Malmö University Publications
Change search
Link to record
Permanent link

Direct link
Knutsson, Kerstin
Publications (10 of 47) Show all publications
Mota de Almeida, F. J., Flygare, L., Knutsson, K. & Wolf, E. (2019). 'Seeing is believing': a qualitative approach to studying the use of cone beam computed tomography in endodontics in Sweden. (ed.). International Endodontic Journal, 52(10), 1519-1528
Open this publication in new window or tab >>'Seeing is believing': a qualitative approach to studying the use of cone beam computed tomography in endodontics in Sweden.
2019 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 52, no 10, p. 1519-1528Article in journal (Refereed) Published
Abstract [en]

Aim: To gain insight into the decision processes of dentists when requesting a cone beam computed tomography (CBCT) examination in endodontic settings. Methodology: Fourteen dentists (eight female) 33–58 years of age (mean = 44) practising in Sweden were interviewed. Ten of the dentists were specialists in Endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists comprised a strategically selected diverse sample in terms of gender, age, work experience, educational background, location of practice, service affiliation and accessibility to CBCT. Data were obtained through semistructured interviews exposing the context of their last three self‐reported referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer's open‐ended questions. The interviews were audio‐recorded and transcribed verbatim. The text was analysed by qualitative content analysis. Results: The manifest content was organized into three categories that were defined as visualization as a desire, facilitating tough decisions and allocating responsibility. Conclusion: An overall theme (covering the latent content) was identified: A balance between clinical common sense and a ‘better safe than sorry’ attitude guides the use of CBCT in endodontic settings. Informants had high clinical standards, knowledge concerning radiation risks and good sense, which could compensate for their lack of knowledge of guidelines. The national radiation regulatory system was perceived to work as a slightly porous gatekeeper for over‐usage.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
cone beam computed tomography, decision-making, endodontics, interviews, qualitative content analysis, qualitative research
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-5710 (URN)10.1111/iej.13144 (DOI)000485318200013 ()31077614 (PubMedID)2-s2.0-85067359489 (Scopus ID)28912 (Local ID)28912 (Archive number)28912 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
Mota de Almeida, F. J., Flygare, L., Knutsson, K. & Wolf, E. (2017). Circumstances behind the use of Cone Beam Computed Tomography for endodontic reasons in Sweden from the perspective of the referring dentist (ed.). Paper presented at 18th ESE (European Society of Endodontology) Biennial Congress, Brussels, Belgium (14–16 September 2017). International Endodontic Journal, 50(S1), Article ID R007.
Open this publication in new window or tab >>Circumstances behind the use of Cone Beam Computed Tomography for endodontic reasons in Sweden from the perspective of the referring dentist
2017 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 50, no S1, article id R007Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Aim: To study the circumstances preceding the CBCT examination referral for endodontic reasons in Sweden. Methodology: Fourteen dentists (8 female) 33–58 years of age (mean =44), practicing in Sweden were strategically selected. Ten of the dentists were specialists in endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists provided a variation concerning gender, age, work experience, education background, location of practice, service affiliation and accessibility to CBCT. Data was obtained through thematic, semi-structured interviews exposing the context of their last self-reported three referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer’s openended questions. The interviews were audio recorded and transcribed verbatim. Qualitative content analysis was used to analyze the text. Results: The preliminary results may indicate that high clinical diagnostic standards, clinical common sense and a willingness of helping the patient with minimal harm may restrict the use of CBCT to address complex diagnostic judgements or therapeutic decisions, which comply with existing European guidelines on the use of CBCT in endodontics. Knowledge of guidelines was however limited among the interviewed dentists. Conclusions: Common sense and high professional standards seem to lead dentists in Sweden to comply with current European guidelines for the use of CBCT in endodontics even when the den tists lack knowledge of the guidelines. Acknowledgements: This work is funded by the Norrbotten County Council.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6542 (URN)28962 (Local ID)28962 (Archive number)28962 (OAI)
Conference
18th ESE (European Society of Endodontology) Biennial Congress, Brussels, Belgium (14–16 September 2017)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-08Bibliographically approved
Milosavljevic, A., Götrick, B., Hallström, H., Stavropoulos, A. & Knutsson, K. (2016). Assessment of Prognosis and Periodontal Treatment Goals Among General Dental Practitioners and Dental Hygienists (ed.). Oral Health & Preventive Dentistry, 14(5), 433-441
Open this publication in new window or tab >>Assessment of Prognosis and Periodontal Treatment Goals Among General Dental Practitioners and Dental Hygienists
Show others...
2016 (English)In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 14, no 5, p. 433-441Article in journal (Refereed)
Abstract [en]

Purpose: To evaluate general dental practitioners' (GDPs) and dental hygienists' (DHs) assessment of prognosis, suggested treatment goals, and estimated number of treatment sessions in patients with varying severity of periodontal disease. Materials and Methods: Seventy-seven GDPs and fifty DHs in a Swedish county participated in a questionnaire study, based on three patient cases: a patient with generalised bone loss but no clinical signs of inflammation (well-maintained); a patient with clinical signs of inflammation and generalised bone loss (periodontitis); and a patient with clinical signs of inflammation but no bone loss (gingivitis). In open-ended questions, the clinicians assessed the prognosis in case of no treatment and proposed treatment goals. Furthermore, based on given fixed-alternative options, they estimated the number of treatment sessions needed for successful management of the condition. Results: Based on a response rate of 94%, the majority of clinicians expected a worsening of the periodontal condition in all three patients (well-maintained: 80%; periodontitis: 94%; gingivitis: 60%). The most common treatment goal in all 3 cases was to improve oral health awareness. The majority of clinicians estimated that the periodontitis case needed slightly more treatment sessions (mean: 3.04, 95% CI: 2.83-3.24) compared to the gingivitis (mean: 1.93, 95% CI: 1.75-2.11) or well-maintained patient case (mean: 1.84, 95% CI: 1.60-2.07). Conclusions: The majority of included clinicians did not perform an individualised risk assessment and did not individually match the number of appointments to the actual periodontal treatment needs of the patient. This may result in overtreatment in some cases and in undertreatment in others, and possibly in suboptimal use of resources.

Place, publisher, year, edition, pages
Quintessence, 2016
Keywords
treatment goals, prognosis, periodontitis, periodontal diseases, clinical decision making
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15348 (URN)10.3290/j.ohpd.a36472 (DOI)000387302900006 ()27351737 (PubMedID)2-s2.0-85012870917 (Scopus ID)23829 (Local ID)23829 (Archive number)23829 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-05-21Bibliographically approved
Mota de Almeida, F. J., Knutsson, K. & Flygare, L. (2015). The impact of cone beam computed tomography on the choice of endodontic diagnosis (ed.). International Endodontic Journal, 48(6), 564-572
Open this publication in new window or tab >>The impact of cone beam computed tomography on the choice of endodontic diagnosis
2015 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 48, no 6, p. 564-572Article in journal (Refereed) Published
Abstract [en]

AIM: To determine whether the outcome of cone beam computed tomography (CBCT) examinations performed in accordance with the European Commission guidelines in a clinical setting has an impact on choosing diagnoses in endodontics. METHODOLOGY: A prospective observational study was conducted. Fifty-three consecutive patients (81 teeth) from two different endodontic specialist clinics in Sweden were followed. After performing a thorough clinical examination (based on the history, clinical findings, and diagnostic tests such as intra-oral radiography), the examiner wrote down a preliminary diagnosis before CBCT examination. After the CBCT examination, a new diagnosis was made by the same examiner. Both the pre- and the post-CBCT examination diagnoses were plotted according to patients and teeth. The CBCT examinations were performed using similar equipment and protocols that were standardized amongst the clinics. RESULTS: The diagnoses were changed for at least one tooth in 22 patients (41%); overall, the diagnoses were changed for 28 teeth (35%). CONCLUSION: CBCT has a substantial impact on diagnostic thinking in endodontics when used in accordance with the European Commission guidelines.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
cone beam computed tomography, decision-making, endodontics, diagnosis
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-5983 (URN)10.1111/iej.12350 (DOI)000354294300009 ()25070420 (PubMedID)2-s2.0-84929134446 (Scopus ID)18907 (Local ID)18907 (Archive number)18907 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-08Bibliographically approved
Milosavljevic, A., Götrick, B., Hallström, H., Stavropoulos, A. & Knutsson, K. (2014). Assessment of prognosis and treatment goals among general dental practitioners and dental hygienists (ed.).
Open this publication in new window or tab >>Assessment of prognosis and treatment goals among general dental practitioners and dental hygienists
Show others...
2014 (English)Report (Other academic)
Abstract [en]

Introduction: Clinicians are expected to base their treatment strategies of periodontal diseases on patient history, clinical appearance, and previous experience of periodontal disease. Treatment decisions are influenced by their prognostic assessment and treatment goals. Therefore the aim was to study patterns regarding general dental practitioners (GDPs) and dental hygienists (DHs) a) assessment of prognosis, b) setting of treatment goals, and c) estimation of amount of treatment of cases with varying severity of periodontal disease. Material and Methods: Seventy-seven GDPs and 50 DHs in a Swedish county were invited to participate in a questionnaire study. The response rate was 94 %. The questionnaire included patient history, clinical charts and radiographs, of three patient cases with a varying degree of periodontal diseases. Clinicians that judged these patients as diseased assessed the prognosis, proposed treatment goals and estimated amount of treatment, i.e. number of treatment sessions. The clinicians were compared to each other regarding their prognostic assessment and estimated amount of treatment. ANOVA and Tukey´s test compared the differences in estimated amount of treatment. Results: The majority of clinicians (58-95%) assessed that a worsening of the periodontal condition (assessment of prognosis) should occur. They had different treatment goals. Regardless of the clinicians’ former prognostic assessment there were almost no differences, overall, in estimated number of treatment sessions (p>0.05). The estimated number of treatment sessions ranged from 2 to 3 sessions in all patients. Conclusions: Most clinicians assessed the prognosis as negative. All patients were estimated to require the same amount of treatment even if their periodontal condition differed significantly in severity. This could mean that patients are over- or undertreated in relation to their periodontal condition and indicates that resources are ineffectively used.

Publisher
p. 1
Keywords
Clinical decision-making, Periodontitis, Gingivitis, Periodontology, Prognosis, Treatment goals
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-16953 (URN)18058 (Local ID)18058 (Archive number)18058 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-05-21Bibliographically approved
Mota de Almeida, F. J., Knutsson, K. & Flygare, L. (2014). Diagnostic thinking and therapeutic decision confidence after cone beam computed tomography in endodontics measured by a visual analogue scale (VAS) (ed.). Paper presented at European Society of Endodontology (ESE), Lisbon, Portugal (2013). International Endodontic Journal, 47(1), 52-52, Article ID R10.
Open this publication in new window or tab >>Diagnostic thinking and therapeutic decision confidence after cone beam computed tomography in endodontics measured by a visual analogue scale (VAS)
2014 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 47, no 1, p. 52-52, article id R10Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Aim To determine if Cone Beam Computed Tomography (CBCT) used in accordance with the European Commission guidelines has an impact on the diagnostic thinking confidence and therapeutic decision confidence in a population referred for endodontic problems. Methodology The study includes data collected from October 2011 until December 2012. From two different endodontic clinics consecutive patients were referred to a CBCT examination using criteria in accordance with the European Commission guidelines. The CBCT examinations were performed with similar equipment and standardized between clinics. After a thorough clinical examination and before CBCT examination, the endodontist scored the confidence for both diagnosis and therapeutic decision on a 100 mm visual analogue scale (VAS). After the CBCT examination both diagnosis and therapy plan were revised by the same dentist and a new VAS-score of confidence was performed. The VAS-scores before and after the CBCT examination were plotted for all teeth. Before and after assessments were analyzed with paired samples t-test. Results Fifty-seven patients were referred for a CBCT examination, representing 4% of all patients examined by both endodontic clinics during the study period. Four patients were excluded from the analysis as the protocol was not followed. The final data included 53 patients, and 81 teeth. For all teeth the mean score for diagnostic confidence before CBCT examination was 63 mm (SD 30). After CBCT-examination, the mean of the changes in diagnostic confidence for each patient was 23 mm (SD 27) (P < 0.01). The mean therapeutic decision confidence score Before CBCT was 67 mm (SD 25). The mean of the changes in therapeutic decision confidence after CBCT was 22 mm (SD 28) P < 0.01. Conclusions CBCT examination used in accordance with the European Commission guidelines increased the clinician’s confidence in both diagnostic thinking and therapeutic decision in a population with endodontic problems.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
cone beam computed tomography, endodontics, visual analogue scale, confidence, decision-making, diagnosis, therapeutics
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6910 (URN)10.1111/iej.12212 (DOI)19184 (Local ID)19184 (Archive number)19184 (OAI)
Conference
European Society of Endodontology (ESE), Lisbon, Portugal (2013)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-08Bibliographically approved
Milosavljevic, A., Götrick, B., Hallström, H., Jansson, H. & Knutsson, K. (2014). Different treatment strategies are applied to patients with the same periodontal status in general dentistry (ed.). Acta Odontologica Scandinavica, 72(4), 290-297
Open this publication in new window or tab >>Different treatment strategies are applied to patients with the same periodontal status in general dentistry
Show others...
2014 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 4, p. 290-297Article in journal (Refereed) Published
Abstract [en]

Abstract Objective. To analyse how general dental practitioners (GDPs) and dental hygienists judge and plan to treat patients with different periodontal conditions. Materials and methods. Seventy-seven GDPs and 50 dental hygienists in a Swedish county, Halland, participated in a questionnaire study. The response rate was 94%. The questionnaire consisted of four simulated patient cases and an attached answer sheet. The patient cases had different periodontal status, ranging from healthy to moderate bone loss with general inflammation. The clinicians judged the periodontal status as healthy or diseased. If judged as diseased the clinicians suggested a diagnosis, selected treatment options and estimated the number of treatment sessions for each patient case. The clinicians were compared to each other regarding their judgement, as healthy or diseased, diagnostics and treatment. Results. Three out of four patients were judged both as healthy and diseased by different clinicians. If judged as diseased the patients were diagnosed as having gingivitis or periodontitis. Regardless of the clinicians' former judgement and diagnostics there were no differences (p > 0.05) in the selected treatment options but there was a difference (p < 0.05) in the suggested number of treatment sessions. Conclusions. Clinicians' judgement of the same periodontal condition, as healthy or diseased, varies, which partly results in different treatment decisions considering the number of treatment sessions. The suggested number of treatment sessions varied also between clinicians even if they judged and diagnosed the condition likewise. The willingness to treat and suggested treatment options were not influenced by the variation in judgement and diagnostics.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
clinical decision-making, gingivitis, periodontal diseases, periodontitis
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15365 (URN)10.3109/00016357.2013.824605 (DOI)000335002400006 ()24053366 (PubMedID)2-s2.0-84899007448 (Scopus ID)16462 (Local ID)16462 (Archive number)16462 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-05-21Bibliographically approved
Mota de Almeida, F. J., Knutsson, K. & Flygare, L. (2014). The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics (ed.). Dento-Maxillo-Facial Radiology, 43(4), Article ID 20130137.
Open this publication in new window or tab >>The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics
2014 (English)In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 43, no 4, article id 20130137Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. METHODS: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. RESULTS: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). CONCLUSIONS: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

Place, publisher, year, edition, pages
British Institute of Radiology, 2014
Keywords
cone beam computed tomography, decision-making, endodontics, therapeutics
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6513 (URN)10.1259/dmfr.20130137 (DOI)000335382800001 ()24766060 (PubMedID)2-s2.0-84901020193 (Scopus ID)18868 (Local ID)18868 (Archive number)18868 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-08Bibliographically approved
Lucander, H., Knutsson, K., Salé, H. & Jönsson, A. (2012). “I’ll Never Forget This”: evaluating a pilot workshop in effective communication for dental students (ed.). Journal of Dental Education, 76(10), 1311-1316
Open this publication in new window or tab >>“I’ll Never Forget This”: evaluating a pilot workshop in effective communication for dental students
2012 (English)In: Journal of Dental Education, ISSN 0022-0337, E-ISSN 1930-7837, Vol. 76, no 10, p. 1311-1316Article in journal (Refereed) Published
Abstract [en]

This study evaluated a pilot workshop for teaching communication skills to dental students. The methodology is based on an experiential learning approach, the use of realistic clinical scenarios, simulated patients, and an integrated teaching team of both educational researchers and dentists. Furthermore, the methodology was adapted for short workshops, which is thought to offer better possibilities for frequent and effective training of communication skills throughout the curriculum. The workshop was piloted with groups of six to ten students from the sixth and tenth semesters (n=94). Results show that the majority of students found the tasks meaningful and well aligned with how they perceived their future profession as dentists. Most students also thought that they learned from the task. An interesting finding is that students not only found it instructive to practice how to communicate in authentic situations, but that they generally found the workshop to be thought-provoking while at the same time providing structure and intellectual tools for the future. A possible explanation for this finding is the sharing of explicit criteria for high-quality communication.

Place, publisher, year, edition, pages
American Dental Education Association, 2012
Keywords
communication, dental education, dental students, dentist-patient relations, program evaluation, patient-simulation
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15991 (URN)10.1002/j.0022-0337.2012.76.10.tb05385.x (DOI)000309569700004 ()23066129 (PubMedID)15139 (Local ID)15139 (Archive number)15139 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-05-07Bibliographically approved
Wiese, M., Wenzel, A., Hintze, H., Petersson, A., Knutsson, K., Bakke, M., . . . Svensson, P. (2011). Influence of cross-sectional temporomandibular joint tomography on daignosis and management decisions of patients with temporomandibular joint disorders (ed.). Journal of Orofacial Pain, 25, 223-231
Open this publication in new window or tab >>Influence of cross-sectional temporomandibular joint tomography on daignosis and management decisions of patients with temporomandibular joint disorders
Show others...
2011 (English)In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 25, p. 223-231Article in journal (Refereed)
Abstract [en]

AIM: To assess whether changes in diagnoses and management of temporomandibular joint disorder (TMJD) patients are influenced by radiographic findings and if there is an association between specific radiologic alterations and management strategy changes. METHODS: A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Diagnoses and management were first decided without the aid of radiographs. Management categories were: pharmacology, physiotherapy, counseling and behavioral treatment, occlusal stabilization, surgery, additional examinations, and referrals, each with subcategories. Sagittal TMJ tomograms were assessed for the presence of flattening, erosion, osteophyte, and sclerosis in the TMJ components. Diagnoses and management were reevaluated after gaining access to the radiographs and radiographic classifications. Logistic regression analyses were performed with changes in management as the dependent variable and age and radiographic findings as the independent variables. RESULTS: Diagnosis was changed for 56 patients, mainly from arthralgia to osteoarthritis. Management was changed for 55 patients. Most changes occurred in pharmacology and physiotherapy followed by counseling and behavioral treatment, occlusal stabilization, referrals, additional examinations, and surgery. Changes were mostly within the categories, and the highest number of changes was seen in pharmacology, physiotherapy, and counseling and behavioral treatment. Radiographic degenerative findings increased the chance of change (any change) (odds ratio [OR] ⋝ 2.03) and the chance of change in pharmacology (OR ⋝ 2.56) and physiotherapy (OR = 2.48) separately. No other significant associations were found. CONCLUSION: Radiographic degenerative findings increased the chance of changes in management strategy. However, 73% of the TMJD patients had no changes in management after radiographic examination. In cases with changes, these were mainly adjustments within management categories.

Place, publisher, year, edition, pages
Quintessence, 2011
Keywords
radiography, tomography, temporomandibular joint
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15581 (URN)12418 (Local ID)12418 (Archive number)12418 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2023-07-05Bibliographically approved
Organisations

Search in DiVA

Show all publications