectives: Temporomandibular disorders (TMDs) is a collective term for pain and functional disturbances related to the jaw muscles and the temporomandibular joint. In contrast to screening for orofacial pain, knowledge is limited on the association between patient-reported outcomes and screening for joint-related functional jaw disturbances. Therefore, our aim was to evaluate the association between a screening question for functional jaw disturbances, and disease-specific outcome measures for functional jaw limitations and oral behaviors.

    Methods: This study included 299 individuals (201 women; 20-69 years, median 37.0) in a general population sample from Västerbotten, Northern Sweden in 2014. A single screening question for functional jaw disturbances “Does your jaw lock or become stuck once a week or more?” was used to categorize individuals as cases or controls. Patient-reported outcomes on functional jaw disturbances were assessed with the 20-item jaw functional limitation scale (JFLS-20) and oral behaviors with the 21-item Oral Behaviors Checklist (OBC-21).

    Results: The strongest predictive probability to have a positive screening outcome was functional jaw limitations related to mobility (AUCboot=0.78, 95 CI:0.71-0.86, P <.001), followed by limitations related to communication (AUCboot = 0.74, 95 CI:0.63-0.80, P <.001) and mastication (AUCboot = 0.73, 95 CI:0.66-0.81, P <.001). The frequency of oral behaviors was not significantly associated with a positive screening outcome (AUCboot = 0.65, 95 CI:0.55-0.72, P =.223).

    Conclusions: Self-reported functional limitations, but not oral behaviors, are strongly associated with a single screening question for frequent functional jaw disturbances. This finding provides support for incorporating a question on jaw catching/locking once a week or more in screening instruments for TMDs.

  • 36.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Karlsson Wirebring, Linnea
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Decision-making in dentistry related to temporomandibular disorders: a 5-yr follow-up study2018In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 126, no 6, p. 493-499Article in journal (Refereed)
    Abstract [en]

    Temporomandibular disorders (TMDs) are common, but many patients with such disorders go undetected and under-treated. Our aim was to evaluate the outcome of using a screening tool (5 yr after it was first implemented), on the clinical decision-making for patients with TMDs. Adults who attended for a dental check-up at the Public Dental Health Services in Västerbotten, Sweden, answered three screening questions (3Q/TMD) on frequent jaw pain, pain on jaw function, and catching/locking of the jaw. The dental records of a random sample of 200 individuals with at least one positive response to 3Q/TMD (3Q screen-positive patients) and 200 individuals with all negative responses (3Q screen-negative patients) were reviewed for TMD-related treatment decisions. A clinical decision related to TMD was absent in 45.5% of 3Q screen-positive patients. Treatment of TMDs was associated with a positive response to the screening question on jaw pain (OR = 6.7, 95% CI: 3.2-14.0) and was more frequent among 3Q screen-positive patients (24%) than among 3Q screen-negative patients (2%; OR = 15.5, 95% CI: 5.5-43.9), just as a female examiner was associated with more frequent treatment of TMDs (OR = 3.1, 95% CI: 1.2-8.4). The results indicate under-treatment of TMD within general dental practice and that male clinicians are less likely to initiate TMD treatment.

  • 37.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Marklund, Susanna
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Visscher, Corine
    Academic Centre for Dentistry Amsterdam (ACTA).
    Lobbezoo, Frank
    Academic Centre for Dentistry Amsterdam (ACTA).
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Malmö Högskola.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Outcome of three screening questions for temporomandibular disorders (3Q/TMD) on clinical decision-making2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 8, p. 573-579Article in journal (Refereed)
    Abstract [en]

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

  • 38.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Parvaneh, Hasti
    Lobbezoo, Frank
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, Corine Mirjam
    Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic.

    Material and methods: Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard.

    Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83–0.94), whereas specificity was low (0.41–0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96).

    Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.

    Download full text (pdf)
    fulltext
  • 39.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, C M
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Lobbezoo, F
    Marklund, Susanna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Validity of three screening questions (3Q/TMD) in relation to the DC/TMD2016In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, no 10, p. 729-736Article in journal (Refereed)
    Abstract [en]

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

  • 40.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, Corine M.
    Alstergren, Per
    Lobbezoo, Frank
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia2020In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 24, p. 97-102Article in journal (Refereed)
    Abstract [en]

    Objective: Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis.

    Methods: A study population (n = 300), randomly selected from the adult population in Västerbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome.

    Results: Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3–9.9). This association was confounded by concurrent myalgia (B = 1.737 → B = 0.996, 42.7%).

    Conclusion: In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia.

    Clinical relevance: Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.

    Download full text (pdf)
    fulltext
  • 41.
    Lövgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Visscher, Corine M.
    Lobbezo, Frank
    Yekkalam, Negin
    Umeå University, Faculty of Medicine, Department of Odontology.
    Vallin, Simon
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    The association between myofascial orofacial pain with and without referral and widespread pain2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 481-486Article in journal (Refereed)
    Abstract [en]

    Objectives: Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain.

    Materials and methods: Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20–69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain.

    Results: Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62–9.05 and OR 11.62 95% CI 5.18–27.88, respectively).

    Conclusion: These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.

    Download full text (pdf)
    fulltext
  • 42.
    Manfredini, Daniele
    et al.
    Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy.
    Ahlberg, Jari
    Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland.
    Aarab, Ghizlane
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Bracci, Alessandro
    School of Dentistry, University of Padova, Padova, Italy.
    Durham, Justin
    Newcastle University's School of Dental Sciences, Newcastle, United Kingdom.
    Emodi-Perlman, Alona
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Ettlin, Dominik
    Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland.
    Gallo, Luigi M.
    Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Koutris, Michail
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Peroz, Ingrid
    Department for Prosthodontics, Charité—University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany.
    Svensson, Peter
    Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden; Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
    Wetselaar, Peter
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
    The development of the Standardised Tool for the Assessment of Bruxism (STAB): an international road map2024In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 51, no 1, p. 15-28Article, review/survey (Refereed)
    Abstract [en]

    This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.

  • 43.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Risk factors associated with incidence and persistence of frequent headaches2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 788-794Article in journal (Refereed)
    Abstract [en]

    Abstract Objective. Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. Materials and methods. The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. Results. The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). Conclusions. The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.

  • 44. Sharma, Sonia
    et al.
    Lövgren, Anna
    Umeå University, Faculty of Medicine, Department of Odontology.
    Åkerman, Sigvard
    Nilsson, Peter M.
    Axtelius, Björn
    List, Thomas
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Prevalence of facial pain and headache in Sweden2021In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 35, no 2, p. 139-149Article in journal (Refereed)
    Abstract [en]

    AIMS: To compare the prevalence of facial pain and headache across various regions in Sweden.

    METHODS: This study involved a comparison of cross-sectional questionnaire studies over a period of 10 years including 128,193 individuals and assessed facial pain, pain on function, and headache. Participants included (1) all Public Dental Service patients aged 16 to 90 years in Västerbotten (n = 57,283) and Gävleborg (n = 60,900); and (2) random samples of residents in Kalmar (n = 3,560) and Skåne (n = 6,450). Facial pain and pain on function were assessed for all participants, and headache was also assessed for participants in Kalmar and Skåne. Descriptive statistics were used to estimate unadjusted prevalence estimates and demographic characteristics. Prevalence estimates were adjusted for age and sex using weighted distributions from the 2015 data in the Swedish population registry before comparisons across the regions.

    RESULTS: Overall, the prevalence of facial pain and headache were significantly higher in female than in male participants (P < .01). The standardized prevalence of facial pain was 4.9% in Västerbotten, 1.4% in Gävleborg, 4.6% in Kalmar, and 7.6% in Skåne. For headache, the standardized prevalence was 18.9% in Kalmar and 21.3% in Skåne. In Skåne, individuals with facial pain had a 15-fold higher odds of headache than those without.

    CONCLUSION: In the present Swedish epidemiologic study, the prevalence of facial pain ranged from 1.4% in Gävleborg to 7.6% in Skåne. Besides different sampling frames and other population characteristics, the presence of a high number of immigrants in Skåne may account for some differences in pain prevalence across the Swedish regions.

  • 45.
    Sharma, Sonia
    et al.
    Department of Neurosurgery, University of Rochester Medical Center, New York, Rochester, United States; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Nilsson, Peter M.
    Department of Clinical Sciences, Research Group Internal Medicine – Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden; Strategic Research Area EpiHealth: Epidemiology for Health, Lund University, Lund, Sweden.
    Östergren, Per-Olof
    Strategic Research Area EpiHealth: Epidemiology for Health, Lund University, Lund, Sweden; Department of Clinical Sciences in Malmö, Division of Social Medicine and Global Health, Lund University, Lund, Sweden.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    List, Thomas
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden; Skåne University Hospital, Specialized Pain Rehabilitation, Lund, Sweden.
    Kallen, Michael A.
    Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Illinois, Chicago.
    A new instrument for assessing work-related body mechanics and strain in the general population2023In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 24, no 2, p. 237-250Article in journal (Refereed)
    Abstract [en]

    Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n = 6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation = .09; comparative fit index = .96; Tucker-Lewis index = .96; standardized root mean residuals = .05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥.70) for T-scores = 39–80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. Perspective: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.

  • 46. Skog, Caroline
    et al.
    Fjellner, Jesper
    Ekberg, EwaCarin
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Tinnitus as a comorbidity to temporomandibular disorders - A systematic review2019In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 46, no 1, p. 87-99Article, review/survey (Refereed)
    Abstract [en]

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

  • 47.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Glas, Linnéa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Magnusson, My
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ilgunas, Aurelija
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö Universiy, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 7, p. 495-501Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate temporomandibular disorder (TMD) patients’ experiences of a supervised jaw-neck exercise programme.

    Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n = 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n = 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open- and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of open-ended questions.

    Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p = .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment.

    Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with wide-spread pain.

    Download full text (pdf)
    fulltext
  • 48.
    Wiesinger, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Eklund, Anton
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    Multimodal Sensory Stimulation of the Masseter Muscle Reduced Precision but Not Accuracy of Jaw-Opening Movements2019In: Frontiers in Neuroscience, ISSN 1662-4548, E-ISSN 1662-453X, Vol. 13, article id 1083Article in journal (Refereed)
    Abstract [en]

    A functional integration between the trigeminal and craniocervical sensorimotor systems has been demonstrated, with simultaneous jaw and head-neck movements during jaw opening-closing. We previously showed that pain induction in the masseter muscle increased the relative contribution of the neck component of integrated jaw-neck movements. Induced pain or manipulation of proprioception by vibration did not affect accuracy during a jaw-opening task in men. It is not known how multimodal sensory stimulation, with a combination of pain induction and vibration, affects jaw-opening accuracy and precision. The aim was to investigate how jaw-neck movements, and specifically accuracy and precision of jaw-opening, are affected during concomitant nociceptive and proprioceptive stimulation of the masseter muscle. Twenty-one healthy men performed jaw-opening to a target position, defined as 75% of individual maximum jaw opening, during control (Ctr), vibration of masseter muscles (Vib), pain induction in the masseter (Pain), and concomitant vibration and pain induction in the masseter muscle (VibPain). Simultaneous jaw and head movements were recorded with an optoelectronic system and amplitudes calculated for each jaw opening-closing cycle. Accuracy of jaw movements was defined as the achievement of the target position. Precision of jaw movements was defined as the cycle-to-cycle variability from the mean of cycles 2-10 (coefficient of variation, CV). Differences between the trials were analyzed with Friedman's test, Dunn's test, and Benjamini-Hochberg correction. There were no significant differences between the trials for jaw movement amplitudes. For head movements, amplitudes for cycles 2-10 were larger during Pain compared to Ctr and Vib (both p = 0.034), and larger during VibPain compared to Ctr (p = 0.034) and Vib (p = 0.035). There were no differences in accuracy of jaw movements between the trials. For precision of jaw movements, the cycle-to-cycle variability was larger during VibPain compared to Ctr (p = 0.027) and Vib (p = 0.018). For integrated jaw-neck motor strategy, there was a difference between pain and non-pain trials, but no differences between unimodal and multimodal stimulation trials. For achievement of jaw-opening to a target position, the results show no effect on accuracy, but a reduced precision of jaw movements during combined proprioceptive and nociceptive multimodal stimulation.

    Download full text (pdf)
    fulltext
  • 49.
    Wiesinger, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, F
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Experimental masseter muscle pain alters jaw-neck motor strategy2013In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 17, no 7, p. 995-1004Article in journal (Refereed)
    Abstract [en]

    Background: A functional integration between the jaw and neck regions has been demonstrated during normal jaw function. The effect of masseter muscle pain on this integrated motor behaviour in man is unknown. The aim of this study was to investigate the effect of induced masseter muscle pain on jaw-neck movements during a continuous jaw opening-closing task.

    Methods: Sixteen healthy men performed continuous jaw opening-closing movements to a target position, defined as 75% of the maximum jaw opening. Each subject performed two trials without pain (controls) and two trials with masseter muscle pain, induced with hypertonic saline as a single injection. Simultaneous movements of the mandible and the head were registered with a wireless optoelectronic three-dimensional recording system. Differences in movement amplitudes between trials were analysed with Friedman's test and corrected Wilcoxon matched pairs test.

    Results: The head movement amplitudes were significantly larger during masseter muscle pain trials compared with control. Jaw movement amplitudes did not differ significantly between any of the trials after corrected Wilcoxon tests. The ratio between head and jaw movement amplitudes was significantly larger during the first pain trial compared with control.

    Conclusions: Experimental masseter muscle pain in humans affected integrated jaw-neck movements by increasing the neck component during continuous jaw opening-closing tasks. The findings indicate that pain can alter the strategy for jaw-neck motor control, which further underlines the functional integration between the jaw and neck regions. This altered strategy may have consequences for development of musculoskeletal pain in the jaw and neck regions.

  • 50.
    Wiesinger, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Hellström, Fredrik
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Umeå, Sweden.
    Englund, Erling
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Does induced masseter muscle pain affect integrated jaw-neck movements similarly in men and women?2016In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 124, no 6, p. 546-553Article in journal (Refereed)
    Abstract [en]

    Normal jaw opening-closing involves simultaneous jaw and head-neck movements. We previously showed that, in men, integrated jaw-neck movements during jaw function are altered by induced masseter muscle pain. The aim of this study was to investigate possible sex-related differences in integrated jaw-neck movements following experimental masseter muscle pain. We evaluated head-neck and jaw movements in 22 healthy women and 16 healthy men in a jaw opening-closing task. The participants performed one control trial and one trial with masseter muscle pain induced by injection of hypertonic saline. Jaw and head movements were registered using a three-dimensional optoelectronic recording system. There were no significant sex-related differences in jaw and head movement amplitudes. Head movement amplitudes were significantly greater in the pain trials for both men and women. The proportional involvement of the neck motor system during jaw movements increased in pain trials for 13 of 16 men and for 18 of 22 women. Thus, acute pain may alter integrated jaw-neck movements, although, given the similarities between men and women, this interaction between acute pain and motor behaviour does not explain sex differences in musculoskeletal pain in the jaw and neck regions.

12 1 - 50 of 52
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf