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  • 1.
    Ahmed, Ammar
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Optimering av personalstrålskydd vid administration av fluor-18 märkt läkemedel2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    At the Nuclear medicine department at Skane University Hospital in Malmoe, the staff inject fluorine-18 labelled radiopharmaceuticals on a daily basis, which entails exposure of radiation dose. The Swedish Radiation Protection Ordinance prescribe dose limits, which works as requirements to prevent and minimize risks for future negative health effects to the public and workers handling ionizing radiation. The aim and purpose of the study was to study whether there is a statistically significant difference of radiation dose to the staffs fingers and body, when injecting fluorine-18 labelled radiopharmaceuticals, depending on when the removal of the peripheral venous catheter (PVK) is performed. The measurements were performed after the injection of fluorine-18 labelled radiopharmaceutical and after the imaging of the patients. In this study 44 measurements were performed, of which 22 measurements were performed after the injection of 18F-labelled radiopharmaceutical and 22 measurements after the medical imaging. The measurements were performed on 11 staff members in the Nuclear Medicine department in Malmoe. The results of 22 measurements showed a mean value of the equivalent doses to the fingers after injection showed 0,20 μSv/MBq and after the medical imaging of the patient of 0,18 μSv/MBq. The mean value of effective dose was entailed to 0,004 μSv/MBq after injection and 0,003 μSv/MBq after imaging. A Mann-Whitney U-test was performed and reported a p-value of >0,05, which indicates that there is no significant difference in radiation dose to the staff between the two different methods of removing the PVK. 

  • 2. Allen, P Danny
    et al.
    Graham, Jim
    Farnell, Damian J
    Harrison, Elizabeth J
    Jacobs, Reinhilde
    Nicopolou-Karayianni, Kety
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    van der Stelt, Paul F
    Horner, Keith
    Devlin, Hugh
    Detecting reduced bone mineral density from dental radiographs using statistical shape models.2007In: IEEE transactions on information technology in biomedicine, Vol. 11, no 6, p. 601-610Article in journal (Refereed)
    Abstract [en]

    We describe a novel method of estimating reduced bone mineral density (BMD) from dental panoramic tomograms (DPTs), which show the entire mandible. Careful expert width measurement of the inferior mandibular cortex has been shown to be predictive of BMD in hip and spine osteopenia and osteoporosis. We have implemented a method of automatic measurement of the width by active shape model search, using as training data 132 DPTs of female subjects whose BMD has been established by dual-energy X-ray absorptiometry. We demonstrate that widths measured after fully automatic search are significantly correlated with BMD, and exhibit less variability than manual measurements made by different experts. The correlation is highest towards the lateral region of the mandible, in a position different from that previously employed for manual width measurement. An receiver-operator characterstic (ROC) analysis for identifying osteopenia (T < -1: BMD more than one standard deviation below that of young healthy females) gives an area under curve (AUC) value of 0.64. Using a minimal interaction to initiate active shape model (ASM) search, the measurement can be made at the optimum region of the mandible, resulting in an AUC value of 0.71. Using an independent test set, AUC for detection of osteoporosis (T < -2.5) is 0.81.

  • 3. Bergkvist, Göran
    et al.
    Koh, Kwang-Joon
    Sahlholm, Sten
    Klintström, Eva
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Bone density at implant sites and its relationship to assessment of bone quality and treatment outcome2010In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 25, no 2, p. 321-328Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the relationship between bone mineral density (BMD) before implant placement, implant stability measures at implant placement, and marginal bone loss of immediately loaded implants after 1 year in situ. MATERIALS AND METHODS: Consecutively recruited patients received Straumann SLActive implants loaded with fixed provisional prostheses within 24 hours. BMD was measured from computed tomographic images before implant placement. Alveolar bone quality was assessed during surgery. Implant stability-both rotational and as measured with resonance frequency analysis-and marginal bone height were assessed at implant placement and after 1 year. The Pearson correlation coefficient was used to calculate correlations, and significance was considered when P < .05. RESULTS: Twenty-one patients received 137 implants (87 in maxillae and 50 in mandibles). BMD was significantly correlated with bone quality classification in both arches (P < .001). Mean BMD was also significantly correlated with stability values (P < .001). Mean marginal bone loss at implant surfaces differed, but not significantly, at the 1-year follow-up, regardless of BMD values (P = .086) and measured stability (rotational stability P = .34, resonance frequency analysis P = .43) at implant placement. CONCLUSION: Within the limits of this study, it can be concluded that computed tomographic examination can be used as a preoperative method to assess jawbone density before implant placement, since density values correlate with prevailing methods of measuring implant stability. However, in the short time perspective of 1 year, there were no differences in survival rates or changes in marginal bone level between implants placed in bone tissue of different density.

  • 4.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jeppsson, Malin
    Clinic of Public Dental Service, Kävlinge, Skane County Council, Sweden.
    Lindh-Ingildsen, Lina
    Clinic of Public Dental Service, Höör, Skane County Council, Sweden.
    Rangne, Klara
    Malmö högskola, Faculty of Odontology (OD).
    Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs2006In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 76, no 1, p. 98-102Article in journal (Refereed)
    Abstract [en]

    Panoramic radiographs, in combination with a clinical examination, are routinely used as an aid to orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the prevalence and location of incidental findings of pathology and abnormalities in pretreatment orthodontic panoramic radiographs. A total of 496 patients (232 girls and 264 boys; mean age 11.2 years, SD 2.33) were randomly selected from the Orthodontic Clinic at the Faculty of Odontology, University of Malmo, Sweden. All radiographic examinations were performed between 1999 and 2003 at the Department of Oral Radiology, Faculty of Odontology, University of Malmo, Sweden. Two independent examiners analyzed the radiographs for abnormalities and diagnoses of pathology. However, caries and findings related to the orthodontic treatment plan, such as eruption disturbances and missing or supernumerary teeth, were not recorded. All radiographs with positive findings were reexamined by a third examiner, a specialist registrar in oral radiology. A total of 56 findings in 43 patients (8.7%) were recorded, and significantly more findings were detected in girls (P = .007). The most common findings were radiopacities (idiopathic sclerosis) in alveolar bone (n = 22), thickening of mucosal lining in sinus maxillaris (n = 15), and periapical inflammatory lesions (n = 10). The majority of the periapical lesions and radiopacities were found in the mandible. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require medical or odontological management. However, the clinician should be aware of the potential to detect pathology and abnormality in pretreatment orthodontic panoramic radiographs.

  • 5. Devlin, Hugh
    et al.
    Allen, Philip D
    Graham, Jim
    Jacobs, Reinhilde
    Karayianni, Kety
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    van der Stelt, Paul F
    Harrison, Elizabeth
    Adams, Judith
    Pavitt, Susan
    Horner, Keith
    Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis2007In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 40, no 4, p. 835-842Article in journal (Refereed)
    Abstract [en]

    General dental practitioners use a vast amount of panoramic radiography in their routine clinical work, but valuable information about patients' osteoporotic status is not collected. There are many reasons for this, but one of the prime reasons must be the disruption involved in clinical routine with lengthy manual radiographic assessment. We have developed computer software, based on active shape modeling that will automatically detect the mandibular cortex on panoramic radiographs, and then measure its width. Automatic or semi-automatic measurement of the cortical width will indicate the osteoporotic risk of the patient. The aim of our work was to assess the computer search technique's ability to measure the mandibular cortical width and to assess its potential for detection of osteoporosis of the hip, spine and femoral neck. Mandibular cortical width was measured using the manually initialized (semi-automatic) method and, when assessed for diagnosing osteoporosis at one of the three measurement sites, gave an area under the ROC curve (A(z))=0.816 (95% CI=0.784 to 0.845) and for the automatically initialized searches, A(z)=0.759 (95% CI=0.724 to 0.791). The difference between areas=0.057 (95% Confidence interval=0.025 to 0.089), p<0.0001. For diagnosing osteoporosis at the femoral neck, mandibular cortical width derived from the manually initialized fit gave an area under the ROC curve (A(z))=0.835 (95% CI=0.805 to 0.863) and for the automatically initialized searches A(z)=0.805 (95% CI=0.773 to 0.835). The difference in A(z) values between active shape modeling search methods=0.030 (95% CI=-0.010 to 0.070), and this was not significant, p=0.138. We concluded that measurement of mandibular cortical width using active shape modeling is capable of diagnosing skeletal osteoporosis with good diagnostic ability and repeatability. PMID: 17188590 [PubMed - indexed for MEDLINE]

  • 6. Devlin, Hugh
    et al.
    Karayianni, Keti
    Mitsea, Anastasia
    Jacobs, Reinhilde
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    van der Stelt, Paul F
    Marjanovic, Elizabeth
    Adams, Judith
    Pavitt, Susan
    Horner, Keith
    Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project2007In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 104, no 6, p. 821-828Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Measurement of cortical thickness and subjective assessment of cortical porosity on panoramic radiographs are methods previously reported for diagnosing osteoporosis. The aims of this study were to determine the relative efficacy of the mandibular cortical index and cortical width in detecting osteoporosis, both alone and in combination, and to determine the optimal cortical width threshold for referral for additional osteoporosis investigation. STUDY DESIGN: Six hundred seventy-one postmenopausal women 45 to 70 years of age were recruited for this study. They received dual energy x-ray absorptiometry (DXA) scans of the left hip and lumbar spine (L1 to L4), and dental panoramic radiographic examinations of the teeth and jaws. Three observers separately assessed the mandibular cortical width and porosity in the mental foramen region of the mandible. Cortical width was corrected for magnification errors. Chi-squared automatic interaction detection analysis (CHAID) software was used (SPSS AnswerTree, version 3.1, SPSS Inc., Chicago, IL). RESULTS: Chi-squared automatic interaction detection analysis showed that the cortical porosity was a poorer predictor of osteoporosis than mandibular cortical width. For the 3 observers, a mandibular cortical width of <3 mm provided diagnostic odds ratios of 6.51, 6.09, and 8.04. The test is therefore only recommended in triage screening of individuals by using radiographs made for purposes other than osteoporosis. CONCLUSION: When evaluating panoramic radiographs, only those patients with the thinnest mandibular cortices (i.e., <3 mm) should be referred for further osteoporosis investigation. PMID: 17428694 [PubMed - in process]

  • 7. Ellervall, Eva
    et al.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Brehmer, B
    Hur övertygade är tandläkare i sina beslut vid förskrivning av antibiotikaprofylax2007Conference paper (Other academic)
  • 8.
    Fischer, Johannes
    et al.
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Halbig, Josefine
    Public Dental Service Competence Centre of Northern-Norway (TkNN), Tromsø, Norway.
    Augdal, Thomas
    Department of Radiology, University Hospital of North Norway, Tromsø, Norway;UiT the Arctic University of North Norway, Tromsø, Norway.
    Angenete, Oskar
    Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Olav Kyrres gate, Trondheim, Norway;Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine, Trondheim, Norway.
    Stoustrup, Peter Bangsgaard
    Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark.
    Dahl Kristensen, Kasper
    Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark.
    Slåttelid Skeie, Marit
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway;Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
    Tylleskär, Karin
    The Children’s Clinic at Haukeland University Hospital, Bergen, Norway.
    Rosén, Annika
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway;Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
    Shi, Xie-Qi
    Malmö University, Faculty of Odontology (OD). Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Rosendahl, Karen
    UiT the Arctic University of North Norway, Tromsø, Norway.
    Observer agreement of imaging measurements used for evaluation of dentofacial deformity in juvenile idiopathic arthritis2022In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 51, no 6Article in journal (Refereed)
    Abstract [en]

    Objectives:To examine the precision of imaging measures commonly used to assess mandibular morphology in children and adolescents with juvenile idiopathic arthritis (JIA). Secondly, to compare cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in the measurement of condylar height.

    Methods:Those included were children diagnosed with JIA during 2015–18 who had had an MRI, a CBCT of the temporomandibular joints (TMJs) and a lateral cephalogram (ceph) of the head within one month of each other. Agreement within and between observers and methods was examined using Bland-Altman mean-difference plots and 95% limits of agreement (LOA). A 95% LOA within 15% of the sample mean was considered acceptable. Minimal detectable change (MDC) within and between observers was estimated.

    Results:90 patients (33 males) were included, with a mean age of 12.8 years. For MRI, intra- and interobserver 95% LOA were relatively narrow for total mandibular length: 9.6% of the sample mean. For CBCT, condylar height, both intra- and interobserver 95% LOA were wide: 16.0 and 28.4% of the sample mean, respectively. For ceph, both intra- and interobserver 95% LOA were narrow for the SNA-angle and gonion angle: 5.9 and 8% of the sample mean, and 6.2 and 6.8%, respectively.

    Conclusions:We have identified a set of precise measurements for facial morphology assessments in JIA, including one MRI-based (total mandibular length), one CBCT-based (condylar height), and three ceph-based. Condylar height was higher for MRI than for CBCT; however, the measurement was too imprecise for clinical use. MDC was also determined for a series of measurements.

  • 9. Geraets, Wil G
    et al.
    Verheij, Johannes G
    van der Stelt, Paul F
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Horner, Keith
    Nicopoulou-Karayianni, Kety
    Jacobs, Reinhilde
    Devlin, Hugh
    Osteoporosis and the general dental practitioner: reliability of some digital dental radiological measures2007In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 35, no 6, p. 465-471Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Dental radiographs are relatively inexpensive and are regularly made of a large fraction of the adult population; therefore, they represent an enormous potential as a screening tool for osteoporosis. Monitoring the population by means of dual X-ray absorptiometry (DXA), which is currently the most accepted method for diagnosing osteoporosis, involves enormous costs and facilities. In previous studies, it was shown that the radiographic trabecular pattern shows correlations with the bone mineral density (BMD) as measured by DXA. The objective of this study was to assess the reproducibility of the quantitative analysis of the trabecular pattern on dental radiographs. METHODS: Six regions of interest were selected manually on three digital radiographic images of 20 women. This process was performed 10 times resulting in 1200 image samples. For each image sample 26 parameters were measured. The reliability of the parameters was evaluated by means of Cronbach's alpha. RESULTS: Of the values of Cronbach's alpha 83% is at least 0.9 and 99% is at least 0.8. CONCLUSIONS: The measurements of the parameters used in this study are very reproducible. Therefore, the manual selection of the regions of interest does not introduce large amounts of noise. The imaging parameters potentially offer an accurate tool for the prediction of BMD values. PMID: 18039288 [PubMed - in process]

  • 10. Geraets, Wil G
    et al.
    Verheij, Johannes GC
    van der Stelt, Paul F
    Horner, Keith
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Nicopoulou-Karayianni, Kety
    Jacobs, Reinhilde
    Harrison, Elizabeth
    Adams, Judith
    Devlin, Hugh
    Prediction of bone mineral density with dental radiographs2007In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 40, no 5, p. 1217-1221Article in journal (Refereed)
    Abstract [en]

    There is consensus to use the bone mineral density (BMD) for the operational definition of the degree of osteoporosis and the risk of osteoporotic fractures. Dual X-ray absorptiometry (DXA) is the common technique to determine BMD. Because of high costs and limited availability of DXA equipment it is worthwhile to look for alternative diagnostic techniques. As part of a larger study, the Osteodent project, we investigated if the trabecular pattern on dental radiographs can be used to predict BMD and to identify the subjects with osteoporosis and increased risk of osteoporotic fractures. In four clinical centers 671 women with an average age of 55 years were recruited. BMD values were measured by DXA equipment at the femoral neck, total hip, and spine. One panoramic and two intraoral radiographs were made. From 525 women a complete set of BMD values and radiographs was obtained. Four regions of interest on the radiographs were selected manually and then processed automatically. On all regions of interest mean and standard deviation of the gray values were measured and several features describing the shape of the binarized trabecular pattern. Multiple regression was used to predict BMD of total hip and spine by means of the radiographic measurements combined with age. It was found that age accounts for 10% of the variation in total hip BMD and 14% of the variation in spinal BMD. When all measurements on the dental radiographs are used the explained variation increases to 22% and 23%. The areas under the ROC curves are comparable to those of commonly used screening instruments for osteoporosis. It is concluded that prediction of DXA measurements of BMD by means of quantitative analysis of the trabecular pattern on dental radiographs is feasible. PMID: 17317351 [PubMed - indexed for MEDLINE]

  • 11. Gunnarsson, Maria
    et al.
    Leide-Svegborn, S
    Malmö högskola, Faculty of Health and Society (HS).
    Stenström, K
    Skog, G
    Nilsson, LE
    Hellborg, R
    Mattsson, S
    No radiation protection reasons for restrictions on 14C urea breath tests in children2002In: British Journal of Radiology, ISSN 0007-1285, E-ISSN 1748-880X, Vol. 75, no 900, p. 982-986Article in journal (Refereed)
  • 12.
    Hellén-Halme, Kristina
    Malmö högskola, Faculty of Odontology (OD).
    Quality Aspects of Digital Radiography in General Dental Practice2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    ABSTRACTThe number of dentists who have converted from conventional film radiography to digital radiography continues to grow. A digital system has numerous advantages, but there are also many new aspects to consider. The overall aim of this thesis was to study how digital radiography was used in general dental practices. The specific aims were to study how different factors affected image quality.To determine whether there were any differences in image quality between conventional film radiographs and digital radiographs, 4863 images (540 cases) were evaluated. The cases had been sent to the Swedish Dental Insurance Office for prior treatment approval. The image quality of digital radiographs was found to be significantly lower than that of film radiographs. This result led to a questionnaire study of dentists experienced in digital radiography. In 2003, a questionnaire was sent to the 139 general practice dentists who worked with digital radiography in Skåne, Sweden; the response rate was 94%. Many general practice dentists had experienced several problems (65%), and less than half of the digital systems (40%) underwent some kind of quality control. One of the weaker links in the technical chain of digital radiography appeared to be the monitor. A field study to 19 dentists at their clinics found that the brightness and contrast settings of the monitors had to be adjusted to obtain the subjectively best image quality. The ambient light in the evaluation room was also found to affect the diagnostic outcome of low-contrast patterns in radiographs.To evaluate the effects of ambient light and technical adjustments of the monitor, a study using standardised set-ups was designed. Seven observers evaluated radiographs of 100 extracted human teeth for approximal caries under five different combinations of brightness and contrast settings on two different occasions with high and low ambient light levels in the evaluation room. The ability to diagnose carious lesions was found to be significantly better in a room with lower ambient light and on a monitor with well-adjusted brightness and contrast values than in a room with bright light and on an unadjusted monitor.In conclusion, many problems with dental digital radiography were identified. Knowledge of digital techniques and how to optimise each link in the system to maintain high radiographic quality at all times must be improved.

  • 13.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Digital radiography in general dental practice. A field study2007In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 36, no 5, p. 249-255Article in journal (Refereed)
    Abstract [en]

    Abstract Objectives: The aim of this study was to conduct a field study to survey the performance of digital radiography and how it was used by dentists in general dental practice. Methods: Nineteen general dental practitioners were visited at their clinics. Ambient light (illuminance) was measured in the rooms where the monitors were placed. Different technical display parameters were noted. Test images and two phantoms—one low-contrast phantom and one line-pair resolution phantom—were used to evaluate the digital system. How the dentists used the enhancement program was investigated by noting which functions were used. Results: Average illuminance in the operating room was 668 lux (range 190–1250 lux). On radiographs of the low-contrast phantom taken at the clinic, the ability to observe the holes decreased as illuminance increased. On average, the “light percentage” initially set on the monitor had to be decreased by 17% and contrast by 10% to optimise the display of the test images. The general dental practitioners used the enhancement programs most often to alter brightness and contrast to obtain the subjectively best image. Large differences between the clinics were noted. Conclusion: Knowledge of how to handle digital equipment in general dental practice should be improved. A calibrated monitor of good quality should be a given priority, as should proper ambient light conditions. There is a need to develop standardised quality controls for digital dental radiography. Key-words: display monitor, enhancement program, digital radiography, quality

  • 14.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Digital röntgen2008In: Digitala kliniken, Gothia Förlag AB, 2008, p. 29-41Chapter in book (Other academic)
  • 15. Horner, Keith
    et al.
    Allen, Philip
    Graham, Jim
    Jacobs, Reinhilde
    Boonen, Steven
    Pavitt, Susan
    Nackaerts, Olivia
    Marjanovic, Elizabeth
    Adams, Judith
    Karayianni, Kety
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    van der Stelt, Paul
    Devlin, Hugh
    The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX2010In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 110, no 2, p. 243-249Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The OSTEODENT index is a predicted probability of osteoporosis derived from a combination of an automated analysis of a dental panoramic radiograph and clinical information. This index has been proposed as a suitable case-finding tool for identification of subjects with osteoporosis in primary dental care; however, no data exist on the relationship between OSTEODENT index and fracture risk. The aims of this study were to assess the relationship between the OSTEODENT index and hip fracture risk as determined by FRAX and to compare the performance of the OSTEODENT index and FRAX (without femoral BMD data), in determining the need for intervention as recommended in UK national treatment guidance. STUDY DESIGN: The study was a retrospective analysis of data from 339 female subjects (mean age 55.3 years), from 2 centers: Manchester (UK) and Leuven (Belgium). Clinical information and femoral neck BMD were available for FRAX, and dental panoramic radiographic data and clinical information were available to calculate the OSTEODENT index. Subjects were classified into "treat" or "lifestyle advice and reassurance" categories using the National Osteoporosis Guideline Group (NOGG) threshold. RESULTS: The OSTEODENT index result was significantly related to the 10-year probability of hip fracture derived from the reference standard FRAX tool (Rs = 0.67, P < .0001); 84 patients (24.8%) were allocated to the "treat" category on the basis of FRAX and the UK national guidance. Using this "treatment/no treatment" classification as the reference standard, ROC analysis showed no significant difference between areas under the curves for the OSTEODENT index (0.815) and the 10-year probability of hip fracture derived from the FRAX index without BMD (0.825) when used as tests for determining therapeutic intervention. CONCLUSION: The results suggest that the OSTEODENT index has value in prediction of hip fracture risk. Prospective trials are needed to confirm this finding and to examine the feasibility for its use in primary dental care.

  • 16. Horner, Keith
    et al.
    Karayianni, Kety
    Mitsea, Anastasia
    Berkas, Leonidas
    Mastoris, Michael
    Jacobs, Reinhilde
    van der Stelt, Paul
    Marjanovic, Elizabeth
    Adams, Judith
    Pavitt, Susan
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Devlin, Hugh
    The mandibular cortex on radiographs as a tool for osteoporosis risk assessment: the OSTEODENT Project2007In: Journal of clinical densitometry, ISSN 1094-6950, E-ISSN 1559-0747, Vol. 10, no 2, p. 138-146Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to measure the accuracy of porosity of the mandibular cortex on dental panoramic radiographs (DPRs) in diagnosis of osteoporosis, alone and in combination with a clinical risk index. Six hundred seventy-one women (45-70yr) were recruited in the study, and dual-energy X-ray absorptiometry of the hip and lumbar spine was performed. A clinical index of osteoporosis risk (OSIRIS) and a DPR were obtained for each subject. The cortical appearance on the DPR was classified using the mandibular cortical index (MCI) by 5 observers. receiver operating characteristic (ROC) curve analysis was performed with calculation of area under the ROC curve (AUC) and sensitivity and specificity at various thresholds. Complete data were available for 653 subjects, of whom 21.6% had osteoporosis. The AUC for OSIRIS was 0.838. When used alone as the diagnostic test, MCI AUC for the 5 observers ranged from 0.560 to 0.670, significantly less than OSIRIS. Intraobserver and interobserver repeatability of MCI assessment was inconsistent. We conclude that MCI has limited value for osteoporosis diagnosis, being most appropriate as a method of fortuitous case-finding. PMID: 17449308 [PubMed - in process]

  • 17. Ivanauskaite, Deimante
    et al.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rangne, Klara
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Comparison between Scanora panoramic radiography and bitewing radiography in the assessment of marginal bone tissue2006In: Stomatologija, Baltic Dental and Maxillofacial Journal, ISSN 1392-8589, E-ISSN 1822-301X, Vol. 8, no 1, p. 9-15Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare panoramic radiographs made with the Scanora dental program and bitewing radiographs in the assessment of marginal bone tissue. MATERIALS AND METHODS: Panoramic and posterior bitewing radiographs were made for 96 consecutive patients. Six observers assessed marginal bone level, and five observers identified the presence or absence of vertical bone defects and furcation involvements. Observer agreement was calculated. RESULTS: Assessments of the marginal bone level with the two methods were identical for 57% of the sites. If a difference of one score was allowed, assessments for 95% of the sites were in agreement. Vertical bone defects and furcation involvement were detected with an agreement of 93%. Ranges of kappa indexes for intra-observer agreement on assessments of the marginal bone level were 0.37-0.46 in panoramic radiography and 0.31-0.55 in bitewing radiography. Ranges for agreement on detection of vertical bone defects were 0.52-0.63 and 0.47-0.56 and on detection of furcation involvements 0.64-0.79 and 0.66-0.77, respectively. The kappa index for inter-observer agreement on marginal bone level was 0.28 for panoramic and 0.29 for bitewing radiography. Corresponding figures for detection of vertical bone defects were 0.38 and 0.35 and for detection of furcation involvement 0.56 and 0.67. CONCLUSIONS: For those sites or teeth that are possible to assess, the diagnostic information available with Scanora panoramic radiography is comparable to that with bitewing radiography for marginal bone tissue. Therefore, Scanora dental panoramic radiography is a valuable diagnostic alternative in the primary examination of the periodontal status.

  • 18. Klein, T.
    et al.
    Hansson, Mattias
    Malmö högskola, School of Technology (TS).
    Karamalis, A.
    Navab, N.
    Registration of RF Ultrasound Data Using Hybrid Local Binary Patterns2012In: 2012 9TH IEEE International Symposium on Biomedical Imaging (ISBI), IEEE , 2012, p. 1072-1075Conference paper (Refereed)
    Abstract [en]

    Registration of ultrasound images is often complicated due to inherent noise. Robust similarity metrics and optimization procedures are required to facilitate medical applicability. In this paper a novel hybrid procedure, incorporating global statistics and local textural features, is proposed for the registration of envelope detected radio frequency ultrasound data. On the global scale this is achieved by Hellinger distance between distribution in images, and on the local scale by a statistics-based extension of Fuzzy Local Binary Patterns (FLBP). The proposed procedure is shown to outperform standard measures such as SSD and NCC, as well as Hellinger distance and histogram matching of standard FLBPs, in rigid registration experiments of envelope detected radio frequency data samples of the human neck.

  • 19.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Development of education for PhD- supervision.2007Conference paper (Other (popular science, discussion, etc.))
  • 20.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Diagnostic efficacy of direct digital intraoral radiography in caries detection.2007Conference paper (Other (popular science, discussion, etc.))
  • 21.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Professionsforskning2007Conference paper (Other academic)
  • 22.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    The initiating of education for PhD-supervision at Malmö University.2007Conference paper (Other (popular science, discussion, etc.))
  • 23.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Advanced dross sectional imaging in lesions of the teeth and jaws2007Conference paper (Other (popular science, discussion, etc.))
  • 24.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Definitions of bone tissue characteristics presented in studies on dental implant planning and placement. A systematic review2007Conference paper (Refereed)
  • 25.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement: a systematic literature review2007In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 22, no 2, p. 289-300Article, review/survey (Other academic)
    Abstract [en]

    PURPOSE: To evaluate the evidence for the diagnostic accuracy of clinical methods to assess bone density, quantity, or quality prior to and during dental implant placement. MATERIALS AND METHODS: A PubMed literature search with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, 3 reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 145 titles and abstracts, of which 71 were selected and read in full text. Seven studies were judged relevant. In 1 study, no method was presented as the test method. In 6 studies, the results of the test method were compared to those of a reference method. However, only 1 study presented the results in terms of percentage of correct diagnoses. In that study, the use of periapical radiography together with reference images yielded correct assessment of the trabecular pattern of the mandible in 3 categories in 58% of the sites. The kappa index of interobserver agreement was 0.35 and intraobserver agreement was 0.67. Corresponding kappa values for 4 classes of bone quality presented by Lekholm and Zarb were 0.33 and 0.43, respectively. No study examined the accuracy of the method originally described by Lekholm and Zarb. CONCLUSION: The evidence for the efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement is sparse. This emphasizes the need for studies that incorporate accepted methodologic criteria for diagnostic efficacy. PMID: 17465355 [PubMed - indexed for MEDLINE]

  • 26.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Takano, Y
    Diagnostic Efficacy of Direct Digital Intraoral Radiography Prior to and During Endodontic Treatment. A systematic literature review2007Conference paper (Refereed)
  • 27. Nackaerts, Olivia
    et al.
    Jacobs, Reinhilde
    Horner, Keith
    Zhao, F
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Karayianni, Kety
    van der Stelt, Paul F
    Pavitt, Susan
    Devlin, Hugh
    Bone density measurements in intra-oral radiographs.2007In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 11, no 3, p. 225-229Article in journal (Refereed)
    Abstract [en]

    Oral Imaging Center, Department of Dentistry, Faculty of Medicine, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium. Jaw bone density measurements are applicable in many clinical situations to assess bone tissue. To be able to implement research findings in clinical reality, tools must be simple and low cost. Intra-oral radiographs including a reference material perform well as a densitometric tool. However, the inclusion of a reference material, usually in the form of a metal wedge, is an additional burden for the dentist. The aim of this study was to evaluate whether a reference step wedge is required for accurate densitometric results. Dual energy X-ray absorptiometry measurements and densitometric measurements on intra-oral radiographs using a custom-made software were performed on bone samples from the premolar region of the mandible. Observer agreement of bone density expressed as grey value was high. The correlation between mandibular bone mineral density and the densitometric values on intra-oral radiographs was substantially higher when the aluminium step wedge was included. The Wilcoxon test revealed no significant difference between the density measurements using nine or three steps of the Al reference wedge. Density determination of grey value and mm Aleq thickness value both have good intra- and inter-observer agreement. However, jaw bone densitometry is far more accurate when including a reference wedge. PMID: 17668257 [PubMed - indexed for MEDLINE]

  • 28. Ribeiro-Rotta, Rejane Faria
    et al.
    Pereira, Andrea Castro
    Oliveira, Guilherme Henrique Costa
    Freire, Maria do Carmo Mathias
    Leles, Cláudio Rodrigues
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    An exploratory survey of diagnostic methods for bone quality assessment used by Brazilian dental implant specialists2010In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 37, no 9, p. 698-703Article in journal (Refereed)
    Abstract [en]

    Bone quality (BQ) has been described as an important predictor for the outcome of dental implant treatment. It is, however, unclear how this factor is assessed in the dental practice routine. The aim of this study was to investigate what Brazilian dental implant specialists know and understand about BQ, if they include BQ assessments in their treatment planning and which methods they use to assess BQ. A questionnaire was posted to Brazilian dental implant specialists, containing open and closed questions about their knowledge and understanding of BQ assessment, and 221 answered the questionnaire. Data were gathered and methods for BQ assessment were grouped using hierarchical cluster analysis. Answers about BQ knowledge and understanding were categorized into quantity of cortical and marrow bone (n = 72), density (n = 55), type of bone (n = 35), bone height (n = 30), bone thickness (n = 27), primary stability (n = 24) and other less common categories. BQ assessment was judged relevant to be considered a selection criterion for implant treatment. Overall frequency analysis showed that methods were roughly divided into usual (n > 170) and unusual methods (n < 9). Cluster analysis grouped BQ assessment methods into four clusters: unusual methods (DEXA, resonance frequency, Periotest and occlusal radiography), perioperative methods (peak insertion torque and tactile perception), sectional imaging (computed tomography) and plain films (periapical and panoramic radiographs). No consensus on BQ understanding or the clinical application of methods to assess BQ was found in this survey. The selection of methods shows a clear natural grouping from basic to advanced strategies for BQ assessment by Brazilian specialists in dental implants.

  • 29. Takano, Yumi
    et al.
    Honda, Kazuya
    Kashima, Masahiro
    Yotsui, Yoritaka
    Igarashi, Chinami
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Magnetic Resonance Imaging of the Temporomandibular Joint: a Study of Inter- and Intraobserver Agreement2004In: Oral Radiology/Springer, ISSN 0911-6028, E-ISSN 1613-9674, Vol. 20, no 2, p. 62-67Article in journal (Other academic)
    Abstract [en]

    Objective. The purpose of this study was to estimate the inter- and intraobserver agreement for interpreting magnetic resonance (MR) images of the temporomandibular joint (TMJ). Methods. The study was based on MR images of 30 TMJs. The images were interpreted by seven observers for disk configuration, disk position, joint fluid, bone marrow changes, and diagnosis. The observers were not calibrated. Kappa statistics were used. Results. The kappa values were, for interobserver agreement of disk configuration, 0.10; for disk position in the sagittal plane with closed mouth, 0.35; for a combination of closed mouth and open mouth, 0.44; for disk position in the coronal plane, 0.17; for joint fluid 0.36; for bone marrow changes, 0.01; and for diagnosis, 0.39. Intraobserver agreement was generally higher than interobserver agreement. Conclusion. Agreement on disk position in the sagittal plane, on presence and amount of joint fluid, and on diagnosis was fair to moderate. Agreement on disk configuration, on disk position in the coronal plane, and on bone marrow changes was poor.

  • 30. Wallnöfer, E A
    et al.
    Thurner, G C
    Kremser, C
    Talasz, H
    Stollenwerk, Maria Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Helbok, A
    Klammsteiner, N
    Albrecht-Schgoer, K
    Dietrich, H
    Jaschke, W
    Debbage, P
    Albumin-based nanoparticles as contrast medium for MRI: vascular imaging, tissue and cell interactions, and pharmacokinetics of second-generation nanoparticles2021In: Histochemistry and Cell Biology, ISSN 0948-6143, E-ISSN 1432-119X, Vol. 155, p. 19-73Article in journal (Refereed)
    Abstract [en]

    This multidisciplinary study examined the pharmacokinetics of nanoparticles based on albumin-DTPA-gadolinium chelates, testing the hypothesis that these nanoparticles create a stronger vessel signal than conventional gadolinium-based contrast agents and exploring if they are safe for clinical use. Nanoparticles based on human serum albumin, bearing gadolinium and designed for use in magnetic resonance imaging, were used to generate magnet resonance images (MRI) of the vascular system in rats ("blood pool imaging"). At the low nanoparticle doses used for radionuclide imaging, nanoparticle-associated metals were cleared from the blood into the liver during the first 4 h after nanoparticle application. At the higher doses required for MRI, the liver became saturated and kidney and spleen acted as additional sinks for the metals, and accounted for most processing of the nanoparticles. The multiple components of the nanoparticles were cleared independently of one another. Albumin was detected in liver, spleen, and kidneys for up to 2 days after intravenous injection. Gadolinium was retained in the liver, kidneys, and spleen in significant concentrations for much longer. Gadolinium was present as significant fractions of initial dose for longer than 2 weeks after application, and gadolinium clearance was only complete after 6 weeks. Our analysis could not account quantitatively for the full dose of gadolinium that was applied, but numerous organs were found to contain gadolinium in the collagen of their connective tissues. Multiple lines of evidence indicated intracellular processing opening the DTPA chelates and leading to gadolinium long-term storage, in particular inside lysosomes. Turnover of the stored gadolinium was found to occur in soluble form in the kidneys, the liver, and the colon for up to 3 weeks after application. Gadolinium overload poses a significant hazard due to the high toxicity of free gadolinium ions. We discuss the relevance of our findings to gadolinium-deposition diseases.

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