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  • 1. de Oliveira, Rubelisa Candido
    et al.
    Leles, Cláudio Rodrigues
    Normanha, Leonardo Martins
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Assessments of trabecular bone density at implant sites on CT images2008In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 105, no 2, p. 231-238Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the association between trabecular bone density measurements of potential implant sites made on axial DICOM images (DentaCT software) and on the same images with eFilm workstation, to correlate bone densities in Hounsfield units (HU) with subjective classification, and to establish a quantitative scale for each bone quality class. STUDY DESIGN: Twenty-seven maxillary and 27 mandibular computed tomographic (CT) examinations of 75 potential implant sites were selected. Trabecular bone density was evaluated with DentaCT and eFilm. Bone quality was subjectively evaluated by 2 examiners. Descriptive statistics, between- and within-group comparison, correlation analysis, and Bland-Altman plot were used for data analysis. RESULTS: DentaCT measurements were higher than eFilm (P < .001). Bone type 2 was the most prevalent, and bone density was significantly reduced from bone types 1 to 4. Quantitative parameters ranged as follows: bone type 4 <200 HU, bone types 2 and 3 >200 to <400 HU, and bone type 1 >400 HU. CONCLUSION: Different qualities of bone can be found in any of the anatomical regions studied (anterior and posterior sites of maxilla and mandible), which confirms the importance of a site-specific bone tissue evaluation prior to implant installation.

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

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

  • 3. Fikackova, Hanna
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Can Infrared Thermography be a Diagnostic Tool for Arthralgia of the Temporormandibular Joint?2004In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 98, no 6, p. 643-650Article, review/survey (Other academic)
    Abstract [en]

    This paper presents a review of the use of infrared thermography in diagnosis of temporomandibular joint (TMJ) arthralgia. The question examined was whether the infrared thermography could be reliably used as a tool to diagnose arthralgia by objectively assessing the site of origin and the degree of irritation. Controlled studies were performed by using advanced thermographic devices to show both diagnostic va-lidity and reliability of infrared thermography as a screening test for selecting healthy subjects from patients with unilateral TMJ arthralgia. The study revealed that thermography fails to meet the criteria of high level of evidence. Further studies are required to confirm these results in order to specify analysis of facial thermal patterns and to better un-derstand the relationship between TMJ arthralgia and regional tem-perature changes. Until then infrared thermography cannot be recom-mended for routine use as a diagnostic technique to identify TMJ dis-orders.

  • 4.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Hellén-Halme, Bengt
    Wenzel, Anne
    The effect of aging on luminance of standard liquid crystal display (LCD) monitors2011In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 112, no 2, p. 237-242Article in journal (Refereed)
    Abstract [en]

    Abstract OBJECTIVES: The aim of this study was to evaluate the luminance level of monitors as a function of the burning time of the lamp in the monitor and further to evaluate if different areas of the monitor varied in luminance levels at a specific time. MATERIAL AND METHODS: Nine standard liquid crystal display (LCD) monitor models, in total 180 monitors, were evaluated. The monitors' maximal luminance levels were measured, and the burning times of the lamps were noted. The estimated function between burning time and luminance was calculated. On 11 monitors, 9 areas distributed over the full screen were measured to evaluate the extent to which different areas had different luminance levels. RESULTS: Over time, the luminance decreased in all monitor models. No difference was found among the monitor models in how rapidly the luminance levels decreased. Different luminance values were found for different areas on the monitors, but no area deteriorated faster than another. CONCLUSIONS: Standard liquid crystal display monitors undergo gradual deteriorations in luminance levels over time, and these deteriorations are correlated with the time that the monitors have been switched on. The degradation in luminance is similar over all areas of the monitors.

  • 5.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Effect of monitors on approximal caries detection in digital radiographs—standard versus precalibrated DICOM part 14 displays: An in vitro study2009In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 107, no 5, p. 716-720Article in journal (Refereed)
    Abstract [en]

    Objectives. The aim of this study was to evaluate if different ways of adjusting brightness and contrast of monitors with different technical standards influence the diagnosis of carious lesions in digital radiographs. Study design. One hundred extracted teeth (premolars and molars) were radiographed. Seven observers evaluated images for approximal carious lesions on 3 monitors: a standard color monitor with brightness and contrast manually adjusted for viewing radiographs, a Digital Imaging and Communication in Medicine (DICOM) part 14 precalibrated color monitor, and a DICOM part 14 precalibrated monochromatic monitor. All evaluations were made in ambient light <50 lux. Receiver operating characteristic curves were plotted to evaluate results. The standard criterion was a histologic examination of sliced teeth. Kappa statistic evaluated intraobserver agreement. Results. No significant difference in accuracy of approximal carious lesion diagnosis was found between the monitors. Intraobserver agreement varied between fair and good. Conclusion. No differences that could affect clinicians’ abilities to detect carious lesions in digital radiographs existed between the standard monitor and the color and monochrome DICOM part 14 precalibrated monitors.

  • 6. Horner, Keith
    et al.
    Allen, Philip
    Graham, Jim
    Jacobs, Reinhilde
    Boonen, Steven
    Pavitt, Susan
    Nackaerts, Olivia
    Marjanovic, Elizabeth
    Adams, Judith
    Karayianni, Kety
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    van der Stelt, Paul
    Devlin, Hugh
    The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX2010In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 110, no 2, p. 243-249Article in journal (Refereed)
    Abstract [en]

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

  • 7. Horner, Keith
    et al.
    Jonasson, Grethe
    Olsson, Peter
    Jacobs, Reinhilde
    Karayianni, Kety
    van der Stelt, Paul
    Adams, Judith
    Marjanovic, Elizabeth
    Pavitt, Sue
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Devlin, Hugh
    The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project2008In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 106, no 2, p. 285-293Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this study was to investigate the diagnostic accuracy of visual assessment of the trabecular pattern in intraoral periapical radiographs to identify female subjects at risk of having osteoporosis. STUDY DESIGN: Six hundred female subjects underwent intraoral periapical radiography of the maxillary and mandibular premolar region. Five observers assessed the trabecular pattern as dense, heterogeneous, or sparse, with the aid of reference images. All patients received a central dual energy x-ray absorptiometry (DXA) examination of the hip and lumbar spine. RESULTS: With sparse trabecular pattern as indicative of osteoporosis, mean specificity was high (91.6 for the upper jaw and 90.8 for the lower jaw) while the sensitivity was low (28.2 for the upper and lower jaw). The mean intraobserver agreement was comparable for radiographs of the upper and lower jaw (median kappa(w) 0.53 and 0.57, respectively). CONCLUSION: Visual assessment of the trabecular pattern in intraoral periapical radiographs of premolar regions is a potential method to identify women at risk of having osteoporosis.

  • 8. Kharazmi, Mohammad
    et al.
    Sjöqvist, Kerstin
    Rizk, Milad
    Warfvinge, Gunnar
    Malmö högskola, Faculty of Odontology (OD).
    Oral ulcer associated with alendronate: a case report2010In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 110, no 6, p. e11-e13Article in journal (Refereed)
    Abstract [en]

    Irritation of the mucosa of the aerodigestive tract is a well-known adverse effect of alendronate, whereas oral ulceration has been reported in only 14 articles in both the English and non-English literature. All of these have been associated with misuse of the drug. We here present the first case of severe oral ulceration attributable to use of alendronate without inappropriate therapeutic administration of the medication.

  • 9.
    Limchaichana, Napat
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    The efficacy of magnetic resonance imaging in the diagnosis of degenerative and inflammatory temporomandibular joint disorders: a systematic literature review2006In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 102, no 4, p. 521-536Article, review/survey (Other academic)
    Abstract [en]

    Objective. To evaluate the evidence for the efficacy of magnetic resonance imaging (MRI) in the diagnosis of disk position and configuration, disk perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint. Study design. A PubMed literature search with specific indexing terms and a hand search were made. Two reviewers assessed the level of evidence of relevant publications as high, moderate, or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited, or insufficient. Results. The literature search yielded 494 titles, of which 22 were relevant. No publication had a high level of evidence, and 12 had moderate and 10 low levels of evidence. The evidence grade for diagnostic efficacy expressed as sensitivity, specificity, and predictive values was insufficient. Conclusion. That evidence is insufficient emphasizes the need for high-quality studies on the diagnostic efficacy of MRI, incorporating accepted methodologic criteria.

  • 10.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Obrant, Karl
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Maxillary Bone Mineral Density and its Relationship to the Bone Mineral Density of the Lumbar Spine and Hip2004In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 98, no 1, p. 102-109Article in journal (Other academic)
    Abstract [en]

    Objective. We sought to measure the bone mineral density (BMD) of various regions in the maxilla before implant treatment and to investigate correlations between these values and the BMDs of the spine and hip. Study design. Eighteen patients were examined by means of quantitative computed tomography, and the BMD of the maxillary alveolar ridge was calculated. The same patients also underwent dual-energy x-ray absorptiometry of the lumbar spine and the total hip. Analysis of variance was used to compare BMD values between an within individuals. The Pearson correlation coefficient was used to correct for sex and body mass and to calculate the correlation between the BMD of the maxillary alveolar ridge and the BMD of the spine and hip. Results. The maxillary BMD varied significantly between individuals (P<.001) and within individuals (P<.001). The BMD of the anterior region of the maxilla was correlated significantly with the BMD of the lubar spine (r = 0.6; P <.05) Conclusion. A site-specific evaluation of maxillary bone tissue could be of value before implant treatment.

  • 11. Matsumoto, Kunihito
    et al.
    Bjørnland, Tore
    Malmö högskola, Faculty of Odontology (OD).
    Kai, Yukiko
    Honda, Masahiko
    Yonehara, Yoshiyuki
    Honda, Kazuya
    An image-guided technique for puncture of the superior temporomandibular joint cavity: clinical comparison with the conventional puncture technique2011In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 111, no 5, p. 641-648Article in journal (Refereed)
    Abstract [en]

    Objective. The objective of this study was to compare an image-guided puncture technique (IGPT) with conventional puncture technique (CPT) with respect to accuracy of needle entry, maximal mouth opening, and pain in pumping manipulation treatment of internal derangement of the temporomandibular joint (TMJ). Study design. The subjects comprised 178 patients with internal derangement of the TMJ with closed lock. Treatment was provided using CPT in 102 cases and IGPT in 76 cases. Three variables, number of repunctures, maximal mouth opening distance, and pain threshold according to a visual analogue scale, were measured and compared between IGPT and CPT groups. Results. Access to the superior joint cavity was achieved without correcting the puncture point in 97% of patients who underwent IGPT and 82% of patients in the CPT group. Significant differences were seen in 1-week maximal mouth opening and pain threshold between IGPT and CPT groups and resetting of the puncture point was significantly less frequent using IGPT compared with CPT. Conclusions. IGPT is effective for pain mitigation and improves mouth opening during the early postoperative period after pumping manipulation treatment.

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  • 12. Mattsson, Ulf
    et al.
    Halbritter, Sandro
    Mörner Serikoff, Elisabeth
    Christerson, Lars
    Warfvinge, Gunnar
    Malmö högskola, Faculty of Odontology (OD).
    Oral pigmentation in the hard palate associated with imatinib mesylate therapy: a report of three cases2011In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 111, no 5, p. e12-e16Article in journal (Refereed)
    Abstract [en]

    Imatinib mesylate is a tyrosine kinase inhibitor which targets Bcr-Abl-protein, c-Kit, and platelet-derived growth factor receptor. The drug was originally developed for treatment of chronic myeloid leukemia but is also regarded as first-line treatment of patients with metastatic gastrointestinal stromal tumours (GIST). Dermatologic side effects are common, with superficial edema and rash as the most frequent. In addition, imatinib mesylate treatment is often associated with hypopigmentation. Intraoral side effects are very rare. The present paper demonstrates 1 patient with GIST and 2 patients with chronic myeloid leukemia treated with imatinib mesylate for 5-6 years. All 3 patients presented with diffuse solitary bluish-brown pigmentations in the hard palate. The lesions persisted at follow-ups. There were no other pigmentations in the oral mucosa. The histopathologic examination showed depositions of melanin pigment in the lamina propria. The possible relationship between the observed melanotic maculae and imatinib mesylate treatment is discussed.

  • 13. Wiese, Mie
    et al.
    Wenzel, Ann
    Hintze, Hanne
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Bakke, Merete
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings2008In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 106, no 2, p. 52-63Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    The objective of this study was to evaluate the impact of clinical TMJ diagnosis, gender, and age on the agreement between expected and actual radiographic findings. STUDY DESIGN: A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria (RDC/TMD). Expected radiographic findings were recorded. TMJ tomograms in closed and open mouth position were assessed for osseous changes and condyle position. Expected and actual findings were compared. Logistic regression analyses were performed with agreement on radiographic findings as the dependent variable and with clinical RDC/TMD diagnoses, gender and age as the independent variables. RESULTS: The number of radiographic findings was mostly underestimated. A clinical diagnosis of osteoarthritis and age increased the chance of overestimating osseous changes. Disc displacement and age decreased the chance of agreement on certain condyle positions. CONCLUSION: Tomography often revealed unexpected findings. It was not possible to select particular patient groups who would benefit more or less from a radiographic examination.

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