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  • 1. Adern, Bengt
    et al.
    Minston, Ava
    Nohlert, Eva
    Tegelberg, Åke
    Malmö University, Faculty of Odontology (OD).
    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
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    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. Ahl, Magnus
    et al.
    Marcusson, Agneta
    Ulander, Martin
    Magnusson, Anders
    Cardemil, Carina
    Larsson, Pernilla
    Malmö University, Faculty of Odontology (OD).
    Translation and validation of the English-language instrument Orthognathic Quality of Life Questionair into Swedish2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 1, p. 19-24Article in journal (Refereed)
    Abstract [en]

    Introduction: In orthognathic surgery, understanding the patient’s motives for treatment is a key factor for postoperative patient satisfaction and treatment success. In countries/systems where orthognathic surgery is funded by public means, patients are referred mainly due to functional problems, although studies of quality of life related changes after treatment indicate that psychosocial and aesthetic reasons might be equal or more important for the patient. There is no available validated condition specific instruments in the Swedish language for quality of life evaluation of patients with dentofacial deformities. Aims/objectives: Cross cultural translation and adaptation of the English-language instrument ‘Orthognathic Quality of Life Questionnaire’ (OQLQ) into Swedish. Methods: OQLQ was translated into Swedish. A total of 121 patients in four groups were recruited and the Swedish version of the OQLQ (OQLQ-S) was tested by psychometric methods. Reliability was assessed by internal consistency and test–retest reliability. Validity was evaluated by face, convergent and discriminant validity. Results/findings and conclusions: OQLQ-S is reliable and showed good construct validity and internal consistency and can be used in a Swedish speaking population as a complement to clinical variables to evaluate patients with dentofacial deformity.

  • 4.
    Ahlgren, Camilla
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Molin, Margareta
    Malmö högskola, Faculty of Odontology (OD).
    Lundin, Thomas
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Levels of gold in plasma after dental gold inlay insertion.2007In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 6, p. 331-334Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Several studies have reported increased levels of gold (Au) in the blood of patients with dental gold restorations. This study analyzed gold levels in blood plasma before dental gold inlay insertion, 0-12 months after, and 15 years after. MATERIAL AND METHODS: Plasma samples from 9 patients were taken before and 0-10 months after gold inlay insertion. Fifteen years after gold inlay insertion, further blood samples taken from 8 of these patients were analyzed for gold using inductively coupled plasma mass spectrometry. An oral examination was also carried out before and 15 years after gold inlay insertion. RESULTS: Gold levels in plasma were significantly higher 0-12 months after gold inlay insertion than before treatment (p=0.008). No significant difference in gold plasma levels was found between 0-12 months after and 15 years after insertion (p=0.109), although there was a significant correlation between the number of gold alloy surfaces and the amount of gold in plasma 15 years after insertion (p=0.028). CONCLUSIONS: This study supports a dose-related release of gold into plasma from dental gold restorations, a release that appears to be stable over time.

  • 5. Ahmed, Naveen
    et al.
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Anca, Catrina I.
    Mustafa, Hamid
    Alstergren, Per
    Malmö högskola, Faculty of Odontology (OD).
    Tumor necrosis factor mediates temporomandibular joint bone tissue resorption in rheumatoid arthritis2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 3, p. 232-240Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate if TNF, IL-1 or their endogenous controls, in relation to ACPA, are associated with radiological signs of ongoing temporomandibular joint (TMJ) bone tissue resorption and disc displacement in RA patients. METHODS: Twenty-two consecutive outpatients with TMJ of RA were included. Systemic inflammatory activity was assessed by DAS28. The number of painful regions in the body and ESR, CRP, RF and ACPA were analyzed. TMJ synovial fluid and blood samples were obtained and analyzed for TNF, TNFsRII, IL-1ra, IL-1sRII and ACPA. The ratios between the mediators and their endogenous control receptors were used in the statistical analysis. Magnetic resonance imaging was performed in closed- and open-mouth positions and evaluated regarding disc position and presence of condylar and temporal erosions of the TMJ. RESULTS: A high TNF level in relation to TNFsRII in TMJ synovial fluid correlated to the degree of TMJ condylar erosion. A high IL-1ra level in relation to TNF in TMJ synovial fluid was also correlated to the degree of TMJ condylar erosion. The total degree of TMJ condylar erosion was correlated with the number of painful regions. CONCLUSION: This study indicates that TNF in TMJ synovial fluid mediates TMJ cartilage and bone tissue resorption in RA. The study also suggests that the degree of endogenous cytokine control is of importance for development of bone tissue destruction.

  • 6. Ahnlide, Ingela
    et al.
    Ahlgren, Camilla
    Malmö högskola, Faculty of Odontology (OD).
    Björkner, Bert
    Bruze, Magnus
    Lundh, Thomas
    Möller, Halvor
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Schütz, Andrejs
    Gold concentration in blood in relation to the number of gold restorations and contact allergy to gold.2002In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 5, p. 301-5Article in journal (Refereed)
    Abstract [en]

    Previous studies have demonstrated an association between gold allergy and the presence of dental gold restorations. The aim of the present study was to investigate the relationship between the concentration of gold in blood (B-Au) and the number of tooth surfaces with gold alloys in subjects with and without contact allergy to gold. In 80 patients referred for patch testing because of eczematous disease, blood samples were taken and analyzed for B-Au using inductively coupled plasma mass spectrometry. The detection limit for the Au determination was 0.04 microg/L. In addition, a dentist made a clinical and radiological examination of the patients and registered the number of dental gold surfaces. Patients with dental gold restorations had a statistically significantly higher B-Au in Mann-Whitney U test (P = 0.025), (range < 0.04-1.07 microg/L) than patients without (range < 0.04-0.15 microg/L). Furthermore, a positive correlation was found between B-Au and the number of dental gold surfaces (P < 0.01). There was no statistically significant difference in B-Au between persons with and without contact allergy to gold. The study thus indicates that gold is released from dental restorations and taken tip into the circulation.

  • 7.
    Aidoukovitch, Alexandra
    et al.
    Lund University; Folktandvården Skåne.
    Bankell, Elisabeth
    Lund University.
    Davies, Julia R
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Nilsson, Bengt-Olof
    Lund University.
    Exogenous LL-37 but not homogenates of desquamated oral epithelial cells shows activity against Streptococcus mutans2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 6, p. 466-472Article in journal (Refereed)
    Abstract [en]

    Objective:  The antimicrobial peptide hCAP18/LL-37 is detected in desquamated epithelial cells of human whole saliva, but the functional importance of this pool of hCAP18/LL-37 is not understood. Here, we assess the impact of homogenates of desquamated oral epithelial cells and exogenous, synthetic LL-37 on two oral bacteria: S. mutans and S. gordonii.

    Material and methods:  Desquamated epithelial cells of unstimulated whole saliva were isolated and cellular and extracellular levels of hCAP18/LL-37 analyzed by ELISA. Bacterial viability was determined by BacLight Live/Dead staining and confocal laser scanning microscopy.

    Results:  Desquamated oral epithelial cells harboured hCAP18/LL-37, and they spontaneously released/leaked the peptide to their medium. Exogenous, synthetic LL-37 showed cytotoxic activity against S. mutans but not S gordonii, suggesting that LL-37 acts differentially on these two types of oral bacteria. Homogenates of desquamated oral epithelial cells had no effect on S. mutans viability. Treatment with exogenous, synthetic LL-37 (8 and 10 μM) reduced S. mutans viability, whereas lower concentrations (0.1 and 1 µM) of the peptide lacked effect.

    Conclusions:  Desquamated oral epithelial cells contain hCAP18/LL-37, but their cellular levels of hCAP18/LL-37 are too low to affect S. mutans viability, whereas exogenous, synthetic LL-37 has a strong effect on these bacteria.

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  • 8. Al-Khotani, Amal
    et al.
    Björnsson, Olof
    Naimi-Akbar, Aron
    Christidis, Nikolaos
    Alstergren, Per
    Malmö högskola, Faculty of Odontology (OD).
    Study on self-assessment regarding knowledge of temporomandibular disorders in children/adolescents by Swedish and Saudi Arabian dentists2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 7, p. 522-529Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To estimate the degree of self-assessed knowledge among dentists in Sweden and Saudi Arabia regarding temporomandibular disorders (TMD) in children and adolescents using a summative form of assessment and further to investigate the possible factors that may influence the self-assessed knowledge. MATERIALS AND METHODS: A questionnaire survey covering four domains (Etiology; Diagnosis and classification; Chronic pain and pain behavior; Treatment and prognosis) regarding TMD knowledge was used. Out of 250 questionnaires (125 in each country) a total of 65 (52%) were returned in Sweden and 104 (83%) in Saudi Arabia. RESULTS: Self-assessed individual knowledge was significantly associated to the level of actual knowledge among the Swedish groups in the domains Etiology; Diagnosis and classification and Treatment and prognosis (p < 0.05). However, in the Saudi Arabian groups a corresponding significant association was only found in the domain Diagnosis and classification (p < 0.05). CONCLUSIONS: This study showed that there is a difference in the accuracy of self-assessment of own knowledge between the dentists in Sweden and Saudi Arabia. The Swedish dentists have a better ability to assess their level of knowledge compared to Saudi Arabian dentists regarding TMD in children and adolescents. This difference could be related to several factors such as motivation, positive feedback, reflection, psychomotor, and interpersonal skills, which all are more dominant in the Swedish educational tradition.

  • 9. Axelsson, Susanna
    et al.
    Söder, Birgitta
    Nordenram, Gunilla
    Petersson, Lars G
    Dahlgren, Helen
    Norlund, Anders
    Malmö högskola, Faculty of Odontology (OD).
    Källestal, Carina
    Lingström, Peter
    Lagerlöf, Folke
    Holm, Anna-Karin
    Mejàre, Ingegerd
    Twetman, Svante
    Effect of Combined Caries-preventive Methods: A Systematic Review of Controlled Clinical Trials2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 3, p. 163-169Article, review/survey (Other academic)
    Abstract [en]

    The aim of this systematic review was to evaluate the caries-preventive effect of combined caries-preventive methods, defined as two or more different interventions in combination, each expected to prevent dental caries. The Medline database was searched for articles published in the period January 1966 to June 2003. Twenty-four controlled studies met the inclusion criteria, and their value as evidence was assessed ac-cording to predetermined criteria. The level of evidence for the overall conclusion regarding each method was graded according to the proto-col of the Swedish Council on Technology Assessment in Health Care. The scientific evidence for the combination of treatments involving fluoride that had a preventive effect on caries in children and adoles-cents was graded as moderate. However, for elderly patients the scien-tific evidence for the caries-preventive effect of different combinations of treatments was found to be incomplete. No conclusion could be drawn regarding the evidence for combinations of treatments being effective for groups at high caries risk, as the results from the identi-fied clinical studies were conflicting.

  • 10.
    Ayala-Luis, Joselyn
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Johansson, Veronica
    Malmö högskola, Faculty of Odontology (OD).
    Sampogna, Francesca
    Axtelius, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    A multivariable analysis of patient dental satisfaction and oral health-related quality-of-life: A cross-sectional study based on DVSS and OHIP-142014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 3, p. 187-193Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this paper was to study the association between dental satisfaction and oral health-related quality-of-life (OHRQoL) when controlling for individual, clinical and psychological factors. Materials. Secondary analysis was conducted using data from a large study carried out in the Swedish region of Varmland in 2004. The questionnaire included demographic variables, clinical assessment and the following instruments: the Dental Visit Satisfaction Scale (DVSS), the short version of Oral Health Impact Profile (OHIP-14) and a modified version of the revised helping alliance questionnaire. Internal consistency analysis was undertaken on the instruments to assess reliability; bivariate comparisons were assessed to compare DVSS scores with individual factors (age, gender and education). In addition, a three step hierarchical multiple regression analysis was performed with DVSS as a dependent variable. Results. Data were completed for 485 randomly selected patients. The mean age of participants was 43.5 years, 54.6% were women, and 41.2% had high education. The median DVSS score was 48 (range 10-50) and the median OHIP was 3.0 (range 0-56). All the instruments showed good reliability. Bivariate analysis showed that females were more satisfied than males (p <= 0.01) and patients of 50 years or older were more satisfied than the younger ones (p <= 0.05). Finally, the following variables explained 31% of the variance of being very satisfied with dental visit: a good OHRQoL and patients' positive perceptions of the relationship with their care provider. Conclusion. This study showed positive associations between dental satisfaction and OHRQoL when controlling for related factors. The result suggests that care providers should take into account the various dimensions of OHRQoL rather than use only clinical measurements when they evaluate patient satisfaction.

  • 11. Barzangi, Jir
    et al.
    Unell, Lennart
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Arnrup, Kristina
    Infant dental enucleation: A literature review on a traditional remedial practice in East Africa2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 3, p. 168-178Article, review/survey (Refereed)
    Abstract [en]

    Objective. To summarize and review the literature on infant dental enucleation, a traditional remedial procedure prevalent mainly in East Africa. Materials and methods. Literature searches were made electronically using general and specialized search engines. The main search was performed through a systematic strategy in PubMed, comprising tabulated keywords, search codes, and translated and transliterated terms. Criteria for the selection of studies were designed to provide a general understanding of the procedure. The findings were synthesized into two sections: a summary of the population prevalence studies, and a thematic literature review. Results. An overview of the known prevalence and clinical specifications was established. Insight was gained into the purpose of the procedure and the factors influencing its performance. Diverging suggestions were seen with regard to the rationale for use of infant dental enucleation between different populations. Moreover, reports of complications and consequences involving the general health and the dentoalveolar structures of patients were examined. Conclusions. Prevalence, clinical features and risks of infant dental enucleation point to a need for greater awareness of the procedure. Further, there is a need for specific guidelines regarding management of suspected cases within dental and healthcare communities.

  • 12.
    Bergström, Kamilla
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Berthelsen, Hanne
    Malmö högskola, Faculty of Odontology (OD).
    Hjalmers, Karin
    Malmö högskola, Faculty of Odontology (OD).
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Overall job satisfaction among dentists in Sweden and Denmark: A comparative study, measuring positive aspects of work2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 6, p. 344-353Article in journal (Refereed)
    Abstract [en]

    Objective. Human service work differs from industrial work, which should be considered when organizing work. Previous research has shown organizational differences in the perceptions of work, often with a focus on negative aspects. The aim of this study was to analyse the overall job satisfaction among private- and public-practising dentists in Sweden and Denmark. This also implied a description of the questionnaire Swedish and Danish Dentists' Perceptions of Good Work about opportunities and positive and rewarding aspects of work. Material and methods. A questionnaire covering the multidimensional concept of good work was developed. A total of 1835 dentists randomly sampled from the dental associations were sent a questionnaire in November 2008. A special non-response study was performed. Principal components analysis (PCA) was used to create a measure of overall job satisfaction, comparing four organizational subgroups. Results. The average net response rate was 68% (n = 1226). The special non-response study of the Danish private practitioners showed more males, managers and dentists with more working hours than the respondents. PCA of three satisfaction questions showed a stable one-factor solution. There were differences in job satisfaction, with Danish public dentists ranked highest in overall job satisfaction and Swedish public dentists lowest. Conclusions. There were organizational differences in the perception of job satisfaction. Further analysis of how the human service is organized in the different groups is needed.

  • 13.
    Berlin, Henrik
    et al.
    Malmö University, Faculty of Odontology (OD).
    Hallberg, Ulrika
    Malmö University, Faculty of Odontology (OD).
    Ridell, Karin
    Malmö University, Faculty of Odontology (OD).
    Toft, Danijela
    Colosseum Smile Dental Group, Malmö, Sweden.
    Klingberg, Gunilla
    Malmö University, Faculty of Odontology (OD).
    A grounded theory study on Swedish 10 to 16-year-olds’ perceptions of pain in conjunction with orthodontically indicated tooth extraction2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 3, p. 235-240Article in journal (Refereed)
    Abstract [en]

    Objective: Children frequently experience pain and/or discomfort during dental treatment. Still, pain research in dentistry has mainly been performed on adults using quantitative methods while research on the child's perspective is scarce. This study aims to explore and describe children's experiences and/or thoughts regarding pain in conjunction with tooth extraction.

    Material and methods: Interviews were carried out with twelve Swedish 10-16-year-olds who had recently undergone tooth extractions due to orthodontic reasons. Interviews were transcribed verbatim and analysed according to grounded theory.

    Results: A core category was identified and named 'handling the unavoidable unknown'. The informants recalled experiences of pain and discomfort during extractions. However, instead of focussing on pain, they described an urge for more information about the procedure and what to expect in terms of pain and/or discomfort, during and/or after treatment. They stated that the levels of pain/discomfort were manageable, while the lack of information negatively affected their coping abilities, causing feelings of unease.

    Conclusions: To improve patients' ability to deal with pain in conjunction with dental extraction, the dental team should ensure better and individually tailored information about the treatment. Thus, the use of psychological techniques is a cornerstone in pain management and must be reflected in clinical guidelines.

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  • 14.
    Berthelsen, Hanne
    et al.
    Malmö University, Centre for Work Life and Evaluation Studies (CTA). Malmö University, Faculty of Odontology (OD).
    Owen, Mikaela
    Centre for Workplace Excellence, University of South Australia, Adelaide, Australia.
    Westerlund, Hugo
    The Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Leadership, work environment and caries prevention: what is good for the staff, is also good for the patients2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 3, p. 196-201Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff.

    METHODS: The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors.

    RESULTS: Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found.

    CONCLUSIONS: In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

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  • 15.
    Berthelsen, Hanne
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Harris, Rebecca
    Hyld Pejtersen, Jan
    Bergström, Kamilla
    Malmö högskola, Faculty of Odontology (OD).
    Hjalmers, Karin
    Malmö högskola, Faculty of Odontology (OD).
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Collegial Support and Community with Trust in Swedish and Danish dentistry2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 6, p. 343-354Article in journal (Refereed)
    Abstract [en]

    Objectives. The aim of the study was to better understand the associations between work factors and professional support among dentists (Collegial Support) as well as the sense of being part of a work community characterized by trust (Community with Trust). Methods. A questionnaire was sent to 1835 general dental practitioners, randomly selected from the members of dental associations in Sweden and Denmark in 2008. The response rate was 68%. Two models with the outcome variables Collegial Support and being part of a Community with Trust were built using multiple hierarchical linear regression. Demographic background factors, work factors, managerial factors and factors relating to objectives and to values characterizing climate of the practice were all introduced as blocks into the models. Results. A different pattern emerged for Collegial Support than for Community with Trust, indicating different underlying mechanisms. The main results were: (I) Female, married/cohabitant, collegial network outside the practice, common breaks, formalized managerial education of leader and a climate characterized by professional values, which were positively associated with Collegial Support, while number of years as a dentist and being managerially responsible were negatively associated. (II) Common breaks, decision authority and a climate characterized by professional values were positively associated with Community with Trust. Conclusion. A professionally-oriented practice climate and having common breaks at work were strongly associated with both outcome variables. The study underlined the importance of managing dentistry in a way which respects the professional ethos of dentists.

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  • 16.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lilja-Karlander, Eva
    Malmö högskola, Faculty of Odontology (OD).
    A Systematic Review of Swedish Research in Orthodontics during the Past Decade.2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 1, p. 46-50Article, review/survey (Other academic)
    Abstract [en]

    The aims of this systematic review were to identify the study designs and topics of Swedish orthodontic articles, to elucidate their interna-tional position, and to verify in which scientific journals the articles had been published in the past decade. A search of the Medline data-base for papers published between 1992 and 2002 was made using the Medical Search Heading terms 'orthodontics', 'malocclusion', 'cepha-lometry', and 'facial bones and growth'. Two independent reviewers selected the articles of Swedish origin and categorized each article ac-cording to research design and principal topic. Overall, 15,571 articles in orthodontic research were found, and the Swedish contribution was 1.9% with the majority of these (71.5%) being submitted by universi-ties. Most of the Swedish articles (84.5%) had been published in 10 journals and many high-quality studies with orthodontic interest were published in non-orthodontic journals with higher impact factor scores than the orthodontic journals. Every second study was prospec-tive, and of these, 15 (5.2% of all Swedish articles) were randomized clinical trials (RCTs). It was found that nearly every third study, pro-spective as well as retrospective, was uncontrolled. The main classifi-cation was treatment studies (51.9%), followed by development (18.6%) and diagnostic information (10.7%) studies. Thus, the major-ity of the articles evaluated therapeutic interventions; however, al-though the RCT is the preferred study design in evaluation studies, few used this method. In an era focused on evidence-based medicine, studies with an RCT design will be the future challenge for research in the field of orthodontics.

  • 17.
    Brodén, Joséphine
    et al.
    Malmö University, Faculty of Odontology (OD).
    Davidson, Thomas
    Fransson, Helena
    Malmö University, Faculty of Odontology (OD).
    Cost-effectiveness of pulp capping and root canal treatment of young permanent teeth2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 4, p. 2751-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To contribute with information on cost-effectiveness of pulp capping and root canal treatment of posterior permanent vital teeth in children and adolescents with pulp exposures due to caries. MATERIAL AND METHODS: Cost-effectiveness by means of a Markov simulation model was studied in a Scandinavian setting. In a simulated 12-year-old patient, treatment of pulpal exposure of a permanent tooth, either by the initial treatment pulp capping or root canal treatment, was followed for 9 years until the patient was 21. The model was based on outcome data obtained from published literature and cost data based on reference prices. RESULTS: In the simulated case, with the annual failure probalility (AFP) of 0.034 for pulp capping, the total cost for an initial treatment with pulp capping and any anticipated following treatments during the 9 years, was 367 EUR lower than for a root canal treatment as the initial treatment. After an initial treatment with pulp capping 10.4% fewer teeth, compared with initial root canal treatment, were anticipated to be extracted. Pulp capping was thus considered to be the cost-effective alternative. The sensitivity analyses showed that the AFP of a tooth requiring a root canal treatment after an initial pulp capping needed to be 0.2 before root canal treatment may be considered being the cost-effective treatment. CONCLUSIONS: This model analysis indicated initial treatment by pulp capping to be cost-effective compared to root canal treatment in children and adolescents with pulp exposures due to caries.

  • 18.
    Cederhag, Josefine
    et al.
    Malmö University, Faculty of Odontology (OD).
    Iskanderani, Durer
    Malmö University, Faculty of Odontology (OD). Department of Oral & Maxillofacial Radiology, KingAbdulaziz University, Jeddah, Saudi Arabia;.
    Alstergren, Per
    Malmö University, Faculty of Odontology (OD). Specialized Pain Rehabilitation, Skåne University Hospital, Lund, Sweden.
    Shi, Xie-Qi
    Malmö University, Faculty of Odontology (OD). Section of Oral and Maxillofacial Radiology, Department ofClinical Dentistry, University of Bergen, Bergen, Norway.
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 6, p. 449-455Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars.

    MATERIAL & METHODS: Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT. Two CBCT scans of each site were made using a default protocol and a low-dose protocol (Veraviewepocs 3D F40, J Morita Corp, Kyoto, Japan). The low-dose protocol had the same tube potential (90 kV) and exposure time (9.4 s) as the default, but with reduced tube current, from 5 mA to 2 mA. Four observers evaluated the visibility of five relevant anatomical variables. Image quality was ranked on a 3-point scale as diagnostically acceptable, doubtful, or unacceptable. The Wilcoxon signed-rank test compared differences between the two protocols. The significance level was set at p ≤ .05.

    RESULTS: No significant differences were found between the two protocols for any observer regarding the visibility of the relationship and proximity between the roots and the mandibular canal; root morphology; and possible root resorption of the second molar. The periodontal ligament differed significantly in visibility between the two protocols (p ≤ .05).

    CONCLUSIONS: This study indicates that a low-dose CBCT protocol with a 60% reduction of the tube current provides, in most cases, acceptable image quality for pre-surgical assessment of mandibular third molars. Optimization of CBCT protocols should be a priority according to recommended guidelines.

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  • 19. Chiang, Huei-Min
    et al.
    Tranæus, Sofia
    Malmö University, Faculty of Odontology (OD).
    Sunnegårdh-Grönberg, Karin
    Caries as experienced by adult caries active patients: a qualitative study2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In the western world, increased oral health has resulted in a skewed occurrence of caries disease where relatively few individuals now account for most caries disease. This study examines how adults with recurrent caries activity experience caries disease and treatment. MATERIALS AND METHODS: The study is based on qualitative data from individual interviews, which were subjected to qualitative content analysis. The interviews were semi-structured and thematic and an interview guide was used that consisted of two main areas with open ended questions. Meaning units were condensed and labelled with a code which preserved the core content of the reduced text. Codes were assigned to different subcategories according to their similarities or differences. Subcategories formed categories which describe the manifest content of the text. RESULTS: The domain "experience with caries" consisted of four subcategories that formed the main category Caries - an unwelcomed acquaintance. The domain "experience with caries treatment" consisted of three subcategories that formed the category Caries treatment - pain for gain. CONCLUSION: Comprehensive non-operative treatment and close follow-ups should precede restorations; this would probably gain insight in how to avoid new cavities to a greater extent. If to be supportive, information and advice about self-care given to individuals with recurrent cavities should be delivered with respect to the patient's feelings about their experience of dental caries.

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  • 20.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Santiago Gomez, Ricardo
    Peripheral calcifying cystic odontogenic tumour and peripheral dentinogenic ghost cell tumour: an updated systematic review of 117 cases reported in the literature2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 8, p. 591-597Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To integrate the available data published on peripheral calcifying cystic odontogenic tumour (CCOT) and peripheral dentinogenic ghost cell tumour (DGCT) into a comprehensive analysis of its clinical and radiologic features. METHODS: An electronic search was undertaken in May, 2016. Eligibility criteria included publications reporting cases of peripheral CCOTs/DGCTs having enough clinical, radiological and histological information to confirm a definite diagnosis. Demographic data, lesion site and size, treatment approach and recurrence were analyzed. RESULTS: Hundred and thirty-eight lesions were found (65 publications), and 117 lesions (63 publications) with enough information were analyzed (55 CCOTs, 50 DGCTs, 12 unknown). Mean age of patients was 51.3 ± 23.4 (min-max, 1-92), with higher mean age for the DGCTs variant. The lesions were more prevalent in the mandible, anterior region of the jaws, and in the second, sixth and eighth decades, with an equal sexual distribution. About 20% of all lesions showed signs of erosion of the underlying bone, with a higher rate for DGCTs. The mean lesion size was 1.3 ± 0.8 (min-max, 0.4-3.0). Time of follow-up was informed for 37 lesions, with a mean ± SD of 30.2 ± 21.0 months (min-max, 6-84). Almost all lesions were treated by conservative surgery; only three recurrences were reported. CONCLUSIONS: Peripheral CCOTs/DGCTs are rare lesions. Most of the lesions were treated by simple excision with or without curettage of the underlying bone. As the recurrence rate is very low, a conservative approach seems to be enough for the great majority of cases.

  • 21.
    Collin Bagewitz, Ingrid
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Palmqvist, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Dimensions of Oral Health-related Quality of Life in an Adult Swedish Population2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 6, p. 353-360Article in journal (Other academic)
    Abstract [en]

    The concept of oral health-related quality of life (OHRQOL) is investigated in this study. The aim was to explore the dimensionality of variables measuring OHRQOL in an adult Swedish population and to discuss the findings in relation to existing indices. The study was based on responses to a 1998 questionnaire sent to a random sample of 1974 persons aged between 50 and 75 years. There were 22 variables based on questions concerning oral situation and the impact on 7 theoretically different dimensions of QOL. The majority were satisfied with their oral health situation. During the previous 12 months, 16% of the population had experienced problems with their mouth or teeth on at least one occasion per mouth. Principal components analysis was used to analyze the dimensionality of the variables. Three factors accounted for 59% of the variance: (1) Physical and social disability, (2) psychological discomfort and disability, and (3) functional limitation and physical pain. The perception of OHRQOL is multidimensional, but the dimensions are not equally important. The dimensions of OHRQOL found in the present study are similar to those of existing instruments.

  • 22.
    Collin Bagewitz, Ingrid
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Palmqvist, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Dental care utilization: a study of 50- to 75-year-olds in southern Sweden.2002In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 1, p. 20-4Article in journal (Refereed)
    Abstract [en]

    This study investigates dental care utilization in an adult population in Southern Sweden in relation to dental and social conditions, attitudes to costs, and perceived need to obtain dental services. The study was based on responses to a questionnaire sent in 1998 to a random sample, 1974 persons, aged 56-75 years. The response rate was 66%. A significantly higher probability of dental care utilization less than once a year was found for men, for those with few remaining teeth, and for those with removable dentures. A higher probability of dental care utilization less than once a year was found for those who stated perceived need to obtain dental care with no possibility because of the cost and for those who stated that the cost had influenced their attendance for dental care. The results showed that there were differences for sex and dental conditions in dental care utilization and that dental care utilization was related to attitudes towards costs of dental care.

  • 23.
    Danesh, Noushin
    et al.
    Malmö University, Faculty of Odontology (OD).
    Ljunggren, Anna Camilla
    Malmö University, Faculty of Odontology (OD).
    Wolf, Eva
    Malmö University, Faculty of Odontology (OD).
    Fransson, Helena
    Malmö University, Faculty of Odontology (OD).
    Development of criteria for investigation of periapical tissue from root-filled teeth.2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 4, p. 269-274Article in journal (Refereed)
    Abstract [en]

    Objective: To develop and assess a set of criteria to grade inflammation including relative area of inflammation in periapical lesions in endodontically treated teeth. Material and methods: A set of criteria was developed, encompassing data on: Lymphocytes, denoting chronic inflammation, were graded 0 (occasional) to 4 (heavy/dense inflammation). Polymorphonuclear cells, denoting acute inflammation, were graded 0 (none) to 2 (many). The third parameter, area of inflammation, that is, the relative area of the specimen that was inflamed, was graded 0 (none) to 4 (76–100%). The criteria were tested on 199 consecutive biopsies from 180 patients (aged 31–75 years). Information about symptoms was retrieved from the referrals. Mann–Whitney’s U-test was used to calculate possible differences in average values for the histopathological variables in the two groups of patients: symptomatic or asymptomatic. Results: Using the criteria, varying grades of inflammation were seen in the biopsies. The majority showed few or no PMN cells. There was a correlation between symptoms and the extent of infiltration of lymphocytes and plasma cells (p = .001), PMN cells (p < .001) and the area of inflammation (p = .002): biopsies from the asymptomatic patients exhibited less pronounced and relatively smaller areas of inflammation. Conclusions: Using the criteria on a specific selection of root-filled teeth with persisting apical periodontitis, periapical inflammation was common, but varied in extent and severity. The inflammation was less pronounced and affected a relatively smaller area in asymptomatic teeth, although outliers in both directions were identified.

  • 24.
    Davidson, Thomas
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Blomma, Caroline
    Public Dental Service Östergötland, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Bågesund, Mats
    Center for Orthodontics and Pediatric Dentistry, Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Krevers, Barbro
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Vall, Martina
    Malmö University, Malmö University Library.
    Wärnberg Gerdin, Elisabeth
    Odontological Research Unit, Public Dental Service, Region Örebro County, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Tranæus, Sofia
    Malmö University, Faculty of Odontology (OD). Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Cost-effectiveness of caries preventive interventions: a systematic review2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 4, p. 309-320Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The primary purpose of this study was to assess the cost-effectiveness of caries preventive interventions.

    MATERIAL AND METHODS: A systematic review was conducted, following the PRISMA Statement. Four electronic databases were searched (final search 16 March 2020). Studies fulfilling the inclusion criteria were independently critically appraised, by two reviewers in parallel. Data from each included study were extracted and tabulated: the analysis used a narrative approach to present the results of the estimated cost-effectiveness.

    RESULTS AND CONCLUSIONS: Twenty-six publications fulfilled the inclusion criteria and were of low or moderate risk of bias. Ten publications were economic evaluations, directly based on empirical studies, and the other 16 were modelling studies. Most of the studies concerned interventions for children and the most common were analyses of fluoride varnish and risk-based programs. Some of the studies showed both reduced cost and improved outcomes, but most studies reported that the improved outcome came with an additional cost. The results disclosed several cost-effectiveness evaluations of caries preventive interventions in the literature, but these target primarily children at high risk. There is a scarcity of studies specifically targeting adults and especially the elderly.

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  • 25. Davidson, Thomas
    et al.
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Hultin, Margareta
    Jemt, Torsten
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Sunnegardh-Gronberg, Karin
    Tranæus, Sofia
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Reimbursement systems influence prosthodontic treatment of adult patients2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 6, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.

  • 26.
    Derand, Tore
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Molin, Margareta
    Malmö högskola, Faculty of Odontology (OD).
    Kvam, Ketil
    Bond strength of a compsite luting agent to alumina ceramic surfaces2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 4, p. 227-230Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to evaluate the shear bond strength (SBS) of a dental luting agent to alumina ceramics after different surface pretreatment. MATERIAL AND METHODS: Specimens (n=50) of pressed blocks (10 x 0 x 5 mm) of alumina ceramic (Procera AllCeram) were divided into untreated specimens (AF) as provided by the manufacturer and polished specimens (AP). Five groups of specimens (n=5 x 10) with different surface pretreatments were prepared. Groups 1 and 2: AF and AP without any pretreatment; Group 3: AF treated with silane, (AF-s); Group 4: AF treated with RF plasma spray (AF-RF); Group 5: AF treated with low fusing porcelain (AF-p) glass pearls. Composite cylinders (5 x 5 mm) were cemented to the test specimens with a resin luting agent. The specimens were loaded to failure in shear mode using a universal testing machine. Recorded loads were used to calculate SBS in MPa. The results were analyzed using one-way ANOVA and the Tukey HSD multiple comparison test at alpha = 0.05. Scanning electron microscopic micrographs (SEM) were used to characterize surfaces of interest. RESULTS: Polished surfaces had significantly lower SBS (p < 0.05) compared with untreated specimens (AP vs AF). Silanated, non-polished surfaces (AF-s) revealed lower SBS, even though the result was not significantly different from that of AF-s without silane treatment. Plasma treatment improved SBS by a factor of 2 (p<0.05) and treatment with low-fusing porcelain micro pearls increased SBS by a factor of 3 compared to untreated surfaces (p<0.05). The layer of glass pearls did not exceed 5 microm (SEM). CONCLUSIONS: Within the limitation of the conditions of this study, treatment of alumina oxide ceramic surfaces with a plasma spray coating or a low-fusing porcelain pearl layer significantly increased the SBS of a resin luting agent to the ceramic surface.

  • 27.
    Dimberg, Lillemor
    et al.
    Dental Research Department, Public Dental Service, Örebro County , Örebro , Sweden; Department of Orthodontics, Eastman Institute, Public Dental Service, Stockholm County Council , Stockholm , Sweden.
    Arvidsson, Caroline
    Department of Orthodontics, Public Dental Service, Region Örebro County , Örebro , Sweden.
    Lennartsson, Bertil
    Dental Research Department, Public Dental Service, Örebro County , Örebro , Sweden.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Arnrup, Kristina
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Sweden.
    Agreement between children and parents in rating oral health-related quality of life using the Swedish versions of the short-form Child Perceptions Questionnaire 11-14 and Parental Perceptions Questionnaire2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 7, p. 534-540Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the agreement between children and parents on children's oral health-related quality of life (OHRQoL) when using the Swedish short forms of CPQ(11-14) and P-CPQ, and to evaluate the impact on agreement of oral health including malocclusion and background characteristics (dental fear, family situation, gender of informant). Material and methods: A total of 257 children and their accompanying parents were asked to fill in the Swedish versions of the short-form CPQ(11-14) and P-CPQ separately in connection with a clinical examination. Results: The participants comprised 247 child-parent pairs: 116 (47%) boys, 131 (53%) girls, 166 (67%) mothers and 81 (33%) fathers. The agreement between the child and parental ratings of the children's OHRQoL was low, with an ICC of 0.22 (95% CI: 0.04-0.37) for the total scale. Conclusions: There was a low agreement between children's and parents' answers. For best care, it is advisable to consider perceptions of both children and parents because they can complement each other in estimating the child's OHRQoL.

  • 28.
    Dimberg, Lillemor
    et al.
    Department of Orthodontics, Postgraduate Dental Education Center, Region Örebro County, Örebro, Sweden.
    Lennartsson, Bertil
    Postgraduate Dental Education Center, Region Örebro County, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Arnrup, Kristina
    Postgraduate Dental Education Center, Region Örebro County, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Oral health-related quality-of-life among children in Swedish dental care: The impact from malocclusions or orthodontic treatment need2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, p. 127-133Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe oral health-related quality-of-life (OHRQoL) and the impact of malocclusions or orthodontic treatment need in a cohort of children in Swedish dental care, using the Swedish version of the Child Perceptions Questionnaire-Impact Short Form (CPQ11-14-ISF:16). SUBJECTS AND METHODS: Two hundred and fifty-seven children (mean age = 11.5 years, SD = 0.8, range = 9.8-13.5 years) completed the CPQ11-14-ISF:16 in conjunction with a clinical examination. In addition to malocclusions and orthodontic treatment need (based on the Index of Orthodontic Treatment Need-Dental Health Component), possible confounders (caries, enamel defects, dental trauma, headache and socio-economic markers) were recorded. Children also rated their own dental fear on the Children's Fear Survey Schedule-Dental Sub-scale (CFSS-DS). RESULTS: The mean total CPQ11-14-ISF:16 score was 9.31. The logistic regression analyses revealed an impact of orthodontic treatment need on OHRQoL (CPQ), but no clear association between higher severity and higher impact on OHRQoL was seen. Dental fear and headache appeared to discriminate for poorer OHRQoL. No impact from caries, enamel defects, dental trauma, or socio-economic markers was revealed. CONCLUSIONS: This cohort of children reported good self-perceived OHRQoL. Effects on OHRQoL from malocclusions or orthodontic treatment need were limited and inconsistent. Dental fear and headache were found to be more distinct impact factors on OHRQoL than were malocclusions or orthodontic treatment need.

  • 29.
    Dimberg, Lillemor
    et al.
    Dental Research Department, Public Dental Service, Region Örebro County, Örebro, Sweden; ;Department of Orthodontics, Public Dental Service, Eastman Institute, Stockholm County Council, Stockholm, Sweden.
    Lennartsson, Bertil
    Dental Research Department, Public Dental Service, Region Örebro County, Örebro, Sweden.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Arnrup, Kristina
    Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.
    Validity and reliability of the Swedish versions of the short-form Child Perceptions Questionnaire 11-14 and Parental Perceptions Questionnaire2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 8, p. 630-635Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the validity and reliability of the Swedish versions of the short-form Child Perceptions Questionnaire 11-14 (CPQ(11-14)) and Parental Perceptions Questionnaire (P-CPQ) for measuring children's oral health-related quality of life (OHRQoL). Material and methods: The sample comprised 247 children and parents. OHRQoL was assessed by asking each child and their accompanying parent to complete the relevant questionnaire. To allow test-retest analysis, 30 children and 32 parents were asked to complete the instrument a second time within 2-4 weeks. Results: In terms of construct validity, significant correlations were observed between CPQ scale scores and the global ratings of oral health and overall well-being for both the CPQ(11-14) and the P-CPQ. Regarding internal consistency, Cronbach's alphas for the total scales were 0.81 and 0.77, respectively, indicating good reliability, and internal consistency for the subscales (two or four dimensions) was acceptable. Test-retest reliability was good for the CPQ(11-14) total scale (ICC 0.77) and acceptable for the P-CPQ total scale (ICC 0.63). Conclusions: The Swedish versions of the short-form CPQ(11-14) and P-CPQ are both valid and reliable, and can be recommended for use among Swedish children aged 11-14 years for evaluation of OHRQoL.

  • 30. Doepel, Marika
    et al.
    Nilner, Maria
    Malmö University, Faculty of Odontology (OD).
    Vahlberg, Tero
    Le Bell, Yrsa
    Similar treatment outcome in myofascial TMD patients with localized and widespread pain.2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 3, p. 175-182Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the outcome of oral appliance treatment in myofascial Temporomandibular disorder (TMD) patients with and without comorbid pain using pain site drawings. MATERIAL AND METHODS: This randomized, controlled multicentre study comprised 65 myofascial TMD patients diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Pain-site drawings were filled in at the baseline examination. The patients were treated with oral appliances. Treatment outcome was followed up for 1 year and analysed according to the recommendations by the Initiative on Methods, Measurement and Pain assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. The data were analysed for two pain profiles, localized pain (face and head, n = 26) versus widespread pain group (pain sites outside the face and head, n = 39). RESULTS: Statistically significant improvement was registered within both groups for all outcome variables (characteristic pain intensity, 30% pain reduction of worst reported pain, graded chronic pain, depression, and somatization scores) during the follow-up with only small differences between the groups. CONCLUSIONS: Oral appliance treatment had a positive effect on all outcome measures during the 1-year follow-up in patients suffering from myofascial TMD pain, regardless of whether the pain was localized or widespread. Multiple pain sites seemed to have surprisingly little influence on the outcome variables. However, some indications of more challenges when treating patients with widespread pain compared to local pain could be observed. Pain-site drawings seem to be useful in the clinical situation and could support the clinicians in decision-making regarding treatment planning.

  • 31.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Treatment Outcome of Appliance Therapy in Temporomandibular Disorder Patients with Myofascial Pain after 6 and 12 Months2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 6, p. 343-349Article in journal (Refereed)
    Abstract [en]

    Aim: To compare the long-term effect of treatment with a stabilization appliance (group T) and treatment with a control appliance (group C) in temporomandibular disorder (TMD) patents with myofascial pain. Methods: In this controlled trial, 60 patients (mean age 29 years) with myofascial pain were evaluated after 10 weeks of treatment with either a stabilization appliance or a control appliance. All 60 patients were then assigned to 1 of 3 groups according to demand for treatment. Seventeen patients from group C requested another appliance and were given a stabilization appliance, thus creating a mixed group (group M). Results: A significant difference was found between groups T and C. at the 6- and 12-months follow-ups, a significant reduction in myofascial pain, as measured on a visual analogue scale, was found in all three groups. A significant decrease in frequency and intensity of myofascial pain was found in group T at the follow-ups. A significant decrease in number of tender sites on the masticatory muscles was found in group T at the follow-ups. Conclusion: The results support the conclusion that the positive treatment outcome obtained by use of a stabilization appliance to alleviate the signs and symptoms in patients with myofascial pain persisted after 6 and 12 months. Most patients in groups T and M reported positive changes in overall subjective symptoms in this trial. We therefore recommend user of the stabilization appliance in the treatment of TMD patients with myofascial pain.

  • 32. Ekbäck, Gunnar
    et al.
    Nordrehaug Åstrøm, Anne
    Klock, Kristin
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Unell, Lennart
    Malmö högskola, Faculty of Odontology (OD).
    Oral health of 65-year olds in Sweden and Norway: A global question and ICF, the latest conceptual model from WHO2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 4, p. 279-288Article in journal (Refereed)
    Abstract [en]

    Objective. The aims of this study were to identify explanatory factors of satisfaction with oral health among Norwegian and Swedish 65 year olds in terms of items from four different domains of ICF and to compare the strengths of the various ICF domains in explaining satisfaction with oral health. Further it was to assess whether the explanatory factors of ICF domains vary between Norway and Sweden. Materials and methods. In 2007, standardized questionnaires were mailed to all the residents in certain counties of Sweden and Norway who were born in 1942. Response rates were 73.1% (n = 6078) in Sweden and 56.0% (n = 4062) in Norway. Results. In total, 33 questions based on four different ICF domains were chosen to explain satisfaction with oral health. Logistic regression showed that four different ICF domains in terms of body function, body structure, activity/participation and environmental factors explained, respectively, 53%, 31%, 12% and 34% of the explanatory variance in the satisfaction with oral health. In the final analysis, only nine items were statistically significant (p < 0.05). Conclusion. This study indicates that ICF as a conceptual model could cover a broad spectrum of factors embedded in OHRQoL measured by a global question in Sweden and Norway. Nine items, representing four ICF domains, were important in the final model for explaining satisfaction with oral health.

  • 33. Ekbäck, Gunnar
    et al.
    Nordrehaug Åstrøm, Anne
    Klock, Kristin
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Unell, Lennart
    Malmö högskola, Faculty of Odontology (OD).
    Variation in subjective oral health indicators of 65-year-olds in Norway and Sweden2009In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 67, no 4, p. 222-232Article in journal (Refereed)
    Abstract [en]

    Objective . Guided by the conceptual framework of Gilbert and co-workers, this study assesses satisfaction with oral health as reported by 65-year-olds in Sweden and Norway, the relationship of socio-demographic factors, clinical and subjective oral health indicators with satisfaction of oral health, and the consistency of those relationships across countries. Material and methods. In 2007, standardized questionnaires were mailed to all the residents in two counties in Sweden and three in Norway who were born in 1942. Response rates were 73.1% (n=6078) in Sweden and 56.0% (n=4062) in Norway. Results. Totals of 76.8% of the Swedish and 76.5% of the Norwegian participants reported satisfaction with oral health. Corresponding figures for toothache were 48.1% (Sweden) versus 51.5% (Norway), and for temporomandibular joint symptoms, 10.9% (Sweden) versus 15.1% (Norway). Multiple logistic regression analysis revealed that subjects who perceived they had bad health, smoked daily, had missing teeth, experienced toothache, had problems with chewing, bad breath, and oral impacts were less likely than their counterparts in the opposite groups to be satisfied with their oral health status. The corresponding odds ratios (ORs) ranged from 0.08 (problems chewing) to 0.2 (oral impact). No statistically significant two-way interactions occurred and the model explained 46% of the variance in satisfaction with oral health across the two countries (45% in Sweden and 47% in Norway). Conclusions. The oral condition of 65-year-olds in Norway and Sweden produced impacts in oral symptoms, functional limitations, and problems with daily activities that varied to some extent. Satisfaction with oral health varied by socio-demographic factors and subjective oral health indicators. A full understanding of the oral health and treatment needs of 65-year-olds cannot be captured by clinical measures alone.

  • 34. Ekbäck, Gunnar
    et al.
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Does different wording of a global oral health question provide different results?2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 4, p. 250-257Article in journal (Refereed)
    Abstract [en]

    Objective. Focusing on 70-year-old adults in Sweden and guided by the conceptual framework of International Classification of Impairments, Disabilities and Handicaps (ICIDH), the purpose of this study was to examine the extent to which socio-demographic characteristics, self-reported oral disease and social/psychological/physical oral health outcome variables are associated with two global measures of self-assessed satisfaction with oral health in Swedish 70-year-olds and if there is a degree of discordance between these global questions. Background. It has become an important task to create a simple way to measure self-perceived oral health. In these attempts to find practical ways to measure health, the 'global oral health question' is a possible tool to measure self-rated oral health, but there is limited knowledge about how important the wording of this question is. Materials and methods. In 2012, a questionnaire was mailed to all persons born in 1942 in two Swedish counties, Orebro (T) and Ostergotland (E). The total population of 70-year-olds amounted to 7889. Bivariate analyses were conducted by cross-tabulation and Chi-square statistics. Multivariate analyses were conducted using binary multiple logistic regression. Results. The two global oral health question of 70-year-olds in Sweden was mainly explained by the number of teeth (OR = 5.6 and 5.2), chewing capacity (OR = 6.9 and 4.2), satisfaction with dental appearance (OR = 19.8 and 17.3) and Oral Impact on Daily Performance (OIDP) (OR = 3.5 and 3.9). Conclusion. Regardless of the wording, it seems that the concept of a global oral health question has the same main determinants.

  • 35. Ekbäck, Gunnar
    et al.
    Ordell, Sven
    Malmö högskola, Faculty of Odontology (OD).
    Ståhlnacke, Katri
    Satisfaction with dental care and life-course predictors: A 20-year prospective study of a Swedish 1942 birth cohort?2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 3, p. 194-201Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to assess the impact of care experience, health factors and socioeconomic factors on satisfaction with dental care across time and to assess the stability or change in levels of self-reported satisfaction with dental care in individuals as they progress from middle age to early old age.Materials and methods: The present work is based on five separate data collections from a cohort study with 3585 individuals responding in all years of the survey. Data collection was conducted in 1992 when the subjects were 50 years of age and again 5, 10, 15 and 20 years later. Absolute stability in satisfaction with dental care was assessed by calculating the proportion of individuals who maintained their position in the same category from one survey period to another. Changes across time were tested using Cochran's Q test. Satisfaction with dental care across the 20-year survey period was modeled using the generalized estimating equation (GEE).Results and conclusion: The result showed that 85% of women and 83% of men remained satisfied with dental care. Binomial GEE revealed no statistical significant change in satisfaction with dental care between 1992-2012. In sum, this study has shown that this age group, born in 1942, was stably satisfied with dental care between age 50 and age 70, despite all changes during this time period. Females are more satisfied than men and the most important factors are the experience of attention during the last visit, satisfaction with dental appearance and good chewing capability.

  • 36.
    Ekstam, Maria
    et al.
    Malmö University, Faculty of Odontology (OD).
    Sonesson, Mikael
    Malmö University, Faculty of Odontology (OD).
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    Effects of premolar extraction and orthodontic treatment in adolescents - a retrospective cephalometric study2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate the cephalometric effects of premolar extraction on skeletal and dental parameters, and on the soft tissues, in patients subsequently treated with fixed appliances. Prevalence and severity of external apical root resorption due to premolar extraction were also examined.Materials and methods: The dental records of 79 patients treated with fixed appliances were retrieved (groups: extraction, n = 19; non-extraction, n = 60). Pre- and post-treatment statuses of skeletal, dentoalveolar, and soft tissue variables were analyzed on lateral cephalograms to determine change. Periapical radiographs of the maxillary incisors were assessed for external apical root resorption using the Levander & Malmgren index. The t-test, Mann-Whitney U test, chi-squared test, and Kruskal-Wallis test were used to analyze the data. Significance was set at p < .05.Results: Changes in the protrusion and proclination of the incisors and in lip position were significantly different between the groups. Prevalence of external apical root resorption in the two groups was similar.Conclusions: Our findings suggest that extraction therapy affects dentoalveolar traits but not jaw position, nor the risk of root resorption, in patients treated with fixed appliances

  • 37. Ellervall, Eva
    et al.
    Björklund, Fredrik
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Vinge, Ellen
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Antibiotic Prophylaxis in Oral Health Care: Administration Strategies of General Dental Practitioners2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 6, p. 321-329Article in journal (Refereed)
    Abstract [en]

    Objective. To examine the strategies that general dental practitioners (GDPs) use to administer antibiotic prophylaxis and to study the agreement between the administration strategies of GDPs and local recommendations. Methods. Postal questionnaires in combination with telephone interviews were used. Two hundred GDPs in two Swedish counties, Skåne and Örebro, were asked to participate. The response rate was 51 % (n=101). The GDPs were presented with eight simulated cases of patients with different medical conditions for which antibiotic prophylaxis might be considered necessary when performing dental procedures (scaling, tooth removal, root canal treatment). The administration strategies of the GDPs were compared with local recommendations. Results. In general, the variation in the administration strategies of the GDPs was large. For two medical condi-tions, type 1 diabetes that was not well controlled and hip prosthesis, significantly more GDPs in Skåne than in Örebro administered antibiotic prophylaxis for tooth removal. Agreement between the administration strategies of the GDPs and local recommendations was low. Differences between the two counties were non-significant. Furthermore, within Örebro, GDPs who did not have formal access to local recommendations did not differ in their administration strategies from those who did. The choice of substance was seldom in agreement with the substance recommended, while the majority followed the recommended duration of treatment. Conclusion. Although recommendations existed, their impact appeared to be limited. This is significant, since the implementation of recommendations is crucial in making clinical practice more effective and in promoting the health of patients.

  • 38.
    Erovic Ademovski, Seida
    et al.
    Department of Oral Health Science, Section for Health and Society, Kristianstad University, Kristianstad, Sweden.
    Lingström, Peter
    Department of Oral Health Science, Section for Health and Society, Kristianstad University, Kristianstad, Sweden; Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Winkel, Edwin
    Academic Centre for Oral Health, Department of Periodontology, University Medical Centre Groningen, Groningen, The Netherlands.
    Tangerman, Albert
    Academic Centre for Oral Health, Department of Periodontology, University Medical Centre Groningen, Groningen, The Netherlands; Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
    Persson, G Rutger
    Department of Oral Health Science, Section for Health and Society, Kristianstad University, Kristianstad, Sweden; Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Oral Medicine; Department of Periodontics, University of Washington, Seattle, WA, USA.
    Renvert, Stefan
    Department of Oral Health Science, Section for Health and Society, Kristianstad University, Kristianstad, Sweden; School of Dental Science, Trinity College, Dublin, Ireland; Blekinge Institute of Technology, Karlskrona, Sweden.
    Comparison of different treatment modalities for oral halitosis.2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 3, p. 224-33Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping.

    MATERIALS AND METHODS: Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography.

    RESULTS: Twenty-one subjects with a mean age of 45.7 years (SD: ±13.3, range: 21-66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H(2)S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H(2)S and MM were found in the active rinse sequence with or without tongue scraping.

    CONCLUSION: The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.

  • 39.
    Flink, Håkan
    et al.
    Malmö University, Faculty of Odontology (OD). Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Reg Vastmanland, Västerås, Sweden..
    Hedenbjörk-Lager, Anders
    Malmö University, Faculty of Odontology (OD).
    Liljeström, Simon
    Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Reg Vastmanland, Västerås, Sweden..
    Nohlert, Eva
    Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Reg Vastmanland, Västerås, Sweden..
    Tegelberg, Åke
    Malmö University, Faculty of Odontology (OD). Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Reg Vastmanland, Västerås, Sweden..
    Identification of caries-active individuals in longitudinal data a methodological study using a national registry2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, p. 1-6Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe aim was to identify caries active individuals among adults by using a trajectory model of longitudinal data from the Swedish national registry (SKaPa) and comparing them with published data from the Dunedin cohort.Materials and methodsData from two different age groups (30- and 40-year-olds) followed for 10 years were retrieved from SKaPa and were compared with published longitudinal birth-cohort data from the Dunedin study. Using the trajectory model, the subjects were divided into three different trajectories according to their caries development over time (i.e. high, 15%; moderate, 45%; low, 40%).ResultsCaries experience, as measured by mean decayed, missing, and filled surfaces (DMFS) index, revealed significant differences among the three trajectories in both age groups. The patterns were similar to those observed in the Dunedin cohort. The mean increase in DMFS during the 10-year follow-up period from SKaPa was significantly higher for the high trajectories in both age groups compared with the moderate and low trajectories.ConclusionsThe method using three trajectories for presentation of caries experience over time, may be a useful tool to identify subjects with different disease activities. Identification of subjects in the high caries experience trajectory may increase the possibility to explore and evaluate more effective caries prevention for this group in the future.

  • 40. Flink, Håkan
    et al.
    Tegelberg, Åke
    Malmö University, Faculty of Odontology (OD).
    Arnetz, Judith E
    Birkhed, Dowen
    Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults.2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 3, p. 229-235Article in journal (Refereed)
    Abstract [en]

    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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  • 41. Flink, Håkan
    et al.
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Arnetz, Judy
    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]

    Abstract 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.

  • 42.
    Franzon, Bengt
    et al.
    Malmö University, Faculty of Odontology (OD).
    Moutakis, Mikael
    Department of Economics, Gothenburg University, Gothenburg, Sweden; The Swedish Dental- and Pharmaceutical Benefits Agency, Stockholm, Sweden.
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    The relationship between practice ownership and follow-up of comprehensive dental care. A Swedish register study.2024In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 83, p. 151-159Article in journal (Refereed)
    Abstract [en]

    AIMS: The aims of this register study were:

    1. To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership.
    2. To study the extent of follow-up of patients who have undergone two types of treatments. 

    MATERIAL & METHODS: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed.  Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently.

    CONCLUSION: Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

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  • 43.
    Franzén, Cecilia
    Malmö University, Faculty of Odontology (OD).
    State governance versus dentists’ autonomy: the case of Swedish dental care2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 2, p. 125-129Article in journal (Refereed)
    Abstract [en]

    Objective: A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists’ autonomy and whether the government’s political intentions can be fulfilled. Material and methods: The paper is based on documents from government authorities and professional theories. Results: The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists’ professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. Conclusions: This article shows that the state’s governance does not directly detail dentists’ work, which indicates a balance between state governance and dentists’ autonomy. However, further research is required to get knowledge on Swedish dentists’ view of the governance.

  • 44.
    Franzén, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Changes in employers' image of ideal dentists and managers in the Swedish public dental sector2002In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 5, p. 290-296Article in journal (Refereed)
    Abstract [en]

    Earlier studies hav  e shown that employers ar e keen to hav e employees whose attitudinal and behavioraltrait  s are consistent with the employers’ ideology. One wa y of ascertaining th e imag   e of idea  l individuals isto analyze th e required qualifications in job advertisements. The ai m of  thi  s study wa s to explore possiblechanges in the employers’ vie w of the idea  l manager and dentist in the Swedish Public Dental HealthService (PDHS). The stud y investigated th e kind s an d frequencies of  manifestly required qualificationsconcerning vacancies in the PDHS fro m January 1990 to December 1998. All job advertisements intendedfo r dentists an d managers on different hierarchical level   s in general dentistry wer e included (n= 1152);570  5 qualification demands were analyzed by  content analysis permitting quantitative descriptions of  thetextual material as  wel  l as  an analysis of th e underlying characteristics over time. The stud  y indicates that  ,fo r dentists, dental professional qualifications or  qualifications in accordance with the official objective ofdental car  e wer  e insufficient. Whil   e requests for qualifications relating to th e economic organizationalgoal   s of  the PDHS increased during the latte r par t of  the period under study, requests relating to thedental profession decreased. For managers, too  , th e demands for dental professional qualifications haddecreased at  the end of  the studied period compared to th e demands fo r managerial qualifications an dnon-professional qualifications, whic h ha d increased. In conclusion, th e job advertisement portrays theidea  l dentist and manager primarily as an economic organizational asset.

  • 45.
    Franzén, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Required qualifications in the Swedish Public Dental Health Service as indicators of organizational ideology2001In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 59, no 6, p. 396-405Article in journal (Refereed)
    Abstract [en]

    Th e manifestly required qualifications in job advertisements in theJournal of the Swedish Dental Associationwere analyzed as indicators of th e organizational ideology in the Swedish Public Dental Health Servicefro m the employers’ viewpoint. Al l job advertisements that concerned dentists an d managers on differenthierarchical level   s in general dentistry from January 199  0 to December 199  8 were included (n= 1152).Th e number of vacancies was 1856 . Th e textual material wa s analyzed by content analysis, permittingquantitative descriptions of the tex t and analysis of th e laten t characteristics. Words an d phrases wereclassified into categories on different level   s of abstraction developed fro m the theoretical background an dthe purpose of the study. Altogether 5705 required qualifications wer  e categorized. Th e inter-coderreliability of  the first-level categorization resulted in 81% correspondence of the classification, an dl= 0.90 . Qualifications wer  e mor   e frequently required wit h higher hierarchical jo b positions, an dpersonality characteristics were mor   e frequent tha  n technical competence an d knowledge. Qualificationsinterpreted as related to economic goal   s occurred mor   e frequently than thos  e related to odontologicalgoals. The qualification demands reflected the language of human resource management (HR M),emphasizing the ‘soft  ’ people-centered approach an d was interpreted as an ‘ideal   ’ model of HRM. Dentistswere regarded as a profitable organizational asse  t rather tha  n participants in relations wit h patients. Inconclusion, the results indicate an  organizational ideology primarily of economic character.

  • 46.
    Gil, Elisabeth Grut
    et al.
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Åstrøm, Anne Nordrehaug
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Lie, Stein Atle
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Rygg, Marite
    Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway.
    Fischer, Johannes
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Rosén, Annika
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
    Bletsa, Athanasia
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Oral Health Centre of Expertise in Western Norway, Vestland, Norway.
    Luukko, Keijo
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Shi, Xie-Qi
    Malmö University, Faculty of Odontology (OD). Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
    Halbig, Josefine
    Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway; Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.
    Frid, Paula
    Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway; Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway.
    Cetrelli, Lena
    Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
    Tylleskär, Karin
    Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
    Rosendahl, Karen
    Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway.
    Skeie, Marit Slåttelid
    Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
    Dental plaque and gingival bleeding in adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 1, p. 50-65Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes.

    MATERIAL AND METHODS: In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual.

    RESULTS:  > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups.

    CONCLUSIONS: Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.

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  • 47. Gnauck, Maja
    et al.
    Magnusson, Tomas
    Ekberg, Ewa Carin
    Malmö högskola, Faculty of Odontology (OD).
    Knowledge and competence in temporomandibular disorders among Swedish general dental practitioners and dental hygienists2017In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 75, no 6, p. 429-436Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to investigate knowledge and competence in temporomandibular disorders (TMD) among dentists and dental hygienists working in the public dental service (PDS) in Sweden. Materials and methods: The study population comprised all general dentists (n = 110) and dental hygienists (n = 80) working in the PDS in two Swedish counties: Kronoberg (K) and Blekinge (B). The participants filled out a questionnaire comprised of 15 questions. Results: The results of these questions are presented. The overall response rate for the general dentists was 87%, while the rate for the dental hygienists was 71%. Statistically significant differences between the general dentists in the two counties were found regarding the following: education in the field of TMD over the last 5 years (K: 37%, B: 73%), evaluation of occlusion when examining patients with suspected TMD ('always': K: 61%, B: 82%), and a desire for consultation of the OFP (orofacial pain)/TMD specialist by telephone (K: 71%, B: 44%). Regarding the dental hygienists, there was a statistically significant difference concerning the use of the treatment modality 'reassurance' (K: 41%, B: 7%). Conclusions: The majority of the dental care providers in both counties - irrespective of professional category - had a positive attitude towards patients with TMD. Knowledge and competence in the field are sparse and require postgraduate education. There is a great need of an OFP/TMD specialist for more complicated patients and a need to implement updated knowledge and competence in the PDS in these two counties.

  • 48.
    Göranson, Emma
    et al.
    Malmö University, Faculty of Odontology (OD). Center for Orthodontics and Pediatric Dentistry, Norrköping, Public Dental Service Östergötland, Östergötland, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Norevall, Lars-Inge
    Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Orthodontics and Pediatric Dentistry, Linköping, Public Dental Service Östergötland, Östergötland, Sweden.
    Bågesund, Mats
    Center for Orthodontics and Pediatric Dentistry, Norrköping, Public Dental Service Östergötland, Östergötland, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Dimberg, Lillemor
    Malmö University, Faculty of Odontology (OD). Department of Orthodontics, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden.
    Translation and validation of the Swedish version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) for adolescents2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 4, p. 241-247Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument developed for assessment of orthodontic aspects of oral health-related quality of life (OHRQoL). This study aimed to translate and validate the Swedish version of PIDAQ for use in Swedish adolescents 12-19 years of age.

    MATERIAL AND METHODS: The translation was made according to the process described in 'Guidelines for Establishing Cultural Equivalency of Instruments' by Ohrbach et al. Field testing was performed in a group of consecutive patients who were about to start orthodontic treatment (untreated group) and a group of consecutive patients who had recently finished orthodontic treatment (treated group).

    RESULTS:  During the translation procedure, a Swedish version of PIDAQ was formed. In the field testing, a total of 144 questionnaires, 72 from untreated patients (mean age 14.6 years) and 72 from treated patients (mean age 17.3 years) were collected. The exploratory factor analysis detected two factors, which differs from the factor structure in the original questionnaire. The mean total PIDAQ score was significantly higher (p < .001) in the untreated group, 40.6 (20.3), than in the treated group, 9.4 (10.5), implying a high discriminant validity. Reliability was excellent, with internal consistency Cronbach's alpha values varying from 0.94 to 0.97.

    CONCLUSION: The Swedish version of PIDAQ demonstrates good validity and excellent reliability and is suitable for future research on the effect of malocclusion on OHRQoL in Swedish 12- to 19-year-olds.

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  • 49. Haag, Per
    et al.
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Bonding between titanium and dental porcelain: A systematic review2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 3, p. 154-164Article, review/survey (Other academic)
    Abstract [en]

    Objectives. The aims of this literature review are to provide answers to questions on how to improve bonding between titanium and dental porcelain and how to further implement, in clinical practice, ceramic-veneered titanium as an alternative to conventional metal-ceramic systems. Material and methods. A literature search of PubMed and also among referenced published scientific papers was performed and 24 fulfilled the search criteria, namely mentions of titanium, ceramics and bond strength. These papers were compiled for comparison and evaluated regarding the bond strength achieved with different methods. Results. The results strongly indicate that there are possibilities to improve both the present materials and methods for titanium-ceramic veneering. Conclusions. The results indicate that present knowledge is sufficient to conclude that veneering titanium with low-fused porcelain for crowns and fixed partial dentures can be recommended for routine clinical use.

  • 50.
    Hajem, Samara
    et al.
    Malmö University, Faculty of Odontology (OD).
    Brogårdh-Roth, Susanne
    Malmö University, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö University, Faculty of Odontology (OD).
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    CBCT of Swedish children and adolescents at an oral and maxillofacial radiology department: A survey of requests and indications.2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 1, p. 38-44Article in journal (Refereed)
    Abstract [en]

    This retrospective study investigated requests and indications for cone-beam computed tomography (CBCT) in children and adolescents over a 3-year period at one oral and maxillofacial radiology department. Specific aims were to determine what technical settings were used, which caregivers write the referrals, and how often and for what reasons re-exposure was necessary. Patients

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