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  • 1. Andrèn, A
    et al.
    Sjöquist, M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Tegelberg, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Effects on blood pressure after treatment of obstructive sleep apnoea with a mandibular advancement appliance - a three-year follow-up2009In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 36, no 10, p. 719-725Article in journal (Refereed)
    Abstract [en]

    P>Obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder; it affects 4% of males and 2% of females. Hypertension has been shown to occur in 28-57% of OSA patients. There is a steady increase in evidence linking OSA to long-term cardiovascular morbidity including hypertension. The purpose of this study was to investigate whether mandibular advancement oral appliance (OA) treatment of OSA affects the patient's blood pressure (BP) in a 3-month and a 3-year perspective. Twenty-nine consecutive patients, with verified OSA defined as apnoea index (AI) > 5 per hour and/or apnoea/hypopnoea index (AHI) >= 10 per hour, received an OA as treatment. BP was measured on three occasions; before treatment, after 3 months of treatment, and after 3 years of treatment. BP was measured with an electronic blood pressure monitor. The treatment effect of OA was measured after 3 months by repeated somnographic registration while the patient was wearing the OA. A treatment response was defined as AHI < 10; this was achieved in 25 of 29 patients (86%) at the 3-month evaluation. Significant reductions in blood pressure were attained between baseline and the 3-month evaluation (P < 0 center dot 001) and these changes remained at the 3-year follow-up in both systolic BP of -15 center dot 4 +/- 18 center dot 7 mm Hg and diastolic BP of -10 center dot 3 +/- 10 center dot 0 mm Hg. OA therapy reduced blood pressure in both a 3-month and a 3-year perspective in patients with OSA.

  • 2.
    Hjalmarsson, Lars
    et al.
    Public Dental Health Service, The Mälar Hospital, Eskilstuna.
    Smedberg, J-I
    Wennerberg, A
    Material degradation in implant-retained cobalt-chrome and titanium frameworks2011In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 38, no 1, p. 61-71Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to estimate in vitro material degradation in implants and cobalt-chrome or titanium frameworks, before and after exposure to artificial saliva. Four full-arch implant frameworks were fabricated according to the Cresco™ method (Astra Tech AB, Mölndal, Sweden), two in a cobalt-chrome alloy and two in commercially pure (CP) titanium. They were cut vertically, and the three central sections of each framework were used. Element leakage into an artificial saliva solution was observed with mass spectrometry. Before artificial saliva exposure, three Brånemark System(®) implants (Nobel Biocare AB, Gothenburg, Sweden) were screw-retained to cobalt-chrome sections, and three to titanium sections. The contact surfaces with the implants of the framework sections and the corresponding surfaces of six implants were examined with optical interferometry before and after exposure to artificial saliva to evaluate material degradation. Conventional descriptive statistics were used to present the mass spectrometry and interferometry data. One-way anova and Dunnett's T3 post hoc test were used to identify and study differences between the groups. To highlight changes within the groups, the Student's t-test was used. The significance level was set at 5%. There was significantly more leakage of cobalt elements than of titanium and chrome (P < 0·05). After saliva exposure and framework connection, the implants roughened (P < 0·05). The titanium frameworks were generally rougher than the cobalt-chrome frameworks, both before and after saliva exposure (P < 0·05). The findings in this study suggest active material degradation processes for both implants and framework materials.

  • 3.
    Isacsson, Göran
    et al.
    Vastmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Vasteras, Sweden.
    Schumann, Mohamad
    Vastmanland Cty Hosp, Dept Orofacial Pain & Jaw Funct, Vasteras, Sweden.
    Nohlert, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Mejersjö, Christina
    Sahlgrenska Acad & Publ Dent Hlth, Clin Orofacial Pain, Gothenburg, Sweden.
    Tegelberg, Åke
    Postgrad Dent Educ Ctr, Dept Orofacial Pain & Jaw Funct, Orebro, Sweden;Malmo Univ, Fac Odontol, Dept Orofacial Pain & Jaw Funct, Malmo, Sweden.
    Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia - A multicentre randomised controlled trial2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, no 1, p. 5-13Article in journal (Refereed)
    Abstract [en]

    Background: Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation.

    Objective: The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain.

    Methods: This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population.

    Results: In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812). Treatment-related adverse events were doubled in the methylprednisolone group.

    Conclusion: Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.

  • 4.
    Nordin, E.
    et al.
    Malmo Univ, Fac Odontol, Malmo, Sweden..
    Stenberg, M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Tegelberg, A.
    Malmo Univ, Fac Odontol, Malmo, Sweden.;Uppsala Univ, Clin Res Ctr, Vasteras, Sweden.;Publ Dent Hlth Serv, Postgrad Dent Educ Ctr, POB 1126, SE-70111 Orebro, Sweden..
    Obstructive sleep apnoea: patients' experiences of oral appliance treatment2016In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, no 6, p. 435-442Article in journal (Refereed)
    Abstract [en]

    Over the past few decades, there has been a pronounced increase in the number of patients being treated by general dental practitioners for obstructive sleep apnoea (OSA). The purpose of this study was to survey the care and patient experiences and the self-reported effectiveness of OSA treatment with an oral appliance (OA) incorporating mandibular advancement. The design was a retrospective, cross-sectional study, with follow-up between 6 months to 1 year after commencement of treatment. A survey form was posted to 1150 subjects, identified in the regional register over a 1-year period as having been treated with an OA for OSA. The questionnaire comprised 70 questions and assertions in various domains, such as general health/lifestyle, changes in symptoms/quality of life and sleep-related experiences, daytime sleepiness, changes in life situation, evaluation of treatment and the value of treatment. The overall response rate was 64% (n = 738). Treatment with OA gave relief of symptoms in 83% of the respondents. Quality of life, somatic and cognitive symptoms improved significantly in patients who used the appliance frequently (P < 0.001). Daytime sleepiness decreased significantly (P < 0.001). Treatment satisfaction and willingness to recommend the similar treatment to a friend were high (>85%). OA treatment of OSA by general dental practitioners is a safe procedure. Most of the survey respondents experienced relief of symptoms. Those who used their appliance frequently reported improvement in quality of life, somatic and cognitive symptoms. Excessive daytime sleepiness was reduced in the majority of the patients under treatment.

  • 5.
    Pettersson, Mattias
    et al.
    Umea Univ, Dept Odontol, Prosthet Dent, Fac Med, Umea, Sweden.
    Pettersson, Jean
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Johansson, Anders
    Umea Univ, Dept Odontol, Mol Periodontol, Fac Med, Umea, Sweden.
    Molin Thorén, Margareta
    Umea Univ, Dept Odontol, Prosthet Dent, Fac Med, Umea, Sweden.
    Titanium release in peri-implantitis2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, no 2, p. 179-188Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate the titanium (Ti) content of biopsies from patients with severe peri-implantitis or controls without Ti exposure.

    Background: Peri-implantitis is considered to be an infectious disease, but recent studies have shown that Ti can aggravate inflammation in combination with bacterial products. The Ti content of peri-implantitis and periodontitis (controls) tissue is unknown.

    Methods: Thirteen patients referred for peri-implantitis and eleven for periodontitis treatment were included in the study. Disease severity was obtained from dental records. Biopsies were taken from both groups and chemically analysed with inductively coupled plasma mass spectrometry for Ti content. Additionally, two patients with peri-implantitis and two with periodontitis were recruited and their biopsies were analysed microscopically with light microscopy, transmission electron microscopy and scanning electron microscopy with element analysis to investigate the presence of particulate Ti.

    Results: All patients lost one or more implants despite undergoing peri-implant or treatment. Peri-implantitis tissue contained significantly higher concentrations of Ti than control samples with a mean +/- SD of 98.7 +/- 85.6 and 1.2 +/- 0.9 mu g/g, respectively. Particulate metal was identified in peri-implantitis and control biopsies, but element analyses could confirm only the presence of Ti in peri-implantitis tissue.

    Conclusion: We showed that high contents of particulate and submicron Ti were present in peri-implantitis tissue. These high Ti contents in peri-implant mucosa can potentially aggravate inflammation, which might reduce the prognosis of treatment interventions.

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