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  • 1.
    Abdulraheem, Salem
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Hawthorne effect reporting in orthodontic randomized controlled trials: truth or myth? Blessing or curse?2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 40, no 5, p. 475-479Article, review/survey (Refereed)
    Abstract [en]

    Objective To investigate in 10 orthodontic journals how many randomized controlled trials (RCTs) considered the Hawthorne effect, and if considered, to determine whether it was related to the patients or the therapists involved in the trial and, finally, to discuss the Hawthorne effect in an educational way. Materials and methods A search was performed on the Medline database, via PubMed, for publication type ‘randomized controlled trial’ published for each journal between 1 August 2007 and 31 July 2017. The American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, Australian Orthodontic Journal, Dental Press Journal of Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, Journal of Orofacial Orthopedics, Korean Journal of Orthodontics, Orthodontics and Craniofacial Research and Progress in Orthodontics were assessed. Two independent reviewers extracted the data and identified whether the Hawthorne effect was considered or discussed in the articles and whether the Hawthorne effect was related to the behaviour of the patients, the therapists, or both. Results The initial search generated 502 possible trials. After applying the inclusion and exclusion criteria, 290 RCTs were included and assessed. The Hawthorne effect was considered or discussed in 10 of 290 RCTs (3.4%), and all were related to the patients’ and none to the therapists’ behaviour. Conclusions The Hawthorne effect reported in orthodontic RCTs was suboptimal. The researchers’ lack of knowledge about this phenomenon is evident, despite evidence that the Hawthorne effect may cause over-optimistic results or false-positive bias.

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  • 2.
    Abdulraheem, Salem
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    The reporting of blinding in orthodontic randomized controlled trials: where do we stand?2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 1, p. 54-58Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse in 10 orthodontic journals how many randomized controlled trials (RCTs) performed 'single-', 'double-', 'triple-', or 'outcome assessors blinding' and to evaluate, from the number of RCTs that did not conduct blinding, how many could actually have achieved it. Material and methods: Randomized controlled trials published in 10 orthodontic journals between 1 September 2012 and 28 February 2018 were included. A search was performed in PubMed and conducted for publication type 'randomized controlled trial' for each journal. Two reviewers independently analysed each RCT and registered that blinding was performed and included which specific type. It was also evaluated whether misclassifications of blinding items occurred and whether it was possible to achieve blinding among the RCTs that did not perform blinding. Results: After applying the inclusion criteria, 203 RCTs were assessed, and 61.6 per cent of them had used blinding, with the main type being 'outcome assessors blinding' (40.4%) followed by 'single-blinding' (15.3%), 'double-blinding' (2.5%), and 'triple-blinding' (3.4%). In 38.4 per cent of the trials, no blinding was performed; however, 79.4 per cent of them could have achieved blinding. Fifteen RCTs (7.3%) misclassified the blinding in relation to single-, double-, or triple-blinding. Journals followed the CONSORT (AJODO, EJO, JO, OCR) published together significantly more RCTs that performed blinding than journals not following the CONSORT. Conclusions: Blinding of outcome assessors was the most frequent type, as orthodontic trials are often of intervention design and thereby difficult to mask for patients and trial staff. The misclassifications of blinding items may indicate suboptimal knowledge among researchers and peer-reviewers regarding the definitions for diverse blinding types.

  • 3.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Henriksson, T
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Alterations of temporomandibular disorders and headache before and after orthognathic surgery: A systematic review2006Conference paper (Refereed)
  • 4.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Alterations of temporomandibular disorders before and after orthognathic surgery2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 4, p. 729-734Article, review/survey (Other academic)
    Abstract [en]

    OBJECTIVE: To answer the question whether orthognathic surgery does affect the prevalence of signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: A literature survey in the PubMed and Cochrane Library electronic databases was performed and covered the period from January 1966 to April 2006. The inclusion criteria were controlled, prospective or retrospective studies comparing TMDs before and after orthognathic surgery in patients with malocclusion. There were no language restrictions, and three reviewers selected and extracted the data independently. The quality of the retrieved articles was evaluated by four reviewers. RESULTS: The search strategy resulted in 467 articles, of which 3 met the inclusion criteria. Because of few studies with unambiguous results and heterogeneity in study design, the scientific evidence was insufficient to evaluate the effects that orthognathic surgery had on TMD. Moreover, the studies had problems with inadequate selection description, confounding factors, and lack of method error analysis. CONCLUSION: To obtain reliable scientific evidence, additional well-controlled and well-designed studies are needed to determine how and if orthognathic surgery alters signs and symptoms of TMD.

  • 5.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Sunzel, Bo
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    TMD in Consecutive Patients Referred for Orthognathic Surgery2009In: Swedish Dental Journal, ISSN 0347-9994, Vol. 33, no 4, p. 201-226, article id 25Article in journal (Other academic)
    Abstract [en]

    Objective: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. Materials and Methods: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Results: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. Conclusions: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.

  • 6.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Sunzel, Bo
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    TMD in consecutive patients referred for orthognathic surgery2009In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 79, no 4, p. 621-627Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. MATERIALS AND METHODS: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. CONCLUSIONS: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.

  • 7.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Masticatory function in patients with dentofacial deformities before and after orthognathic treatment: a prospective, longitudinal, and controlled study2015In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 37, no 1, p. 67-72Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to investigate the self-estimated masticatory ability and masticatory performance in patients with dentofacial deformities before and after orthognathic treatment; in comparison to an age- and gender-matched control group. SUBJECTS AND METHODS: The masticatory ability and masticatory performance were evaluated in 121 consecutive patients (treatment group), referred for orthognathic treatment. Eighteen months after treatment, 98 patients (81%) completed a follow-up examination. Masticatory ability was assessed on a visual analog scale, while the masticatory performance was evaluated by a masticatory test using round silicon tablets. Signs and symptoms of temporomandibular disorders (TMD) were registered by a clinical examination and a questionnaire. The control group comprised 56 age- and gender-matched subjects who were examined at baseline. RESULTS: At the baseline examination, the treatment group had a significantly lower masticatory ability and performance compared with the control group. After treatment, the masticatory ability significantly improved in the treatment group and reached the same level as in the control group. The masticatory performance index increased significantly but was still lower than in the control group. Both the masticatory ability and masticatory performance were affected by the number of occlusal contacts during maximal biting pressure and by the self-estimated overall symptoms of TMD. CONCLUSIONS: Patients with dentofacial deformities, corrected by orthognathic treatment, have a significant positive treatment outcome in respect of masticatory ability and masticatory performance. Furthermore, the occlusion and symptoms of TMD have an impact on both masticatory ability and masticatory performance.

  • 8.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Sunzel, Bo
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment2013In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 46, no 6, p. 752-758Article in journal (Refereed)
    Abstract [en]

    Abstract The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain

  • 9. Bazargani, Farhan
    et al.
    Feldmann, Ingalill
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones2013In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 83, no 6, p. 1074-1082Article in journal (Refereed)
    Abstract [en]

    ABSTRACT Objective: To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. Materials and Methods: The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. Results: The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. Conclusions: CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.

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  • 10.
    Bjerklin, Krister
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Management of ectopic maxillary canines: variations among orthodontists2008In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 78, no 5, p. 852-859Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To document and analyze factors involved in decision-making by orthodontists in managing disturbances of eruption of maxillary canines. MATERIAL AND METHODS: The participants comprised orthodontic specialists and active members of the Swedish Orthodontic Society. Those selected for the study sample were under 65 years of age or younger and had been treating orthodontic patients for at least 1 year as a specialist. Three typical cases were presented for treatment proposals. The case notes, including radiographs and specific background data, were sent to the 182 selected orthodontists. The orthodontists were also requested to complete a questionnaire about practice profile, comprising eight questions. RESULTS: The response rate was 86.3%; yielding 157 participants (mean age 53.8 years, SD 8.12). Analysis disclosed no differences between responders and nonresponders regarding age, gender, and years of specialist practice. For treatment plans based on panoramic radiographs, intraoral radiographs, and status and anamnesis, there was general consensus. However, when supplementary information from computer tomography (CT) was provided, disclosing root resorption half-way to the pulp or more on the lateral incisor, the orthodontists' treatment proposals varied. Gender, age, and practice profile of the orthodontists had little association with the decision-making. CONCLUSIONS: Supplementary CT information led to variations in decision-making with respect to treatment of eruption disturbances of maxillary canines. This lack of consensus among specialist orthodontists can have negative implications for patients.

  • 11.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Bettdiagnostik och ortodontisk behandling i växelbettet.2005In: Pedodonti / [ed] Ingegerd Mejàre, Thomas Modéer, Svante Twetman, Gothia Förlag AB, 2005, p. 55-61Chapter in book (Other academic)
  • 12.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    How to succeed with high quality randomised clinical trials in clinical orthodontic research2019In: Journal of orthodontics, ISSN 1465-3125, E-ISSN 1465-3133, Vol. 46, no 1_Suppl, p. 13-16Article in journal (Refereed)
    Abstract [en]

    One goal of producing relevant clinical research is to ensure that evidence-based research results are transformed into everyday clinical practice that help clinicians deliver high quality care. It also involves ensuring that the individual patient receives the most effective and least risky treatment, ultimately leading to an optimal treatment outcome both in the short and long term. Some fundamentals of evidence-based dentistry are highlighted with focus on performing orthodontic randomised controlled trials.

  • 13.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Publication pattern, study design, authors and countries involved in orthodontic RCTs: a bibliometric MEDLINE survey over the past 50 years2019In: Journal of orthodontics, ISSN 1465-3125, E-ISSN 1465-3133, Vol. 46, no 2, p. 110-117Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of this study was to investigate the number and proportions, study design, journal publications, authors and countries involved in orthodontic randomised controlled trials (RCTs) over the past 50 years. METHOD: A MEDLINE database search (Entrez PubMed, http://www.ncbi.nlm.nih.gov ) was performed in November 2018 for RCT publications from 1 January 1968 to 31 December 2017. All orthodontic publications, clinical trials (CTs) or RCTs were selected. For each year from 1968 to 2017, the total number of orthodontic publications and total number of CTs and RCTs were computed. Following this, study design, journal publications, authors and countries involved in orthodontic RCTs were noted. RESULTS: The RCTs accounted for 0.1% of all orthodontic publications in the 1970s and 1980s, and, following this, the proportion of RCTs was increased and amounted to 2.7% over the past decade (2008-2017). The majority of RCTs were of single centre design (93.4%) and in 88.3% a parallel-arm design was performed. The United States and United Kingdom endorsed 16.9% and 15.5% of the RCTs, followed by Turkey (11.1%), Brazil (7.0%), Sweden (6.6%), China (5.6%), Italy (5.4%), and Germany (4.1%). Of all RCTs, 74.2% were published in 20 orthodontic journals and 25.8% in 81 non-orthodontic journals. The American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, European Journal of Orthodontics and Journal of Orthodontics contributed to 60.2% of all the RCTs. CONCLUSION: The considerable increase in orthodontic RCTs over the past 50 years implies an increased scientific impact of orthodontic literature.

  • 14.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    The use of magnets for maxillary molar distalization2006In: Orthodontic treatment for the Class II noncompliant patient: Current principles and techniques / [ed] Moschos Papadopoulos, Mosby , 2006, p. 297-307Chapter in book (Other academic)
  • 15.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    The use of onplants for maxillary molar distalization2006In: Orthodontic Treatment of the Class II Noncompliant Patient: Current Principles and Techniques / [ed] Moschos Papadopoulos, Mosby , 2006, p. 359-364Chapter in book (Other academic)
  • 16.
    Bondemark, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Abdulraheem, Salem
    Malmö University, Faculty of Odontology (OD).
    Intention to treat (ITT) analysis as reported in orthodontic randomized controlled trials-evaluations of methodology and recommendations for the accurate use of ITT analysis and handling dropouts2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 40, no 4, p. 409-413Article in journal (Refereed)
    Abstract [en]

    Objective To systematically evaluate in five orthodontic journals how many randomized controlled trials (RCTs) use intention to treat (ITT) analysis and to assess the methodological quality of the ITT analysis, and finally, to demonstrate in an academic way how outcomes can be affected when not implementing the ITT analysis. Material and methods A search of the database, Medline, was performed via PubMed for publication type ‘randomized controlled trial’ published for each journal between 1 January 2013 and 30 April 2017. The five orthodontic journals assessed were the American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, and Orthodontics and Craniofacial Research. Two independent reviewers assessed each RCT to determine whether the trial reported an ITT or not or if a per-protocol analysis was accomplished. Results The initial search generated 137 possible trials. After applying the inclusion and exclusion criteria, 90 RCTs were included and assessed. Seventeen out of 90 RCTs (18.9%) either reported an ITT analysis in the text and/or supported the ITT by flow diagrams or tables. However, six RCTs applied and reported the ITT analysis correctly, while the majority performed a per-protocol analysis instead. Conclusions Nearly all the trials that applied the ITT analysis incorrectly analysed the results using a per-protocol analysis, and thus, overestimating the results and/or having a reduced sample size which then could produce a diminished statistical power.

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  • 17.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Feldmann, Ingagill
    Capacity of Osseointegrated and Conventional Anchorage Systems - A Randomized Controlled Trial.2007Conference paper (Other (popular science, discussion, etc.))
  • 18.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Fredriksson, Katarina
    Ilros, Susanna
    Separation Effect and Perception of Pain and Discomfort from two Types of Orthodontic Separators.2004In: World Journal of Orthodontics, ISSN 1530-5678, E-ISSN 1941-6741, Vol. 5, no 2, p. 172-176Article in journal (Other academic)
    Abstract [en]

    AIM: To examine two types of orthodontic separators, focusing on the separating effect and patients' perception of pain and discomfort. METHODS: The separators tested were spring-type and elastomeric separators. Thirty teenagers participated, and all were scheduled for treatment with a fixed orthodontic appliance. Two spring-type and two elastomeric separators were placed alternately in the left or the right quadrant. After a separation period of 5 days, the amount of separation was measured with a leaf gauge. Nine questionnaires with visual analogue scales and questions with fixed answers were used to register the patient perceptions. RESULTS: The mean separation was 0.3 mm for the spring-type and 0.4 mm for the elastomeric separators (P < .05). The springs were considered less painful than the elastomerics, but the difference was not statistically significant. For both separators, the pain was worst at day 2 and subsided almost completely by day 5. Due to pain, 14 of the 30 patients changed their food habits, and 13 took analgesics. CONCLUSIONS: The separation effect of the two separators was considered clinically equivalent and since pain of moderate intensity occurs during the separation period, analgesics and soft food can be recommended.

  • 19.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Holm, Anna-Karin
    Hansen, Ken
    Axelsson, Susanna
    Mohlin, Bengt
    Brattström, Viveka
    Paulin, Gunnar
    Pietila, Terttu
    Long-term stability of orthodontic treatment and patient satisfaction. A systematic review2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 1, p. 181-191Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate morphologic stability and patient satisfaction at least 5 years after orthodontic treatment. MATERIALS AND METHODS: Published literature was searched through the PubMed and Cochrane Library electronic databases from 1966 to January 2005. The search was performed by an information specialist at the Swedish Council on Technology Assessment in Health Care. The inclusion criteria consisted of a follow-up period of at least 5 years postretention; randomized clinical trials, prospective or retrospective clinical controlled studies, and cohort studies; and orthodontic treatment including fixed or removable appliances, selective grinding, or extractions. Two reviewers extracted the data independently and also assessed the quality of the studies. RESULTS: The search strategy resulted in 1004 abstracts or full-text articles, of which 38 met the inclusion criteria. Treatment of crowding resulted in successful dental alignment. However, the mandibular arch length and width gradually decreased, and crowding of the lower anterior teeth reoccurred postretention. This condition was unpredictable at the individual level (limited evidence). Treatment of Angle Class II division 1 malocclusion with Herbst appliance normalized the occlusion. Relapse occurred but could not be predicted at the individual level (limited evidence). The scientific evidence was insufficient for conclusions on treatment of cross-bite, Angle Class III, open bite, and various other malocclusions as well as on patient satisfaction in a long-term perspective. CONCLUSIONS: This review has exposed the difficulties in drawing meaningful evidence-based conclusions often because of the inherent problems of retrospective and uncontrolled study design.

  • 20.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jeppsson, Malin
    Lindh-Ingildsen, Lina
    Rangne, Klara
    Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs2006In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 76, no 1, p. 98-102Article in journal (Refereed)
    Abstract [en]

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

  • 21.
    Bondemark, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Kallunki, Jenny
    Malmö University, Faculty of Odontology (OD).
    Paulsson, Liselotte
    Malmö University, Faculty of Odontology (OD).
    An updated systematic review regarding early Class II malocclusion correction2019In: Journal of the World Federation of Orthodontists, E-ISSN 2212-4438, Vol. 8, no 3, p. 89-94Article, review/survey (Refereed)
    Abstract [en]

    Background and aim: Class II malocclusion is one of the most common malocclusions in young children and a great deal of research on this topic has been undertaken. Despite this, there are still knowledge gaps on whether it is effective to treat these malocclusions early or what type of treatment should be performed. The aim of this article was to systematically review and update the quality of evidence for various treatment modalities considering Class II malocclusion correction before 10 years of age and with a focus on improvement of dental and skeletal relationships, soft tissue profile, relation to temporomandibular disorder (TMD), incidence on dental trauma, cost-effectiveness, and quality of life. Material and methods: Four databases were searched, from January 1960 to April 2019. Inclusion criteria were randomized or controlled trials reporting short- or long-term effects on dental or basal relationships, soft tissue profile, associations to TMD, quality of life, incidence of trauma, or costs. The quality of evidence was scored according to Grading of Recommendations Assessment Development and Evaluation. Results: A total of 300 publications were identified and 23 satisfied the inclusion criteria for full evaluation. The quality of evidence was high in 5 trials, moderate in 3, and low in 15. Conclusions: From the short- term perspective, there is a high level of evidence that early treatment reduces overjet and improves the anterior-posterior skeletal relationship. There is insufficient evidence about whether early treatment can reduce the incidence of trauma, is cost-effective, provides improved soft tissue profile, improves oral healtherelated quality of life, or possesses a risk of developing TMD. (C) 2019 World Federation of Orthodontists.

  • 22.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Karlsson, Ingela
    Extraoral vs intraoral appliance for distal movement of maxillary first molars: a randomized controlled trial2005In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 75, no 5, p. 699-706Article in journal (Other academic)
    Abstract [en]

    Using randomized controlled trial methodology, the aim of this study was to evaluate and compare the treatment effects of an extraoral appliance (EOA) and an intraoral appliance (IOA) for distal movement of maxillary first molars. A total of 40 patients (mean 11.5 years, SD 1.29) at the Orthodontic Clinic, National Health Service, Skane County Council, Malmö, Sweden, were randomized to receive treatment with either extraoral traction (cervical headgear) or an IOA us-ing superelastic coils for distal movement of maxillary first molars. The inclusion criteria were a nonextraction treatment plan, a Class II molar relationship and maxillary first molars in occlusion with no erupted maxillary second molars. The outcome measures to be assessed in the trial were treatment time, cephalometric analysis of distal molar movement, anterior movement of maxillary central incisors, ie, anchorage loss and sagittal and vertical skeletal positional changes of the maxilla and mandible. In the IOA group, the molars were distalized during an average time of 5.2 months, whereas in the EOA group the corresponding time was 6.4 months (P < .01). The mean amount of distal molar movement was significantly higher in the IOA than in the EOA group, three mm vs 1.7 mm (P < .001). Moderate anchorage loss was produced with the IOA implying increased overjet (0.9 mm) whereas the EOA created decreased overjet (0.9 mm). It can be concluded that the IOA was more effective than the EOA to create distal movement of the maxillary first molars.

  • 23.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Brown, George
    A Self-directed Summative Examination in Problem-based Learning in Dentistry: a New Approach2004In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 26, no 1, p. 46-51Article in journal (Other academic)
    Abstract [en]

    This paper describes and evaluates a new method of assessment in PBL, which was developed with two cohorts of dental students. The method involves students in PBL groups designing PBL problems and assessment tasks that are in line with the objectives of the course and the principles of PBL. Construction of tasks and feedback were provided. The student groups based the summative assessment on a selection of the PBL assessments provided. The evaluation indicates that senior students are capable of designing challenging PBL assessment tasks that are in line with course objectives and PBL principles. This experience raised the pass rates of the students compared those of with earlier cohorts of students. The students rated the method favourably; they considered it enabled them to demonstrate their competences and that it was more closely in line with PBL principles than other methods of assessment that they had experienced. The method is a promising innovation, which could be used in a variety of PBL courses.

  • 24.
    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.

  • 25.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Wolf, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Funktionsstörningar och smärta2008In: Tandläkartidningen, ISSN 0039-6982, Vol. 100, no 9-10, p. 64-68Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Orofaciala funktionsstörningar och smärta är en sammanfattning av kliniska problem och sjukdomar som involverar bett, käkar, tuggmuskulatur, käkleder och omgivande strukturer. Orsakerna är oftast multifaktoriella för de barn, ungdomar och vuxna som drabbas.

  • 26.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Medin, L
    Pälvärinne, R
    Skallsjö, K
    Vilken ortodontivård förväntas allmäntandläkare göra och har allmäntandläkare rätt utbildning för att göra den förväntade ortodontivården?2007Conference paper (Other (popular science, discussion, etc.))
  • 27.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ruf, Sabine
    Malmö högskola, Faculty of Odontology (OD).
    Randomized controlled trial: the gold standard or an unobtainable fallacy?2015In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 37, no 5, p. 457-461Article in journal (Refereed)
    Abstract [en]

    Background: This article is the result of a debate at the European Journal of Orthodontics Open Session in 2013 in Reykjavik, Iceland. Objective: The aim of this article is to highlight some of the strengths and weakness of clinical orthodontic research, with particular emphasis on randomized controlled trials (RCT). The ultimate aim of improving clinical orthodontic research in general. Design: This article is organized into two sections with arguments for and against RCTs. The backgrounds to evidence-based evaluation and the level or quality of evidence in trials are discussed. The article emphasises what makes high quality clinical research, and gives practical advice including examples of tips and potential pitfalls for those undertaking clinical research. Results and Conclusion: The overriding message is constructive and it is hoped that the article serves as an aid in evaluating, designing, conducting, and reporting clinical research.

  • 28.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ruf, Sabine
    Malmö högskola, Faculty of Odontology (OD).
    RCTs are here to stay: Reply2016In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 38, no 3, p. 335-335Article in journal (Other academic)
  • 29.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Thorneus, Johan
    Anchorage Provided during Intra-arch Distal Molar Movement: a Comparison between the Nance Appliance and a Fixed Frontal Bite Plane2005In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 75, no 3, p. 437-443Article in journal (Other academic)
    Abstract [en]

    The aim of this retrospective study was to evaluate and compare the anchorage provided with the Nance appliance (NA) and the fixed frontal bite plane (FBP) during intra-arch distal molar movement. After a sample size calculation, 20 patients were recruited and randomly selected for each group from patients who fulfilled the following criteria: use of an intra-arch Ni-Ti coil appliance with either NA or FBP to provide anchorage during a six-month molar distalization period, no orthodontic treatment before molar distalization, and first and second maxillary molars in occlusion. The outcome measures assessed were anchorage loss, ie, anterior movement of maxillary central incisors, distal movement of maxillary molars, and bite opening effect. The mean age in the NA group was 14.7 years (SD 1.09) and in the FBP group 15.0 years (SD 0.99). The data revealed that the maxillary central incisors moved anteriorly 1.4 mm in the NA group and 1.9 mm in the FBP group. The difference in anchorage loss was not significant. The mean amount of molar distalization within the maxilla was 1.7 mm in the NA group and 1.8 mm in the FBP group. In both groups, the overbite was significantly reduced and the overbite was decreased significantly more in the FBP group. Because neither the NA nor FBP provided stable anchorage, a second treatment phase is recommended to reverse the anchorage loss after distal molar movement. If molar distalization is planned in deep bite cases, the FBP is the anchorage system of choice.

  • 30.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Tsiopa, Jola
    Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 5, p. 773-778Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    OBJECTIVE: To elucidate the prevalence of ectopic eruption, impaction, and primary and secondary retention as well as agenesis of the permanent second molar (M2) among adolescents. MATERIALS AND METHODS: After a sample size calculation, dental records, including radiographs, of 1543 patients (722 girls and 821 boys), from three clinics in the city of Malmoe, Sweden, were retrospectively analyzed. Series of annual records and radiographs were examined for all patients from 10 to 16 years of age and were carried out during 2004-2006. The prevalence of ectopic eruption, impaction, and primary and secondary retention as well as agenesis of M2s was registered in a standardized manner and according to preset definitions. In addition, the times of emergence of the M2s were recorded. RESULTS: The prevalence of ectopic eruption of M2 was 1.5%, the prevalence of primary retention was 0.6%, and the prevalence of impaction was 0.2%. This means that the overall prevalence of eruption disturbances was 2.3%. In addition, the prevalence of agenesis was 0.8%. The prevalence of ectopic eruption was significantly higher in the mandible. Those patients with eruption disturbances and agenesis of M2 showed significantly delayed eruption of their other M2s compared to the individuals without any eruption disturbances. CONCLUSIONS: The prevalence of eruption disturbances was higher than reported earlier, and, even if the disturbances do not occur frequently, it is important to develop an early diagnosis in order to start the treatment at the optimal time.

  • 31.
    Christell, Helena
    et al.
    Malmö University, Faculty of Odontology (OD).
    Birch, Stephen
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Horner, Keith
    Lindh, Christina
    Malmö University, Faculty of Odontology (OD).
    The impact of Cone Beam CT on financial costs and orthodontists' treatment decisions in the management of maxillary canines with eruption disturbance2018In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, no 1, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Background: Examination with Cone Beam CT (CBCT) is common for localizing maxillary canines with eruption disturbance. The benefits and costs of these examinations are unclear. Objectives: To measure: 1. the proportion of orthodontists' treatment decisions that were different based on intraoral and panoramic radiography (M1) compared with CBCT and panoramic radiography (M2); and 2. the costs of producing different treatment plans, regarding patients with maxillary canines with eruption disturbance. Subjects and methods: Orthodontists participated in a web-based survey and were randomly assigned to denote treatment decisions and the level of confidence in this decision for four patient cases presented with M1 or M2 at two occasions for the same patient case. Results: One hundred and twelve orthodontists made 445 assessments based on M1 and M2, respectively. Twenty-four per cent of the treatment decisions were different depending on which method the raters had access to, whereof one case differed significantly from all other cases. The mean total cost per examination was €99.84 using M1 and €134.37 using M2, resulting in an incremental cost per examination of €34.53 for M2. Limitations: Benefits in terms of number of different treatment decisions must be considered as an intermediate outcome for the effectiveness of a diagnostic method and should be interpreted with caution. Conclusions: For the patient cases presented in this study, most treatment decisions were the same irrespective of radiological method. Accordingly, this study does not support routine use of CBCT regarding patients with maxillary canine with eruption disturbance.

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  • 32. Dimberg, Lillemor
    et al.
    Arnrup, Kristina
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Letters to the Editor2016In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 38, no 2, p. 223-223Article in journal (Other academic)
  • 33. Dimberg, Lillemor
    et al.
    Arnrup, Kristina
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    The impact of malocclusion on the quality of life among children and adolescents: a systematic review of quantitative studies2015In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 37, no 3, p. 238-247Article, review/survey (Refereed)
    Abstract [en]

    Background: Among child and adolescent patients, persistent but untreated malocclusions may or may not have psychological and social impacts on the individual's quality of life. Objectives: To gain knowledge of malocclusions and its impact on oral health-related quality of life (OHRQOL), we conducted a systematic review of quantitative studies for evidence regarding the influence of malocclusions on OHRQOL in children and adolescents. Materials and methods: Five databases (MEDLINE via PubMed, EMBASE, Psychinfo, CINAHL, and the Cochrane Library) were searched using specified indexing terms. The following inclusion criteria were used: child or adolescent study population; healthy study participants without syndromes such as cleft lip/palate or severe illness; no previous or ongoing orthodontic treatment among participants; a focus on malocclusions and quality of life; controlled or subgrouped according to malocclusions/no malocclusions; malocclusions and/or orthodontic treatment need assessed by professionals using standardized measures; self-assessed OHRQOL estimated using validated questionnaire instruments; full-text articles written in English or Scandinavian languages. Quality of evidence was classified according to GRADE guidelines as high, moderate, or low. Results: The search produced 1142 titles and abstracts. Based on pre-established criteria, the full-text versions of 70 articles were obtained, 22 of which satisfied the inclusion criteria. After data extraction and interpretation, six publications were deemed eligible for full inclusion. All six were of cross-sectional design, and the quality of evidence was high in four cases and moderate in the remaining two. The four studies with a high level of quality reported that anterior malocclusion had a negative impact on OHRQOL, and the two with a moderate level of quality reported that increased orthodontic treatment need had a negative impact on OHRQOL. Conclusion: The scientific evidence was considered strong since four studies with high level of quality reported that malocclusions have negative effects on OHRQOL, predominantly in the dimensions of emotional and social wellbeing.

  • 34.
    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.

  • 35. Dimberg, Lillemor
    et al.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lennartsson, Bertil
    Prevalence of malocclusion traits and sucking habits among 3-year-old children2010In: Swedish Dental Journal, ISSN 0347-9994, Vol. 34, no 1, p. 35-42Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to evaluate the prevalence of malocclusion traits and sucking habits among 3-year-old children. A sample of 457 3-year-old children (234 girls and 223 boys) was obtained from three Public Dental Health clinics in Orebro County Council, Sweden. Data from clinical examination and a questionnaire were used to determine malocclusion traits, sucking habits, snoring and breathing pattern including nocturnal breathing disturbances. The results showed that 70% had one or more malocclusion traits at 3 years of age. The most common malocclusion traits were anterior open bite (50%), Class II occlusion (26%), increased overjet (23%) and posterior crossbite (19%). The prevalence of sucking habit was 66% and dummy sucking was dominating and in connection with more malocclusion traits than finger/thumb sucking. A significant association was found between the sucking habits and the most prevalent malocclusions, anterior open bite, Class II occlusion, increased overjet and posterior crossbite. In conclusion, the prevalence of malocclusion traits in 3-year-old children was high. Sucking habits was highly prevalent and dummy sucking resulted in more malocclusion traits than finger/thumb sucking did.

  • 36. Dimberg, Lillemor
    et al.
    Lennartsson, Bertil
    Arnrup, Kristina
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study2015In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 85, no 5, p. 728-734Article in journal (Refereed)
    Abstract [en]

    Objective: To follow a group of children from primary to early permanent dentition and determine the prevalence, self-correction, and new development of malocclusions; the need for orthodontic treatment; and the possible influences of habits, breathing disturbances, and allergies. Materials and Methods: Two hundred and seventy-seven children were followed at 3, 7, and 11.5 years of age. Malocclusions and orthodontic treatment need were determined by clinical examinations. Data on sucking habits, breathing disturbances, allergies, dental trauma, and orthodontic treatments were collected from a questionnaire and dental records. Results: Malocclusions were found in 71% of participants at 3 years of age, 56% at 7 years of age, and 71% at 11.5 years of age. Self-correction was noted for anterior open bite, sagittal malocclusions, and posterior crossbite, while deep bite developed. A high number of contact point displacements and spacings contributed to the prevalence of malocclusion rate of 71% at 11.5 years. Severe or extreme orthodontic treatment need was apparent in 22%. Habits, allergies, or breathing disturbances found at 3 years of age had no associations with malocclusions at 11.5 years of age. Conclusions: This sample revealed a significant percentage of malocclusions and orthodontic treatment need. A substantial number of self-corrections and establishment of new malocclusions occurred during the transition from primary to early permanent dentition.

  • 37. Dimberg, Lillemor
    et al.
    Lennartsson, Bertil
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Arnrup, Kristina
    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.

  • 38. Dimberg, Lillemor
    et al.
    Lennartsson, Bertil
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Arnrup, Kristina
    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.

  • 39. Dimberg, Lillemor
    et al.
    Lennartsson, Bertil
    Söderfeldt, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Malocclusions in children at 3 and 7 years of age: a longitudinal study2013In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 35, no 1, p. 131-137Article in journal (Refereed)
    Abstract [en]

    The aim of this longitudinal study was to compare the prevalence of malocclusion at ages 3 and 7 years in a sample of children, exploring the hypothesis that prevalence of malocclusion is higher at 3 than at 7 years of age and may be influenced by sucking habits. The study sample comprised 386 children (199 girls and 187 boys), aged 3 years at study start, sourced from three Public Dental Service clinics in Sweden. Malocclusion was diagnosed by clinical examination, using a specific protocol. Data on allergy, traumatic injuries, sucking habits, and breathing pattern including nocturnal breathing disturbances were obtained by means of a questionnaire answered by child and parent in conjunction with the initial and final clinical examination. The overall prevalence of malocclusion decreased significantly, from 70 to 58% (P < 0.0001): predominantly anterior open bite, excessive overjet, and Class III malocclusion. Although high rates of spontaneous correction were also noted for deep bite, Class II malocclusion and posterior and anterior crossbites, new cases developed at almost the same rate; thus, the prevalence was unchanged at the end of the observation period. Anterior open bite and posterior crossbite were the only conditions showing significant associations with sucking habits. The results confirm the hypothesis of higher prevalence of malocclusion at 3 years of age and clearly support the strategy of deferring orthodontic correction of malocclusion until the mixed dentition stage.

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  • 40.
    Edman Tynelius, Gudrun
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lilja-Karlander, Eva
    Malmö högskola, Faculty of Odontology (OD).
    A randomized controlled trial of three orthodontic retention methods in Class I four premolar extraction cases: stability after 2 years in retention2013In: Orthodontics & craniofacial research, ISSN 1601-6335, E-ISSN 1601-6343, Vol. 16, no 2, p. 105-115Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate three different retention methods in compliant patients after 2 years of retention. DESIGN: Three group randomized controlled trial. MATERIALS AND METHODS: The sample was recruited from patients having their fixed appliance treatment between 2001 and 2007. Seventy-five patients (45 girls and 30 boys with a mean age of 14.4 years at start of retention) were randomized into three retention methods: vacuum-formed retainer in the maxilla and bonded canine-to-canine retainer in the mandible (Group V-CTC), vacuum-formed retainer in the maxilla combined with stripping of the 10 proximal surfaces of the lower mandibular anterior teeth (Group V-S) and prefabricated positioner covering the teeth in the maxilla and the mandible (Group P). The following linear measurements were performed: Little's irregularity index (LII), intercanine width, intermolar width, arch length, overjet, overbite and body height growth. Registrations were made before orthodontic treatment, at start of retention, after 12 and finally 24 months in retention. Differences in means between groups were tested by one-way analysis of variance (SPSS). RESULTS: After 2 years all three retention methods were successful in retaining orthodontic treatment results. The major part of relapse took place during the 1st year of retention. CONCLUSIONS: All 3 types of retention methods were equally effective in controlling relapse to a clinically acceptable level.

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  • 41. Edman Tynelius, Gudrun
    et al.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lilja-Karlander, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Evaluation of orthodontic treatment after 1 year of retention - a randomized trial2010In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 32, no 5, p. 542-547Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to use a randomized controlled trial methodology to evaluate and compare three different retention methods. The capacity of the retention methods to retain orthodontic treatment results was in this first phase analysed on a short-term basis, i.e. after 1 year of retention. The subjects were recruited from adolescents undergoing fixed appliance treatment at an orthodontic clinic in the National Health Service (NHS) in Sweden between 2001 and 2007. Seventy-five patients (45 girls and 30 boys with a mean age of 14.4 years at the start of retention) were randomized into three retention systems; a vacuum-formed retainer in the maxilla and bonded canine-to-canine retainer in the mandible (group V-CTC), a vacuum-formed retainer in the maxilla combined with stripping of the 10 proximal surfaces of the lower mandibular anterior teeth (group V-S), and a prefabricated positioner covering the teeth in the maxilla and mandible (group P). The main outcome measures were: Little's irregularity index (LII), intercanine and intermolar width, arch length, overjet, and overbite. Registrations were made before orthodontic treatment, when the fixed orthodontic appliance was removed, and after 12 months in retention. Differences in means between groups were tested by one-way analysis of variance. After 1 year of retention, no clinically significant difference in retention capacity was found between the three retention methods. Small but significant differences (P < 0.05) were observed between the V-CTC and V-S groups regarding mandibular canine width, mandibular arch length, and overbite. In group P, two patients failed to co-operate.

  • 42. Edman Tynelius, Gudrun
    et al.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lilja-Karlander, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Utvärdering av tre retentionsmetoder - uppföljning efter ett års retention efter ortodontisk behandling2007Conference paper (Other (popular science, discussion, etc.))
  • 43.
    Edman Tynelius, Gudrun
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petrén, Sofia
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lilja-Karlander, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Five-year postretention outcomes of three retention methods: a randomized controlled trial2015In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 37, no 4, p. 345-353Article in journal (Refereed)
    Abstract [en]

    Objective: Comparison of three different retention strategies 5 years or more postretention. Design, Setting, and Participants: Randomized, prospective, single-centre controlled trial. Forty-nine patients (33 girls and 16 boys) were randomly assigned to one of three retention methods during 2 years by picking a ballot shortly before start of retention treatment. Inclusion criteria were no previous orthodontics, permanent dentition, normal skeletal sagittal, vertical, and transversal relationships, Class I dental relationship, space deficiencies, treatment plan with extractions of four premolars followed by fixed straight-wire appliance. Maxillary and mandibular Little's irregularity index (LII), intercanine and intermolar width, arch length, and overbite/overjet were recorded in a blinded manner, altogether 10 measurements on each patient. Significant differences in means within groups assessed by t-test and between groups by one-way analysis of variance. Interventions: Retention methods: removable vacuum-formed retainer (VFR) covering the palate and the maxillary anterior teeth from canine-to-canine and bonded canine-to-canine retainer in the lower arch (group V-CTC); maxillary VFR combined with stripping of the lower anterior teeth (group V-S); and prefabricated positioner (group P). Results: Maxillary mean LII ranged from 1.8 to 2.6 mm, mean intercanine width 33.6-35.3 mm with a significant difference between groups V-S and P, mean intermolar width 46.8-47.4 mm and mean arch length 21.8-22.8 mm. Mandibular mean LII ranged from 2.0 to 3.4 mm with a significant difference between groups V-S and P, mean intercanine width from 25.4 to 26.6 mm, mean intermolar width from 40.8 to 40.9 mm and mean arch length from 16.9 to 17.3 mm. Mean overbite ranged from 1.8 to 2.7 mm and mean overjet from 3.7 to 4.1 mm. Limitations: A single centre study could be less generalizable. Conclusions: The three retention methods disclosed equally favourable clinical results.

  • 44. Feldmann, Ingalill
    et al.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Anchorage capacity of osseointegrated and conventional anchorage systems: a randomized controlled trial2008In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 133, no 3, p. 19-28Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Our aim in this investigation was to evaluate and compare orthodontic anchorage capacity of 4 anchorage systems during leveling/aligning and space closure after maxillary premolar extractions. METHODS: One hundred twenty patients (60 girls, 60 boys; mean age, 14.3 years; SD 1.73) were recruited and randomized into 4 anchorage systems: Onplant (Nobel Biocare, Gothenburg, Sweden), Orthosystem implant (Institut Straumann AG, Basel, Switzerland), headgear, and transpalatal bar. The main outcome measures were cephalometric analysis of maxillary first molar and incisor movement, sagittal growth changes of the maxilla, and treatment time. The results were also analyzed on an intention-to-treat basis. RESULTS: The maxillary molars were stable during the leveling/aligning in the Onplant, Orthosystem implant, and headgear groups, but the transpalatal bar group had anchorage loss (mean, 1.0 mm; P <.001). During the space-closure phase, the molars were still stable in the Onplant and Orthosystem groups, whereas the headgear and transpalatal bar groups had anchorage loss (means, 1.6 and 1.0 mm, respectively; P <.001). Thus, the Onplant and the Orthosystem implant groups had significantly higher success rates for anchorage than did the headgear and transpalatal bar groups. Compared with the Orthosystem implant, there were more technical problems with the Onplant. CONCLUSIONS: If maximum anchorage is required, the Orthosystem implant is the system of choice.

  • 45. Feldmann, Ingalill
    et al.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Orthodontic anchorage: a systematic review2006In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 76, no 3, p. 493-501Article, review/survey (Other academic)
    Abstract [en]

    The aim of this systematic review was to examine, in an evidence-based way, what kind of orthodontic anchorage systems/applications are evaluated and their effectiveness. A literature survey from the Pub Med and Cochrane databases covering the period from January 1966 to December 2004 was performed. Randomized controlled trials (RCT), prospective and retrospective controlled studies, and clinical trials comparing at least two anchorage situations were included. Two reviewers selected and extracted the data independently and also assessed the quality of the retrieved studies. The search strategy resulted in 494 articles, of which 14 met the inclusion criteria. Two main anchorage situations were identified: anchorage of molars during space closure after premolar extractions and anchorage loss in the incisor or premolar region (or both) during molar distalization. Because of contradictory results and the vast heterogeneity in study methods, the scientific evidence was too weak to evaluate anchorage efficiency during space closure. Intraoral molar distalization leads to anchorage loss in various amounts depending on the choice of distalization unit. Most of the studies had serious problems with small sample size, confounding factors, lack of method error analysis, and no blinding in measurements. To obtain reliable scientific evidence, controlled RCT's with sufficient sample sizes are needed to determine which anchorage system is the most effective in the respective anchorage situation. Further studies should also consider patient acceptance and cost analysis as well as implants as anchorage.

  • 46. Feldmann, Ingalill
    et al.
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function: a randomized controlled trial.2012In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 34, no 1, p. 102-108Article in journal (Refereed)
    Abstract [en]

    The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients’ perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.

  • 47. Feldmann, Ingalill
    et al.
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Feldmann, Hartmut
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 4, p. 578-585Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate and compare perceived pain intensity and discomfort between the placement of two different orthodontic anchoring units designed for osseointegration and premolar extraction in adolescent patients. MATERIALS AND METHODS: A total of 120 adolescent patients (60 girls and 60 boys) were recruited and randomized into three groups. Group A underwent installation of an onplant, group B installation of an Orthosystem implant, and group C premolar extraction. Pain intensity and discomfort, analgesic consumption, limitations in daily activities, and functional jaw impairment were evaluated the first evening and one week after the intervention. RESULTS: Pain intensity following surgical installation of an onplant was comparable to the pain intensity experienced after premolar extraction, but there was significantly less pain after surgical installation of an Orthosystem implant compared to installation of an onplant (P = .002) or premolar extraction (P = .007). The protective, vacuum-formed stent caused great discomfort, even more discomfort than the surgical sites following installation of the onplant or the Orthosystem implant. CONCLUSION: The Orthosystem implant was better tolerated than the onplant in terms of pain intensity, discomfort, and analgesic consumption and was, therefore, the anchorage system of choice in a short-term perspective.

  • 48.
    Feldmann, Ingalill
    et al.
    Uppsala University; County Council of Gävleborg.
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    John, Mike T
    University of Leipzig, Germany.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Reliability of a questionnaire assessing experiences of adolescents in orthodontic treatment2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 2, p. 311-317Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the reliability of a questionnaire that assessed the expectations and experiences of adolescent patients about orthodontic treatment. MATERIALS AND METHODS: The study included two groups of patients: 30 consecutive patients (19 girls and 11 boys, mean age 14.6 years, SD 2.3 years) naïve to orthodontic treatment, and 30 consecutive adolescent patients (17 girls and 13 boys, mean age 15.1 years, SD 2.0 years) in active orthodontic treatment with fixed appliances in both jaws. A questionnaire comprising 46 items was developed, based upon focus group interviews and previous established questionnaires. The questionnaire covered the following domains: Treatment motivation; treatment expectations; pain and discomfort from teeth, jaws, and face; functional jaw impairment; and questionnaire validity. Internal consistency as well as temporal stability with the test-retest method was investigated. RESULTS: A majority of the questions exhibited acceptable test-retest reliability, and composite scores yielded excellent reliability for all domains. Internal consistency was acceptable and good face validity was found for all domains. CONCLUSION: The questionnaire can be recommended for use in the assessment of expectations and experiences of orthodontic treatment.

  • 49.
    Ganzer, Niels
    et al.
    Malmö University, Faculty of Odontology (OD).
    Feldmann, Ingalill
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Anchorage reinforcement with miniscrews and molar blocks in adolescents: A randomized controlled trial2018In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 154, no 6, p. 758-767Article in journal (Refereed)
    Abstract [en]

    Introduction: Anchorage can be reinforced in many ways. Due to the variety of anchorage concepts, only a few general conclusions can be drawn. Therefore, more research is needed to investigate specific concepts with specific indications. The objective of this trial was to compare the anchorage capacities of miniscrews and molar blocks. Methods: This randomized controlled trial was conducted on 2 parallel arms. The trial was conducted at the Public Dental Service Orthodontic Clinic in Gavle, Sweden. Participants were adolescents who needed orthodontic treatment with a fixed appliance, extraction of the maxillary first premolars, and anchorage reinforcement. In group A, miniscrews were used as direct anchorage during space closure. In group B, molar blocks were used as anchorage reinforcement during leveling and alignment and space closure. The primary outcome was loss of anchorage assessed as maxillary first molar movement. Random allocation was maintained with a simple randomization stratified by sex. The observer was blinded to the allocations during the measurements. Results: Forty participants each were randomized to groups A and B. Results were analyzed on an intention-to-treat basis, meaning that all participants, successful or not, were included in the analysis. Group A showed a mean anchorage loss of 1.2 mm during leveling and alignment. During space closure with miniscrews, no significant anchorage loss was found. Group B showed mean anchorage losses of 1.4 mm during leveling and alignment and 2.4 mm during space closure. No serious harms were detected. The first molar rotation, torque, and tipping showed different characteristics during the treatment phases. Conclusion: Miniscrews can be recommended for anchorage reinforcement. Depending on the need for anchorage reinforcement, miniscrews can be inserted at the beginning of treatment or when space closure starts. Molar blocks cannot be recommended for anchorage reinforcement. Protocol: The protocol was published after trial commencement.

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  • 50.
    Ganzer, Niels
    et al.
    Department of Orthodontics, Public Dental Service Region Gävleborg, Gävle, Sweden, and Centre for Research and Development, Uppsala University/Region Gävleborg, Sweden.
    Feldmann, Ingalill
    Department of Orthodontics, Public Dental Service Region Gävleborg, Gävle, Sweden, and Centre for Research and Development, Uppsala University/Region Gävleborg, Sweden.
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Letters From Our Readers2017In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 87, no 3, p. 483-484Article in journal (Other academic)
    Abstract [en]

    Response to: Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial. The Angle Orthodontist; 2016;86:891–899. https://dspace.mah.se/handle/2043/21687

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