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  • 1.
    Abrahamsson, Helene
    et al.
    Malmö University, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö University, Faculty of Odontology (OD).
    Abrahamsson, Peter
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Treatment of temporomandibular joint luxation: a systematic literature review2020In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 24, p. 61-70Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation. MATERIALS AND METHODS: This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018. RESULTS: Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients. CONCLUSIONS: In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods. CLINICAL RELEVANCE: Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.

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  • 2.
    Alexander, Louise
    et al.
    National Dental Health Service, Skurup, Sweden.
    Hall, Emma
    National Dental Health Service, Karlshamn, Sweden.
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    The combination of non-selective NSAID 400 mg and paracetamol 1000 mg is more effective than each drug alone for treatment of acute pain: a systematic review2014In: Swedish Dental Journal, ISSN 0347-9994, Vol. 38, no 1, p. 1-14Article, review/survey (Refereed)
    Abstract [en]

    The aim was to evaluate the evidence on outcomes of the combination of non-selective NSAID/ paracetamol compared to either drug alone, to relieve acute pain following oral surgery in adult patients. A systematic review of available literature was performed. The first step comprised searches in three electronic databases. Original studies written in English were searched. As a second step, the reference lists of included publications were searched for additional publications. Abstracts were retrieved if the title contained information on postoperative pain, NSAID, and paracetamol in combination with oral surgery. Two reviewers selected publications on the basis of predetermined inclusion criteria. Data were extracted using one protocol and the quality of each study was • assessed using another protocol. The initial search in PubMed resulted in 138 abstracts and in the Cochrane library a further four. The search in the Web of Science resulted in no additional abstract. Five RCTs fulfilled the inclusion criteria. Pain relief from the combination of non-selective NSAID with paracetamol was significantly better than with paracetamol alone as well as with NSAID alone. Nausea, vomiting, headache, and dizziness were among the most common adverse events in all treatment groups. Most of the adverse events were of mild to moderate severity. Two studies reported no significant differences in adverse events between the treatment groups. According to one study the adverse events were significantly lower for the combination ibuprofen 400 mg/paracetamol 1000 mg compared to ibuprofen 400 mg alone. The need for rescue drugs in the different groups varied between the studies. Since the studies reported a significantly better postoperative pain relief with the combination of non-selective NSAIDs/paracetamol compared to each drug alone, this combination might be considered the treatment of choice, as long as side effects of NSAIDs are observed. 

  • 3. Andersson, J
    et al.
    Hallmer, F
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Unilateral mandibular condylar fractures: a 31-year follow-up of non-surgical treatment2007In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 36, no 4, p. 310-314Article in journal (Refereed)
    Abstract [en]

    At the University Hospital of Malmö, Sweden, standardized trauma charts were used for registration of all jaw fractures from 1972 to 1976. During the year 2005 the aim was to interview all patients treated non-surgically for unilateral mandibular condylar fractures during this period. In total, 49 patients with unilateral condylar fractures were treated non-surgically in 1972–1976. Of these, 23 patients were available for follow-up, 17 were dead, 7 were not found and 2 did not answer letters or phone calls. The follow-up was a telephone interview according to a standardized questionnaire concerning occurrence of pain and headache, function of the jaw and joint sounds. Information from original records, radiographic reports and the standardized trauma charts revealed fracture site, type of fracture and intermaxillary fixation if any. Eighty-seven percent of the patients reported no pain from the jaws, 83% had no problems chewing and 91% reported no impact of the fracture on daily activities. Neck and shoulder symptoms were reported by 39% and back pain by 30%. The 31-year results of non-surgical treatment of unilateral non-dislocated and minor dislocated condylar fractures seem favourable concerning function, occurrence of pain and impact on daily life.

  • 4. Baker, Z.
    et al.
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Sahlstrom, L. Englesson
    Ekberg, Ewa Carin
    Malmö högskola, Faculty of Odontology (OD).
    Questionable effect of lavage for treatment of painful jaw movements at disc displacement without reduction: a 3-year randomised controlled follow-up2015In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 42, no 10, p. 742-750Article in journal (Refereed)
    Abstract [en]

    The present randomised controlled study compared the 3-year outcome of local anaesthetics with anaesthetics and lavage in patients suffering from painful temporomandibular joint (TMJ) locking. The study included 45 patients referred for treatment of temporomandibular disorders (TMD) to the Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden. All patients received a history questionnaire and clinical examination according to the Research Diagnostic Criteria for TMD, panoramic radiographs and magnetic resonance imaging at baseline. Twenty-five patients were randomised to anaesthetics alone and 20 patients to anaesthetics and lavage. Three years after treatment, we sent the 37 patients who were available for follow-up a questionnaire that evaluated pain intensity, physical and emotional functioning, and global improvement. Thirty-four patients responded. The primary outcome was defined as >= 30% pain relief. In an intention-to-treat analysis, 28 of 45 patients (62%) reported >= 30% pain relief at the follow-up. At 3 years, improvement in pain relief, physical functioning, emotional functioning and global improvement differed non-significantly between local anaesthetics and anaesthetics and lavage. Compared with baseline, significant improvements (P < 0.05) in pain intensity, physical functioning, emotional functioning and global changes had occurred in both groups after 3 years. Because outcome measurements in the local anaesthetics and lavage and the local anaesthetics groups differed non-significantly 3 years after treatment of painful TMJ disc displacement without reduction, use of lavage (50 mL saline) has an equivalent effect as local anaesthetics.

  • 5. Bakke, Merete
    et al.
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Thorsen, Niels Max
    Sewerin, Ib
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Wagner, Aase
    Modified condylotomy versus conventional conservative treatment in painful reciprocal clicking-a preliminary prospective study in eight patients2008In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 12, no 4, p. 353-359Article in journal (Refereed)
    Abstract [en]

    Modified condylotomy may be relevant in severe painful reciprocal clicking of the temporomandibular joint (TMJ) where conservative treatment is insufficient. The effect of the modified condylotomy was analyzed and compared with conventional nonsurgical treatment in a randomized pilot study of eight patients, 19-44 years of age, with severe painful reciprocal clicking. Before and after treatment, assessments were performed by subjective reports, clinical recordings, and blinded evaluations of radiography and magnetic resonance imaging (MRI). Based on the clinical evaluations before treatment, all conditions were disc displacements with reduction and arthralgia (Research diagnostic criteria for temporomandibular disorders), but based on MRI, one patient had disc displacement without reduction and another had normal disc position. The treatment effect was significantly better and the disorders were significantly more reduced with condylotomy than with conventional nonsurgical treatment (P < 0.05, Mann-Whitney U test). In the surgical group, the clicking and locking had disappeared, the pain during function was significantly reduced (P < 0.05, Friedman ANOVA), and in two patients the disc position was normalized. The clicking still persisted in the nonsurgical patients and the disc position was unchanged. Our conclusion is that modified condylotomy is a promising option to reduce symptoms and signs in severe painful reciprocal clicking.

  • 6.
    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.

  • 7. Bryndahl, Fredrik
    et al.
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Legrell, Per Erik
    Isberg, Annika
    Bilateral TMJ Disk Displacement Induces Mandibular Retrognathia2006In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 85, no 12, p. 1118-1123Article in journal (Refereed)
    Abstract [en]

    Unilateral non-reducing TMJ disk displacement has been shown to retard mandibular growth on the ipsilateral side, with facial asymmetry a sequela. We hypothesized that bilateral affliction would impair mandibular growth bilaterally, generating mandibular retrognathia. Non-reducing TMJ disk displacement was surgically created in 10 growing New Zealand White rabbits. Ten additional rabbits served as a sham-operated control group. Facial growth was followed in serial cephalograms, with tantalum implants, during a period corresponding to childhood and adolescence in man. The results verified that bilateral non-reducing TMJ disk displacement retarded mandibular growth bilaterally, the extent corresponding to mandibular retrognathia in man. Maxillary growth was also retarded, but to a lesser degree. Growth impairment fluctuated over time, the most striking retardation occurring during periods of general growth acceleration. This should be taken into consideration when orthodontic treatment, aimed at stimulating mandibular growth, is initiated in adolescent individuals with non-reducing TMJ disk displacement.

  • 8. Bryndahl, Fredrik
    et al.
    Warfvinge, Gunnar
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Isberg, Annika
    Cartilage changes link retrognathic mandibular growth to TMJ disc displacement in a rabbit model2011In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 40, no 6, p. 621-627Article in journal (Refereed)
    Abstract [en]

    Recent experimental research demonstrated that non-reducing temporomandibular joint (TMJ) disc displacement in growing rabbits impaired mandibular growth. TMJ disc displacement is also shown to induce histological changes of the condylar cartilage. The authors hypothesized that the severity of these changes would correlate to the magnitude of mandibular growth. Bilateral non-reducing TMJ disc displacement was surgically created in 10 growing New Zealand White rabbits. Ten additional rabbits constituted a sham operated control group. Aided by tantalum implants, growth was cephalometrically determined for each mandibular side during a period equivalent to childhood and adolescence in man. At the end of the growth period, histologically classified cartilage features were correlated with the assessed ipsilateral mandibular growth. Non-reducing displacement of the TMJ disc during the growth period induced histological reactions of the condylar cartilage in the rabbit model. The severity of cartilage changes was inversely correlated to the magnitude and the direction of mandibular growth, which resulted in a retrognathic growth pattern.

  • 9.
    Ekberg, Ewacarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Hansson, Lars-Göran
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Sahlström, Lotta
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Can MRI Observations Predict Treatment Outcome of Lavage in Patients with Painful TMJ Disc Displacement without Reduction?2015In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 30, no 1, article id e5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to examine magnetic resonance imaging findings in patients with painful disc displacement without reduction of the temporomandibular joint to determine whether the findings were able to predict treatment outcome of lavage and a control group treated with local anaesthesia without lavage in a short-term: 3-month perspective. MATERIAL AND METHODS: Bilateral magnetic resonance images were taken of 37 patients with the clinical diagnosis of painful disc displacement without reduction. Twenty-three patients received unilateral extra-articular local anaesthetics and 14 unilateral lavage and extra-articular local anaesthetics. The primary treatment outcome defining success was reduction in pain intensity of at least 30% during jaw movement at the 3-month follow-up. RESULTS: Bilateral disc displacement was found in 30 patients. In 31 patients the disc on the treated side was deformed, and bilaterally in 19 patients. Osteoarthritis was observed in 28 patients, and 13 patients had bilateral changes. Thirty patients responded to treatment and 7 did not, with no difference between the two treated groups. In neither the treated nor the contralateral temporomandibular joint did treatment outcome depend on disc diagnosis, disc shape, joint effusion, or osseous diagnoses. Magnetic resonance imaging findings of disc position, disc shape, joint effusion or osseous diagnosis on the treated or contralateral side did not give information of treatment outcome. CONCLUSIONS: Magnetic resonance imaging findings could not predict treatment outcome in patients treated with either local anaesthetics or local anaesthetics and lavage.

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  • 10. Englesson Sahlström, Lotta
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lavage Questionable in Treatment of Painful Reduced Mouth Opening (Stockholm)2008Conference paper (Other academic)
    Abstract [en]

    Objective: To compare treatment with local anaesthetics and local anaesthetics in combination with lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. Material and methods: Forty-one women and four men (mean age of 35 years) participated. All patients had had TMJ pain for more than 3 months, had reduced mouth opening capacity, and had non-reducing disc displacement confirmed by magnetic resonance imaging. The patients were randomized to treatment with extra-articular local anaesthetic alone (control) or with extra-articular local anaesthetic in combination with lavage (treatment). All patients were examined at baseline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm analog scale (VAS). Results: At baseline, mean pain intensity (VAS) of the TMJ during mandibular movements was rated 58 among the controls and 61 in the treatment group. At the 3 months follow-up, treatment was considered successful in 76% of the controls and 50% of the treatment group. Mouth opening capacity was 34 mm and 33 mm at baseline and 43mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in pain intensity (VAS), successful treatment outcome (≥ 30%), and mouth opening capacity (mm) were non-significant between groups. Conclusion: Use of lavage to supplement extra-articular local anesthetic treatment of painful reduced mouth opening at non-reducing dics does not appear to improve treatment outcome. only.

  • 11. Englesson-Sahlström, Lotta
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lavage question in treatment of painful reduced mouth opening capacity2008In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 36, no Suppl 1, p. 162-163Article in journal (Other academic)
    Abstract [en]

    OBJECTIVES: To compare treatment with local anaesthetics and local anaesthetics and lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. METHODS: Forty-one women and four men (mean age 35 years) participated. All patients had had TMJ pain för more than 3 months, had reduced mouth opening capacity, and had non-reducin disc displacement confirmed by magnetic resonance imaging. The patient were randomized to treatment with extra-articular local anaesthetics alone (control) or with extra-articular local anaesthetics and lavage (treatment). All patients were examined at basline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm visual analog scale (VAS). RESULTS: At baseline, mean pain intensity (VAS) on movement of the TMJ was 58 among the controls and 61 in the treatment group. At the 3-month folow-up, treatment was considered succesful in 76% of the controls and 50% of the treatment group. Mouth opening capacity without assistance was 34 mm and 33 mm at baseline and 43 mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in median pain intesity, successful treatment outcome, and mouth opening capacity with assistance were nonsignificant. CONLUSIONS: Use of lavage to supplement extra-articular local anaesthetic treatment of painful reduced mouth opening at non-reducing discs does not appear to improve treatment outcome.

  • 12.
    Eriksson, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Hillerup, Sören
    Reibel, Jesper
    Persson, Sixten
    Brun, Aarne
    Traumatic changes of the inferior alveolar nerve and gasserian ganglion after removal of a mandibular third molar: report of a case2006In: Journal of oral and maxillofacial surgery (Print), ISSN 0278-2391, E-ISSN 1531-5053, Vol. 64, no 12, p. 1821-1825Article in journal (Other (popular science, discussion, etc.))
  • 13.
    Eriksson, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Analgesic efficacy and clinical acceptability of adjunct pre-emptive intravenous tramadol in midazolam sedation for third molar surgery2012In: Oral and Maxillofacial Surgery, ISSN 1865-1550, E-ISSN 1865-1569, Vol. 17, no 3, p. 193-199Article in journal (Refereed)
    Abstract [en]

    Introduction This study aims to compare two routine procedures of sedation, with and without intravenous adjunct analgesia, in third molar surgery regarding postoperative pain and consumption of analgesics. Material and methods In a randomized, controlled, single-blinded procedure, 87 men and women aged 18–44 years were divided into two treatment groups, midazolam + tramadol (M + T) and midazolam + saline (M + S), and one control group (C), with no additional medication. After removal of a third lower molar, patients recorded postoperative pain on a visual analog scale (VAS) and consumption of analgesics during the first day after surgery. Results Time from the end of operation until first rescue pill (400 mg Ibuprofen tablet) differed significantly between the M + S group (193 min) and the C group (110 min) (p = 0.001) as well as the M + T group (157 min) and the C group (p = 0.049). The study did not show any significant reduction of postoperative pain, VAS, after third molar surgery in patients who received adjunct pre-emptive intravenous administration of 1 mg/kg tramadol under midazolam sedation. Discussion and conclusion The lack of significant difference between the study and placebo groups indicates that tramadol at 1 mg/kg might be an insufficient dose, though the suitability for tramadol in oral and maxillofacial surgery has already been settled in other studies.

  • 14. Nörholt, S.E
    et al.
    Hallmer, Fredrik
    Malmö högskola, Faculty of Odontology (OD).
    Hartlev, J
    Pallesen, L
    Blomlöf, Johan
    Hansen, E J
    Fernandes, N
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Pinholt, E.M
    Analgesic efficacy with rapidly absorbed ibuprofen sodium dihydrate in postsurgical dental pain: results from the randomized QUIKK trial2011In: International journal of clinical pharmacology and therapeutics, ISSN 0946-1965, Vol. 49, no 12, p. 722-729Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the onset of analgesic effect for a new formulation of ibuprofen sodium dihydrate versus conventional ibuprofen (ibuprofen acid). MATERIALS AND METHODS: In this randomized, double-blind, double-dummy, crossover trial, patients requiring surgical removal of two impacted or partially impacted mandibular third molars received: ibuprofen sodium dihydrate 400 mg plus conventional ibuprofen placebo (Group 1); or conventional ibuprofen 400 mg plus ibuprofen sodium dihydrate placebo (Group 2) following the first surgery. Patients were then crossed over to the alternative treatment. RESULTS: 72 patients were enrolled in Group 1 and 72 patients in Group 2. Ibuprofen sodium dihydrate produced faster initial pain relief than conventional ibuprofen as assessed by time to first pain relief (24.6 vs. 30.5 minutes; p = 0.004), and patient-assessed pain relief at 15 minutes ("some" to "complete" pain relief: 43% vs. 29%; p < 0.001) and 30 minutes (82% vs. 63%; p < 0.001) and pain intensity at 30 minutes (p < 0.001). Substantial pain relief with ibuprofen sodium dihydrate was twice that of conventional ibuprofen at 30 minutes (11% vs. 5%; not significant); 29% and 33% of patients did not reach substantial pain relief at 120 minutes. There were no adverse events leading to treatment discontinuation and only two serious adverse events (oral abscess and facial paresis with conventional ibuprofen) considered unrelated to treatment. CONCLUSIONS: Ibuprofen sodium dihydrate was as effective as conventional ibuprofen, but had a faster onset of initial pain relief and significantly reduced pain intensity within the first 30 minutes after administration, providing rapid clinically meaningful pain relief for patients.

  • 15.
    Petersson, Arne
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Westesson, Per-Lennart
    MR images mimic disc after discectomy2005In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 34, no 4, p. 237-239Article in journal (Other academic)
    Abstract [en]

    MRI of a 30-year-old woman 1 year after discectomy showed a residual disc-like tissue. The observation was initially confusing, but a close comparison of pre- and post-operative images suggested that the inferior wall of the anterior joint capsule had migrated superiorly after the removal of the disc and mimicked a residual disc on the follow-up MR images.

  • 16. Rudin, Åsa
    et al.
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Liedholm, Rolf
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Werner, Mads U
    Prediction of postoperative pain after mandibular third molar surgery2010In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 24, no 2, p. 189-196Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS). Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled for MTMS were included. Preoperative psychometric indicators of anxiety, depression, and vulnerability were evaluated by patient questionnaires. Thermal thresholds and heat pain perception (1 second phasic stimuli: 44°C to 48°C) were evaluated with quantitative sensory testing techniques. Standardized surgery was performed during local anesthesia. Postoperative pain management was with rescue paracetamol and ibuprofen. The patients were instructed to record each day their pain at rest and during dynamic conditions, and their requirement of analgesics for 14 days following surgery. Results: Thirty-eight patients completed the study. Eight patients were readmitted because of pain. During the postoperative period, one or more episodes of moderate to severe pain (> 30 on a visual analog scale) was reported by 60% (23/38) at rest, 63% (24/38) during mouth-opening, and 73% (28/38) during eating. In a multiple regression model, the combination of psychological vulnerability and heat pain perception rendered a predictive model that could account for 15 to 30% of the variance in postoperative pain during resting and dynamic conditions (P = .03 to .001).Conclusion: Implementation of clinically relevant preoperative screening methods may offer more efficacious postoperative pain therapies to pain-susceptible individuals undergoing mandibular third molar surgery.

  • 17. Sahlström, LE
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lavage treatment of painful jaw movements at disc displacement without reduction: a randomized controlled trial in a short-term perspective2013In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 42, no 3, p. 356-363Article in journal (Refereed)
    Abstract [en]

    This study compared the short-term efficacy of two treatments (local anesthetics (A) and local anesthetics and lavage (AL)) in patients with permanently displaced discs and temporomandibular disorder (TMD) pain. 45 patients participated in the single-blind randomized controlled trial. All patients had received: a Research Diagnostic Criteria/TMD diagnosis of disc displacement without reduction; and magnetic resonance imaging confirmation of non-reducing disc displacement. Participants were randomized to treatment with A or AL and were assessed at baseline and at 1 and 3 month follow-ups. The primary outcome measure defining success was reduction in pain intensity of at least 30% during jaw movement. At the 3 month follow-up, the success rate was 76% for A and 55% for AL. Both groups reported similar pain relief with no significant difference between the groups. Similar trends were observed for outcome measures in the physical functioning, emotional functioning, and global improvement domains with no significant difference between the groups. Use of lavage to supplement extra-articular local anesthetic treatment of painful jaw movements at non-reducing discs does not appear to improve TMD pain and mouth opening capacity in the short term

  • 18. Schüttert, Eva-Maria
    et al.
    Alstad, Vera
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Orthognathic surgery: postoperative clinical and radiographic follow-up routines at Swedish oral and maxillofacial surgery department2012In: Swedish Dental Journal, ISSN 0347-9994, Vol. 36, no 3, p. 109-114Article in journal (Refereed)
    Abstract [en]

    Orthognathic surgery is a frequent procedure at Swedish Oral and Maxillofacial Surgery Departments.The number of clinical and radiographic postoperative follow-up examinations and the choice of radiographic methods seem to vary.The intention with this study was to find out when postoperative clinical and radiographic follow-up was performed following orthognathic surgery and the type of radiographic examinations that were used. In 2009, all Swedish Oral and Maxillofacial Surgery Departments in the Public Health Service (25 centres) were given a form containing standardized questions on the time for clinical follow-up after orthognathic surgery and the radiographic examinations used. A pilot study on 49 consecutive patients at one of the centres was performed to determine if the postoperative radiographic examinations added additional information, leading to further procedures compared to the clinical observations only. A one-year follow-up was the most frequently used clinical control reported by 15 centres, and a six-month follow-up, the next most frequent. At 14 of the 15 centres, radiographic examinations were included at the one-year follow-up. A five-year clinical and radiographic follow-up was reported by two centres. One or, at the most, two postoperative radiographic follow-up sessions were reported by 68% of the centres. Profile and panoramic imaging were most often used. In the evaluation of the postoperative handling of the 49 consecutive patients in the pilot study, a radiolucency around a fixation screw noted radiographically was the only additional postoperative radiological finding that resulted in a surgical procedure. Postoperative clinical and radiographic follow-up routines following orthognathic surgery vary considerably between the Swedish Oral and Maxillofacial Surgery Departments.There appears to be a need for studies on the value of the information,which repeated postoperative clinical and radiographic follow-up controls add in routine medical attendance.

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