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  • 1.
    Adern, Bengt
    et al.
    Mälar Hosp, Dept Stomatognath Physiol, Dent Care Ctr, Eskilstuna, Sweden.
    Minston, Ava
    Inst Odontol, Dept Stomatognath Physiol, Jönköping, Sweden;Postgrad Dent Educ Ctr, Orofacial Pain & Jaw Funct, Klostergatan 26,Box 1126, S-70111 Örebro, Sweden.
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Postgrad Dent Educ Ctr, Orofacial Pain & Jaw Funct, Klostergatan 26,Box 1126, S-70111 Örebro, Sweden; Malmö Univ, Fac Odontol, Malmö, Sweden.
    Self-reportance of temporomandibular disorders in adult patients attending general dental practice in Sweden from 2011 to 20132018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 7, p. 530-534Article in journal (Refereed)
    Abstract [en]

    Objectives: The study aim was to evaluate the prevalence of self-reported temporomandibular disorders (TMD) and acceptance or nonacceptance of such disorders in adult patients attending all public dental health services in the County of Sormland, Sweden, during a 3-year period, 2011-2013.

    Methods: Two questions were asked about TMD and the voluntary mouth-opening capacity was measured. The results were registered in a score 0-3. The registration was completed with a question about each patient's acceptance or nonacceptance of their condition.

    Results: More than 73,000 registrations of the TMD condition were performed in general dental clinics from 2011 to 2013. The mean prevalence of a TMD score of 1-3 was 5% and was consistent over these years. Seventy percent of these patients were women. The peak prevalence of TMD was registered in patients aged 30-45years (38%), and the frequency declined in older age groups. Reduced voluntary mouth-opening capacity (<= 35 mm) was found in less than 2% of the participants. About one-fifth of the patients with a TMD-score of 1-3 did not accept their condition and wanted professional care. The frequency of nonacceptance of the condition increased with the severity of symptom score: 15%, 27%, and 49% for scores 1, 2, and 3, respectively.

    Conclusions: This study shows that the prevalence of self-reported TMD in adult patients was consistent from 2011 to 2013 and should be considered as a public health issue in Sweden. Patients with more severe TMD pain symptoms wanted care more frequent. The annual clinical calibrations should be continued to achieve an acceptable level of registration.

  • 2. Adern, Bengt
    et al.
    Stenvinkel, Christer
    Sahlqvist, Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Tegelberg, Ake
    Prevalence of temporomandibular dysfunction and pain in adult general practice patients2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 585-590Article in journal (Refereed)
    Abstract [en]

    Objective. To analyse the prevalence of temporomandibular disorders and related pain (TMD-pain) among adult recall patients in general dental practice. Materials and methods. From November 2006 to September 2008, all adults attending a Swedish Public Dental Service (PDS) clinic for recall examination were asked two standardized questions about temporomandibular pain and dysfunction. Mouth-opening capacity was measured. The responses to the questions and mouth-opening capacity were combined to give a TMD-pain score, on a scale of 0-3. The patients' acceptance of their TMD condition was also noted. Results. The subjects comprised 2837 adults (53% females, 47% men). Of the total sample, 4.9% reported a TMD-pain score of 1-3. The gender difference was significant: women predominated (p < 0.003). Forty-three per cent of those with TMD-pain scores of 1-3 (36% men, 47% women) considered that the condition warranted treatment, especially those registering a pain score (significant difference between pain and dysfunction groups, p < 0.000). Conclusions. The TMD-pain score shows promise as a useful instrument for detecting and recording TMD-pain. The prevalence of TMD disclosed in the study is high enough to be considered a public health concern. Most of the subjects with lower scores on the TMD-pain scale accepted their condition as not severe enough to require treatment.

  • 3.
    Bayat, Jari Taghavi
    et al.
    Karolinska Inst, Dept Dent Med, Huddinge, Sweden.
    Huggare, Jan
    Karolinska Inst, Dept Dent Med, Huddinge, Sweden.
    Akrami, Nazar
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Distinguishing between global and dental self-esteem in evaluating malocclusions2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 6, p. 452-456Article in journal (Refereed)
    Abstract [en]

    Objective: When dealing with the impact of malocclusion on self-esteem, the terms global and dental self-esteem are sometimes used. Although these terms are related to one another, they do not depict the same concept. The aims of this paper were to explore if the two forms of self-esteem are distinguishable, to find out if they represent different factors, and to investigate how they are related to malocclusion. Materials and methods: A sample consisting of 150 adolescents, aged 13 years, completed self-assessed measures of Dental and Global Self-Esteem. Orthodontic treatment need for each individual was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC). Data were analysed by factor analyses and a 5 (IOTN-DHC grades) by 2 (global vs. dental self-esteem) ANOVA, with the IOTN-DHC grades as the independent and self-esteem (repeated measure) as the dependent variables. Results: The factor analyses showed that the two forms of self-esteem, based on the measures, are distinguishable. More importantly, the results of the ANOVA revealed that Dental and Global Self-Esteem are differentially related to IOTN-DHC. Specifically, Dental Self-Esteem varied across IOTN-DHC scale while Global Self-Esteem did not. There was no effect of gender. Conclusions: Dental self-esteem is related to malocclusion while global self-esteem is not. These findings have implications in areas where the predictive power of dental self-esteem needs to be considered.

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  • 4.
    Edman, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Öhrn, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Nordström, Birgitta
    Public Dental Service, Falun.
    Holmlund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population: Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 5, p. 385-392Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this study was to investigate the prevalence of dental caries in an adult population using four different cross-sectional studies over a 30-year period and to assess its possible associations with socio-economic and socio-behavioral factors. Materials and methods. Four cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008, and 2013. Random samples of 1012–2243 individuals, aged 20–85 years, who answered a questionnaire about socio-economic and socio-behavioral factors, were radiographically and clinically examined. Results. The proportion of individuals with at least one decayed surface (DS) was 58% in 1983 and significantly lower, 34% in 2008 (p<0.05) and 33% in 2013; the mean number of DS was 2.0 in 1983 and 1.1 in 2013 in the age group 35 to 75 (p < 0.05). In the age group 85, the mean number of DS was 1.2 in 2008 and 2.4 in 2013. Adjusted for age and number of teeth, irregular dental visits, limited financial resources for dental care, smoking, education below university, male gender, daily medication, and single living were positively and statistically associated with manifest caries. Conclusion. The declining trend in the prevalence of manifest caries seems to be broken. In the oldest age group mean number of DS was higher in 2013 compared with 2008, indicating a possible beginning of an increase.  This needs special attention as this group increases in the population, retaining natural teeth high up in age. Manifest caries was found to be associated with socio-economic and socio-behavioral factors.

  • 5.
    Flink, Håkan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Publ Dent Clin Sala, Publ Dent Hlth Vastmanland, Box 300, S-73325 Sala, Sweden..
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Malmö Univ, Fac Odontol, Malmö, Sweden..
    Arnetz, Judith E.
    Michigan State Univ, Coll Human Med, Dept Family Med, Grand Rapids, MI USA..
    Birkhed, Dowen
    Fersens Vag, Malmö, Sweden..
    Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 3, p. 229-235Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25-50 years of age (mean age 39.96.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p<.001). The CA group reported worse oral health (p<.001) and general health (p<.01), more xerostomia (p<.001) and lower salivary flow rate (p<.01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p<.01). There were no differences between groups in quality of life.Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.

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  • 6.
    Flink, Håkan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Arnetz, Judy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Birkhed, Dowen
    Correlation between perceived experience of caries disease and recorded caries activity among adult patients at a Swedish Public Dental Clinic: A longitudinal study2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 6, p. 1486-1492Article in journal (Refereed)
    Abstract [en]

    Objective. To compare patients' perceived experiences of caries activity with recorded longitudinal caries prevalence, consequences of caries and length of recall intervals. Materials and methods. A questionnaire was mailed to 134 caries active (CA) and 40 caries inactive (CI) adult patients at a Swedish Public Dental Clinic. The overall response rate was 69%. The questionnaire included items regarding perceived caries activity, general health, dietary and oral hygiene habits, level of education and socioeconomic status. Questionnaire responses were studied for their association to clinical data extracted from patient dental records. Results. There was a correlation between patient-perceived and documented caries activity for all respondents (rho = 0.65; p < 0.001). CA patients had significantly more perceived caries activity (p < 0.001), decayed teeth (p < 0.001), root fillings (p = 0.001) and extractions (p < 0.001) than CI patients. The mean recall interval was 1.5 years for CA and 2.1 years for CI (p < 0.001). In multiple logistic regression analysis, CA patients were at increased risk for xerostomia (OR = 22.66, p = 0.003), sleep disturbances (OR = 4.36, p = 0.04) and more frequent use of daily extra fluoride (OR = 3.58, p = 0.03). Conclusions. Patient-perceived experience of caries correlated well with recorded caries activity in this group of middle-aged Swedish adults. Individuals with active caries were aware of their disease and made more frequent attempts to reduce caries activity by use of daily extra fluoride. Individual risk-based recall intervals did not seem to eliminate consequences of disease activity such as root fillings and extractions during the follow-up period.

  • 7. Hultvall, Majlis Morhed
    et al.
    Lundgren, Jesper
    Gabre, Pia
    Factors of importance to maintaining regular dental care after a behavioural intervention for adults with dental fear: a qualitative study2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 6, p. 335-343Article in journal (Refereed)
    Abstract [en]

    Objective. Dental phobia is prevalent in the general population and can be successfully treated through cognitive behavioural therapy, which results in patients being able to cope with dental treatments. The aim of this study was to increase the understanding of factors of importance for maintaining regular dental care after completion of a cognitive behavioural therapy programme. Material and methods. A qualitative study design was used. Fourteen individuals who had successfully completed the programme and had thereafter been referred to a general dental practitioner were interviewed. An interview guide with open-ended questions was used. The interviews were tape-recorded and transcribed verbatim. The texts were analysed using descriptive and qualitative content analysis ( Grounded Theory). Results. The manifest analysis identified four content areas: experience of dental care, content of the behavioural therapy programme, perception of therapy and impact on quality of life. The latent analysis identified influence on quality of life, security, activity and barriers to dental care as categories. Although all informants had successfully completed the dental fear treatment programme, only a few stated that they had an uncomplicated relation to dental care afterwards. Barriers to dental care were lack of money and fear. A sense of security was conclusive to coping with dental care, and a respectful approach on the part of the dental care personnel was essential to development of this sense. Conclusions. Confidence in one's own ability to cope with dental care and the right to guide the treatment were important. Thus the theme in the present study was self-efficacy and respectful dental care personnel.

  • 8.
    Klobas, Luciano
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Axelsson, Susanna
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 6, p. 341-347Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate the effect of a specific therapeutic jaw exercise on the temporomandibular disorders of patients with chronic whiplash-associated disorders. MATERIAL AND METHODS: Ninety-four consecutive patients with whiplash-related conditions were referred to and accepted for a treatment period at a center for functional evaluation and rehabilitation during 2001-2002. The patients followed a program of physical therapy, occupational therapy, and pain management. At the start of their stay, they were examined by a physician specialized in rehabilitation medicine and also by a dentist who performed a functional examination of the stomatognathic system. Of the 93 patients who accepted participation in the study, 55 were diagnosed with temporomandibular disorders and chronic whiplash-associated disorders in accordance with the inclusion criteria. They were randomized into a jaw exercise group (n = 25), who performed specific therapeutic jaw exercises, and a control group (n = 30). Both groups undertook the whiplash rehabilitation program at the center. RESULTS: There were no inter- or intra-group differences in symptoms and signs of temporomandibular disorders at baseline, nor at the 3-week and 6-month follow-ups, except for an increase of maximum active mouth-opening capacity in the control group. CONCLUSIONS: In conclusion, the therapeutic jaw exercises, in addition to the regular whiplash rehabilitation program, did not reduce symptoms and signs of temporomandibular disorders in patients with chronic whiplash-associated disorders.

  • 9.
    Korytowska, Magdalena
    et al.
    NÄL Hosp, Publ Dent Serv, Clin Orofacial Med, Uddevalla, Sweden.
    Schwab, Gabriela
    Inst Trop Med Sao Paulo, Sch Med, Lab Virol, Sao Paulo, Brazil.
    Giglio, Daniel
    Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Oncol, Gothenburg, Sweden.
    Hirsch, Jan-Micháel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Publ Dent Serv Reg Stockholm, Dept Res & Dev, Stockholm, Sweden.
    Holmberg, Erik
    Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Oncol, Gothenburg, Sweden.
    Kjeller, Göran
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Dept Oral & Maxillofacial Surg, Gothenburg, Sweden.
    Sand, Lars
    Univ Oslo, Fac Odontol, Dept Oral Biol, Oslo, Oslo, Norway.
    Wallström, Mats
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Dept Oral & Maxillofacial Surg, Gothenburg, Sweden.
    Öhman, Jenny
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Dept Oral Med & Pathol, Gothenburg, Sweden.
    Braz-Silva, Paulo
    Inst Trop Med Sao Paulo, Sch Med, Lab Virol, Sao Paulo, Brazil; Univ Sao Paulo, Sch Dent, Dept Stomatol, Sao Paulo, Brazil.
    Hasséus, Bengt
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Dept Oral Med & Pathol, Gothenburg, Sweden; Publ Dent Hlth Serv, Clin Oral Med, Gothenburg, Sweden.
    Patient-reported pain after surgical removal of leukoplakia: an observational 1-year follow-up study2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 5, p. 383-389Article in journal (Refereed)
    Abstract [en]

    Objective

    Oral leukoplakia (OL) presents as a white lesion of the oral mucosa and is not typically associated with the sensation of pain. OL should be surgically removed when possible because it is considered a potentially malignant oral disorder (PMOD). This study assessed the pain sensations experienced by patients in association with the occurrence and surgical treatment of OL.

    Methods

    Inclusion criteria were: a clinical diagnosis of OL; biopsy excision; and observation for at least 12 months in the ORA-LEU-CAN study. At the first visit, all the patients were asked about the occurrence of symptoms within the lesion. Ninety-four subjects were assessed over a period of 1 year. All patients underwent complete removal of OL. The patient cohort was divided into three sub-groups: (i) no pain before excision and at the 1-year follow-up; (ii) pain before excision; and (iii) pain at the 1-year follow-up.

    Results

    Overall, pain was reported by 21.3% of the patients at the study start whereas 13.8% of the patients reported pain 1 year after surgical treatment. Patient-reported pain from the lesion at study inclusion was significantly associated with lesions found on the lateral side of the tongue (p=.002). Pain reported by patients one year after surgery was significantly related to female gender (p=.038) and the presence of epithelial cell dysplasia (p=.022).

    Conclusion

    We conclude that surgical removal of OL results in a low risk of long-term post-surgical pain. However, OL located on the lateral side of the tongue and in OL with dysplasia are more likely to be associated with pain.

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  • 10.
    Lindfors, Erik
    et al.
    Publ Dent Hlth Serv, Dept Stomatognath Physiol, Box 1813, SE-75148 Uppsala, Sweden.;Karolinska Inst, SCON, Dept Dent Med, Huddinge, Sweden..
    Tegelberg, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Malmo Univ, Fac Odontol, Dept Orofacial Pain & Jaw Funct, Malmo, Sweden.;Postgrad Educ Dent Ctr, Orebro, Sweden..
    Magnusson, Tomas
    Jonkoping Univ, Sch Hlth & Welf, Jonkoping, Sweden..
    Ernberg, Malin
    Karolinska Inst, SCON, Dept Dent Med, Huddinge, Sweden..
    Treatment of temporomandibular disorders - knowledge, attitudes and clinical experience among general practising dentists in Sweden2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 6, p. 460-465Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to investigate the self-perceived level of knowledge, attitudes and clinical experience in treatment of temporomandibular disorders (TMD) among general practising dentists (GPDs).

    Material and methods: A web-based questionnaire was sent to all GPDs in the public dental health service in the County of Uppsala in 2010 (n=128) and 2014 (n=113). The GPDs were asked to answer questions in the following categories: Demographic information, Quality assurance, Clinical experience and treatment, Need for specialist resources in the field of TMD and Attitudes. Between the two questionnaires, the GPDs were offered TMD education and an examination template including three TMD questions was introduced in the computer case files. The results were also compared with a previous questionnaire from 2001.

    Results: The response rate was 71% (2010) and 73% (2014). The majority of the GPDs were women (70% in 2010 and 72% in 2014). The reported frequency of taking a case history of facial pain and headache increased between 2010 and 2014. In 2014, the GPDs were more secure and reported higher frequency of good clinical routines in treatment with jaw exercises and pharmacological intervention compared to 2001. Interocclusal appliance was the treatment with which most dentists felt confident and reported good clinical routines.

    Conclusions: The GPDs felt more insecure concerning TMD diagnostics, therapy decisions and treatment in children/adolescents compared to adults. There is a high need for orofacial pain/TMD specialists and a majority of the GPDs wants the specialists to offer continuing education in TMD.

  • 11.
    Lindquist, Susanne
    et al.
    Umeå Univ, Dept Odontol, Mol Periodontol, SE-90187 Umeå, Sweden..
    Isehed, Catrine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Research and Development, Gävleborg. Gävle Cty Hosp, Publ Dent Hlth Cty Council Gävleborg, Dept Periodontol, Gävle, Sweden..
    Lie, Anita
    Umeå Univ, Dept Odontol, Mol Periodontol, SE-90187 Umeå, Sweden..
    Lundberg, Pernilla
    Umeå Univ, Dept Odontol, Mol Periodontol, SE-90187 Umeå, Sweden..
    Enamel matrix derivative does not affect osteoclast formation or bone resorption in cultures of mouse bone marrow macrophages or human monocytes2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 487-493Article in journal (Refereed)
    Abstract [en]

    Objective Enamel matrix derivative (EMD) is widely used under the brand name Emdogain(R) to promote periodontal regeneration in surgical treatment of periodontitis and peri-implantitis. The molecular mechanisms are unclear, but it has been proposed that EMD has stimulatory effects on the root cementum and periodontal ligament cells. Since dental implants lack these structures, we hypothesized that EMD-induced bone gain involve interactions with osteoclast precursor cells, with consequent inhibitory effect on osteoclast formation and/or activity. The aim was to evaluate this hypothesis. Material and methods Primary mouse bone marrow macrophages (BMMs) and human peripheral blood monocytes were cultured in the presence of receptor activator nuclear factor-kappa B ligand (RANKL) to stimulate osteoclast formation. A purified Emdogain(R) fraction was added to the cell cultures and the effect on number and size of newly formed osteoclasts were evaluated. In cultures on natural bone slices, bioanalytical methods were used to assay osteoclast number and bone resorption. Results EMD had a negative effect on osteoclastogenesis in mouse cultures on plastic surface, whereas addition of EMD to osteoclast precursor cells on bone substrate did not affect osteoclast formation or bone resorption. Conclusions The results on natural bone matrix contradict a direct effect of EMD on osteoclast precursor cells.

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  • 12.
    Sörensen, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland.
    Lemberger, Mathias
    Larsson, Pernilla
    Pegelow, Marie
    Comparing oral health-related quality of life, oral function and orofacial aesthetics among a group of adolescents with and without malocclusions.2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 2, p. 99-104Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim was to analyze how malocclusion relates to perception of oral health-related quality of life (OHRQOL), oral function and orofacial aesthetics among a group of adolescents in Sweden.

    MATERIAL AND METHODS: Thirty patients with a need for orthodontic treatment (IOTN-DHC grade 4 and 5) and 30 patients with normal occlusion (IOTN-DHC grade 1), aged 13-17 years, were included in the study. A questionnaire containing three parts was used; The Oral Health Impact Profile (OHIP-S14), Jaw Functional Limitational scale (JFLS-20) and Orofacial Aesthetic scale (OES). Malocclusions, orthodontic treatment need and confounders, such as earlier dental treatment and temporomandibular disorders, were registered.

    RESULTS: Adolescents with malocclusions were more often embarrassed by their mouth and teeth compared to controls (p < .05). Aesthetically, adolescents with malocclusions were more negatively affected by the appearance of the mouth and teeth as well as the over-all facial appearance (p < .05).

    CONCLUSIONS: Malocclusions clearly affects the adolescents with need for orthodontic treatment in this study. It influences their OHRQOL in the psychosocial impact dimension. Aesthetically they perceive their oral and facial appearance as worse compared to controls. Although embarrassed and unpleased with their oral appearance they still rate themselves as having a good oral health with low jaw function limitations.

  • 13.
    Taghavi Bayat, Jari
    et al.
    Karolinska Institutet, Department of Dental Medicine.
    Hallberg, Ulrika
    Nordic School of Public Health, Gothenburg.
    Lindblad, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Huggare, Jan
    Karolinska Institutet, Department of Dental Medicine.
    Mohlin, Bengt
    Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy at the University of Gothenburg.
    Daily life impact of malocclusion in Swedish adolescents: a grounded theory study2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 792-798Article in journal (Refereed)
    Abstract [en]

    Objective. To explore how malocclusions affect daily life in adolescents and how adolescents cope with malocclusionrelated distress.

    Materials and methods. Twelve strategically selected teenagers, seven girls and five boys aged 13–14 years, participated in this study. Open, tape-recorded in-depth interviews based on Focus Group Discussions (FGD) were performed using a theme guide and analyzed according to the qualitative method of classic grounded theory (GT).

    Results. A core category was identified and named‘Repeatedly reminded of the malocclusion’. Associated to the core category,five categories were generated and labeled ‘Being directed by the media’s ideal image’, ‘Monitoring others’teeth’, ‘Struggling with low selfesteem’, Hiding one’s teeth’ and ‘Striving for cure’. Low self-esteem appeared to be frequently reinforced through the concerns for the malocclusion and handled via different coping strategies, such as hiding the teeth and striving to receive orthodontic treatment. Such processes were further enforced through the influence of media. Low self-esteem could be associated to a visible malposition of teeth, according to the informants. Having to wait for orthodontic treatment was frustrating the adolescents.

    Conclusions. Adolescents with malocclusion are often reminded of their condition, which can lead to avoiding strategies to minimize the negative feelings associated with the teeth and low self-esteem. Clinicians may therefore need to be aware of potential irrational behaviors when interacting with adolescents with malocclusions. The findings also suggest that there might be a discrepancy of attitudes between professionals focusing on oral health aspects of malocclusions and the adolescents focusing on esthetic aspects.

  • 14.
    Tegelberg, Åke
    et al.
    Malmö Univ, Dept Orofacial Pain & Jaw Funct, Malmö, Sweden..
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Bornefalk Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Fransson, Anette
    Örebro Univ, Postgrad Dent Educ Ctr, Örebro, Sweden.;Örebro Univ, Fac Med & Hlth, Örebro, Sweden..
    Isacsson, Göran
    Västmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Västerås, Sweden..
    Respiratory outcomes after a 1-year treatment of obstructive sleep apnoea with bibloc versus monobloc oral appliances: a multicentre, randomized equivalence trial2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 6, p. 401-408Article in journal (Refereed)
    Abstract [en]

    Objective: The benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that these types of appliances would be equally effective.

    Material and methods: In this multicentre, randomized equivalence trial, patients with OSA received one type of bibloc or one type of monobloc treatment. At baseline, a 1-night polygraphy study was done, and this was repeated after 1 year. The outcome was any change in the apnoea–hypopnoea index (AHI) and the limits of equivalence between the two devices were set at ±5 AHI units.

    Results: Of 302 patients, 146 were randomly assigned to bibloc and 156 to monobloc appliances. In 88 and 104 patients, respectively, there were significant reductions in the AHI (p < .001) with a mean change of −16.7 (95% CI −19.4 to −14.1) in the bibloc and −11.8 (−14.9 to −8.7) in the monobloc groups. The proportions of responders defined as having an AHI <10 were 68% and 65% for the bibloc and monobloc groups, respectively. Treatment-related adverse events were mild, transient and the dropouts were more frequent in the bibloc group.

    Conclusions: Both types of treatments positively and significantly reduced respiratory disturbances, but at the 1-year follow-up, they were not significantly different in treating OSA, with a numerically greater reduction of the AHI value with the bibloc appliance. However, the higher proportion of treatment-related adverse events and higher proportion of dropouts among bibloc users should be balanced against the advantage of a greater reduction in the AHI.

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  • 15. Wallström, Mats
    et al.
    Bolinder, Gunilla
    Hassèus, Bengt
    Hirsch, Jan M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    A cessation program for snuff-dippers with long-term, extensive exposure to Swedish moist snuff: A 1-year follow-up study2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 6, p. 377-384Article in journal (Refereed)
    Abstract [en]

    Objective: Smokeless tobacco (Swedish moist 'snus') users are often strongly addicted to nicotine. Compared to the large number of smoking-cessation studies, there have been few evaluated clinical cessation programs in conjunction with nicotine replacement therapy (NRT). The aim of this study was to evaluate a cessation program for snus users with a weekly use of >2 cans/week for >10 years. Material and methods: A prospective, open, non-randomized intervention trial was undertaken including baseline oral examination and soft tissue biopsy, minor physical examination, brief cessation advice, NRT recommendations and five prospective follow-up visits within 12 months. Individual cessation counseling was given, together with oral examination in the dental office. Fifty snus users with a minimum consumption of 100 g/week who were actively seeking cessation treatment were recruited through advertising. Self-reported abstaining, including random-sample biochemical verification, and NRT use were evaluated at 6 weeks and 3, 6 and 12 months. Results: At the 3-, 6- and 12-month visits, 58%, 46% and 30% of subjects, respectively were tobacco-abstinent. All nicotine abstinence was randomly controlled during the study except at 12 months, where all subjects claiming abstinence were confirmed biochemically and clinically. Conclusion: Smokeless tobacco cessation achieved together with suitable NRT seems a promising way to improve a persistent tobacco-free condition.

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