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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. Bajramaj, Ermira
    et al.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Dawson, Andreas
    Malmö University, Faculty of Odontology (OD).
    Gerdle, Björn
    Ghafouri, Bijar
    The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls2019In: Diagnostics (Basel), ISSN 2075-4418, Vol. 9, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the metabolic milieu and thereby influence the results when comparing healthy subjects to those with TMD. This study aimed to investigate the levels of serotonin and glutamate during the acute tissue trauma period in healthy subjects and in patients with TMD. Microdialysis was carried out in 15 patients with TMD and 15 controls, and samples were collected every 20 min during a period of 140 min. No significant alterations of serotonin or glutamate were observed over the 2 h period for the healthy subjects. For the TMD group, a significant decrease in serotonin was observed over time (p < 0.001), followed by a significant increase between 120 and 140 min (p < 0.001). For glutamate, a significant reduction was observed at 40 min compared to baseline. The results showed that there was a spontaneous increase of serotonin 2 h after the insertion of the catheter in patients with TMD. In conclusion, the results showed that there are differences in the masseter muscle levels of serotonin and glutamate during acute nociception in patients with myofascial TMD compared to healthy subjects.

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  • 3.
    Bracci, Alessandro
    et al.
    Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Colonna, Anna
    Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy.
    Bender, Steven
    Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA.
    Conti, Paulo C R
    Bauru School of Dentistry, University of Sao Paulo, São Paulo, Brazil.
    Emodi-Perlman, Alona
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Telaviv, Israel.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Klasser, Gary D
    Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA.
    Michelotti, Ambra
    Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy.
    Lavigne, Gilles J
    Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, and Universite de Montreal, Montreal, Quebec, Canada.
    Svensson, Peter
    Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
    Ahlberg, Jari
    Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland.
    Manfredini, Daniele
    Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy.
    Research routes on awake bruxism metrics: implications of the updated bruxism definition and evaluation strategies.2024In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 51, no 1, p. 150-161Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, i.e. better assessment and more efficient management.

    METHODS: We summarised current strategies for AB assessment and proposed a research route for improving its metrics.

    RESULTS: Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity.

    CONCLUSIONS: Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally-based and subject-based information must be gathered in a universally accepted standardized approach.

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  • 4.
    Bracci, Alessandro
    et al.
    Univ Padua, Sch Dent, Dept Neurosci, I-35128 Padua, Italy..
    Lobbezoo, Frank
    Univ Amsterdam, Acad Ctr Dent Amsterdam ACTA, Dept Orofacial Pain & Dysfunct, NL-1081 LA Amsterdam, Netherlands.;Vrije Univ Amsterdam, NL-1081 LA Amsterdam, Netherlands..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Colonna, Anna
    Univ Siena, Sch Dent, Dept Biomed Technol, I-53100 Siena, Italy..
    Nykanen, Laura
    Univ Helsinki, Dept Oral & Maxillofacial Dis, Helsinki 00100, Finland..
    Pollis, Matteo
    Univ Siena, Sch Dent, Dept Biomed Technol, I-53100 Siena, Italy..
    Ahlberg, Jari
    Univ Helsinki, Dept Oral & Maxillofacial Dis, Helsinki 00100, Finland..
    Manfredini, Daniele
    Univ Siena, Sch Dent, Dept Biomed Technol, I-53100 Siena, Italy..
    Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations2022In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 17, article id 5083Article in journal (Other academic)
    Abstract [en]

    Awake bruxism (AB) is differentiated from sleep bruxism (SB) by the differences in etiology, comorbidities, and consequences related to the different spectrum of muscle activities exerted in relation to the different circadian manifestations. Furthermore, less literature data are available on AB than on SB. The introduction of ecological momentary assessment (EMA) strategies has allowed for collecting valuable data on the frequency of the different activities reported by an individual in his/her natural environment. This strategy has been further improved with the recent use of smartphone technologies. Recent studies have described an average frequency of AB behaviors, within the range of 23-40% for otherwise healthy young adults. An association between AB and some psychological traits has emerged, and the findings have indicated that patients with musculoskeletal symptoms (e.g., temporomandibular joint and/or muscle pain, muscle stiffness, and fatigue) report higher AB frequencies. Preliminary data suggest that muscle bracing and teeth contact are the most commonly reported behaviors, while teeth clenching is much less frequently reported than commonly believed previously. Report of teeth grinding during wakefulness is almost absent. This paper has critically reviewed the currently available approaches for the assessment of AB. In addition, some future perspectives and suggestions for further research have been provided.

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  • 5.
    Bredberg, Clara
    et al.
    Malmö University, Faculty of Odontology (OD).
    Vu, Camila
    Malmö University, Faculty of Odontology (OD).
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Chrcanovic, Bruno Ramos
    Malmö University, Faculty of Odontology (OD).
    Marginal bone loss around dental implants: comparison between matched groups of bruxer and non-bruxer patients2023In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 25, no 1, p. 124-132Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To compare marginal bone loss (MBL) around dental implants in a group of bruxers in relation to a matched group of non-bruxers.

    METHODS: The present record-based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö. Only implants not lost and with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up were considered for inclusion. Univariate linear regression models and a linear mixed-effects model were performed.

    RESULTS: Two hundred and four patients (104 bruxers, 100 non-bruxers), with a total of 811 implants (416 in bruxers, 395 in non-bruxers) were included in the study. The results of the linear mixed-effects model suggested that bruxism, smoking, age, region of the jaws, implant diameter, and prosthesis type had a statistically significant influence on MBL over time. Individuals who are both bruxers and smokers showed greater MBL when compared to individuals who are either a bruxer or smoker, or neither (p < 0.001).

    CONCLUSIONS: Bruxism is suggested to increase the risk of MBL over time, as well as higher age, smoking, and the combination of bruxism and smoking. Other factors that showed a correlation with increased MBL were implant diameter, region of the jaws, and prosthesis type, but it is not possible to draw robust conclusions for these factors, as the categories of these variables were very unbalanced.

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  • 6.
    Böthun, A
    et al.
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Häggman-Henrikson, B
    Malmö University, Faculty of Odontology (OD). Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Stålnacke, B-M
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Wänman, A
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Nordh, E
    Department of Clinical Science, Neurosciences, Div Clinical Neurophysiology, Umeå University, Umeå, Sweden.
    Lampa, E
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Hellström, F
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Clinical Signs in the Jaw and Neck Region Following Whiplash Trauma - a 2-year follow-up2023In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 27, no 6, p. 699-709Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective.

    METHODS: In total, 84 cases (48 women) diagnosed with neck distortion after a car accident and 116 controls (68 women) were examined within one month, and 49 cases (27 women) and 71 controls (41 women) were reexamined two years later. Outcome measures were pain on palpation of jaw and neck muscles and maximal jaw opening. Analysis was performed using mixed-models.

    RESULTS: Cases and women were at higher risk for pain on palpation of jaw muscles (OR:7.7;P<0.001 and OR:3.2;P=0.010, respectively) and neck muscles (OR:12.7;P<0.001 and OR:2.9;P=0.020, respectively) but with no significant effect of time. Cases and women also had lower maximal jaw opening (-3.1;P=0.001 and -3.3;P=0.001, respectively). There was no significant time effect, but a significant interaction between cases and time (2.2;P=0.004).

    CONCLUSION: Individuals with a whiplash trauma present a higher risk for pain on palpation in jaw and neck muscles both in a short- and long-term perspective, but show normal jaw movements. No time effect suggest that cases do not spontaneously improve nor get worse. Investigating pain on palpation in the jaw and neck muscles after whiplash trauma can identify individuals at risk for developing long-term orofacial pain and dysfunction.

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  • 7.
    Böthun, Alicia
    et al.
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden..
    Wiesinger, Birgitta
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Research and Development, Umeå University, Sundsvall, Sweden..
    Wänman, Anders
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden..
    Hellström, Fredrik
    Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden..
    Österlund, Catharina
    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden..
    Jaw-neck motor strategy during jaw-opening with resistance load2022In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 514-521Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known.

    OBJECTIVES: To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions.

    METHODS: Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex®) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant.

    RESULTS: The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, P<0.001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, P=0.018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, P=0.025).

    CONCLUSION: There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.

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  • 8.
    Chrcanovic, Bruno Ramos
    et al.
    Malmö University, Faculty of Odontology (OD).
    Larsson, Johan
    Skåne University Hospital.
    Malmström, Eva-Maj
    Skåne University Hospital; Lund University.
    Westergren, Hans
    Skåne University Hospital; Lund University.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis.2022In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 22, no 2, p. 232-261Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVES: Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list.

    CONTENT: The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers.

    SUMMARY: The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability.

    OUTLOOK: Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.

  • 9.
    Colonna, Anna
    et al.
    Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy.
    Bracci, Alessandro
    Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy.
    Ahlberg, Jari
    Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland.
    Câmara-Souza, Mariana Barbosa
    Ingá University Center, Maringá 87035-510, Brazil.
    Bucci, Rosaria
    Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples “Federico II”, 80138 Naples, Italy.
    Conti, Paulo César Rodrigues
    Bauru School of Dentistry, University of Sao Paulo, Sao Paulo 05508-000, Brazil.
    Dias, Ricardo
    Institute of Oral Implantology and Prosthodontics, Dentistry Department, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal.
    Emodi-Perlmam, Alona
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
    Favero, Riccardo
    Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy;Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Michelotti, Ambrosina
    Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples “Federico II”, 80138 Naples, Italy.
    Nykänen, Laura
    Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland.
    Stanisic, Nikola
    Malmö University, Faculty of Odontology (OD).
    Winocur, Efraim
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
    Manfredini, Daniele
    Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy.
    Ecological Momentary Assessment of Awake Bruxism Behaviors: A Scoping Review of Findings from Smartphone-Based Studies in Healthy Young Adults2023In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 5, article id 1904Article, review/survey (Refereed)
    Abstract [en]

    Background: The recent introduction of ecological momentary assessment (EMA) smartphone-based strategies has allowed achieving some interesting data on the frequency of different awake bruxism (AB) behaviors reported by an individual in the natural environment. Objective: The present paper aims to review the literature on the reported frequency of AB based on data gathered via smartphone EMA technology. Methods: On September 2022, a systematic search in the Pubmed, Scopus and Google Scholar databases was performed to identify all peer-reviewed English-language studies assessing awake bruxism behaviors using a smartphone-based Ecological Momentary Assessment. The selected articles were assessed independently by two authors according to a structured reading of the articles’ format (PICO). Results: A literature search, for which the search terms “Awake Bruxism” and “Ecological Momentary Assessment” were used, identified 15 articles. Of them, eight fulfilled the inclusion criteria. The results of seven studies using the same smartphone-based app reported a frequency of AB behaviors in the range between 28.3 and 40% over one week, while another investigation adopted a different smartphone-based EMA approach via WhatsApp using a web-based survey program and reported an AB frequency of 58.6%. Most included studies were based on convenience samples with limited age range, highlighting the need for more studies on other population samples. Conclusions: Despite the methodological limits, the results of the reviewed studies provide a standpoint for comparison for future studies on the epidemiology of awake bruxism behaviors.

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  • 10.
    Durham, Justin
    et al.
    School of Dental Sciences Newcastle University Newcastle UK;Newcastle Hospitals' NHS Foundation Trust Newcastle UK.
    Ohrbach, Richard
    Oral Diagnostic Sciences University at Buffalo School of Dental Medicine Buffalo New York USA.
    Baad‐Hansen, Lene
    Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function Aarhus University Aarhus Denmark.
    Davies, Stephen
    Division of Dentistry University of Manchester UK Manchester UK.
    De Laat, Antoon
    Department Oral health Sciences KU Leuven and Department Dentistry UZ Leuven Belgium.
    Goncalves, Daniela Godoi
    School of Dentistry, Araraquara São Paulo State University (Unesp) Araraquara Brazil.
    Gordan, Valeria V.
    Restorative Dental Sciences Department University of Florida College of Dentistry Gainesville Florida USA.
    Goulet, Jean‐Paul
    Faculty of Dental Medicine Laval University Quebec Quebec Canada.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Horton, Michael
    College of General Dentistry UK (CGDent) London UK.
    Koutris, Michail
    Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Law, Alan
    Endodontist, The Dental Specialists Woodbury Minnesota USA;Research Professor, Division of Endodontics University of Minnesota Minneapolis Minnesota USA.
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Skåne University Hospital, Specialized Pain Rehabilitation Lund Sweden.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Michelotti, Ambra
    Department of Neurosciences, School of Orthodontics, Reproductive Sciences and Oral Sciences University of Naples Federico II Naples Italy.
    Nixdorf, Donald R.
    Division of TMD &amp; Orofacial Pain, School of Dentistry and Department of Radiology, Medical School University of Minnesota Minneapolis Minnesota USA.
    Oyarzo, Juan Fernando
    TMD and Orofacial Pain Program, Faculty of Odontology Universidad Andres Bello Santiago Chile.
    Peck, Chris
    Faculty of Dentistry National University of Singapore Singapore Singapore.
    Penlington, Chris
    School of Dental Sciences Newcastle University Newcastle UK;Newcastle Hospitals' NHS Foundation Trust Newcastle UK.
    Raphael, Karen G.
    Department of Oral and Maxillofacial Pathology, Radiology &amp; Medicine New York University College of Dentistry New York New York USA.
    Santiago, Vivian
    Department of Oral and Maxillofacial Pathology, Radiology &amp; Medicine New York University College of Dentistry New York New York USA.
    Sharma, Sonia
    Oral Diagnostic Sciences University at Buffalo School of Dental Medicine Buffalo New York USA.
    Svensson, Peter
    Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function Aarhus University Aarhus Denmark.
    Visscher, Corine M.
    Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Yoshiki, Imamura
    Department of Oral Diagnostic Sciences Nihon University School of Dentistry Tokyo Japan.
    Alstergren, Per
    Malmö University, Faculty of Odontology (OD). Skåne University Hospital, Specialized Pain Rehabilitation Lund Sweden.
    Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing2023In: Journal of Oral Rehabilitation, E-ISSN 1365-2842Article in journal (Refereed)
    Abstract [en]

    Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.

    Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.

    Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.

    Results: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.

    Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.

  • 11. Eklund, Anton
    et al.
    Wiesinger, Birgitta
    Lampa, Ewa
    Österlund, Catharina
    Wänman, Anders
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Jaw-neck motor function in the acute stage after whiplash trauma.2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 7, p. 834-842Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Jaw-neck motor function is affected in the chronic stage following whiplash trauma. It is not known whether motor function is affected also in the early stage after whiplash trauma.

    OBJECTIVES: To determine how jaw and head movement amplitudes and movement cycle times correlate with jaw and neck pain, and neck disability in the acute stage after whiplash trauma.

    METHODS: Jaw and head movements during jaw opening-closing were recorded with an optoelectronic system in 23 cases (4 men, 19 women, 18-66 yrs) within one month after whiplash trauma and compared with 27 controls without neck trauma (15 men, 12 women, 20-66 yrs). Jaw and head movement amplitudes, head/jaw ratio (quotient of head and jaw movement amplitude), and movement cycle times were evaluated in relation to jaw and neck pain (Numeric Rating Scale) and neck disability (Neck Disability Index). Analyses were performed with Mann-Whitney U test and Spearman´s correlation.

    RESULTS: Compared with controls, cases showed smaller jaw movement amplitudes (p=0.006) but no difference in head movement amplitudes, head/jaw ratios, or movement cycle times. There were no significant correlations between movement amplitudes or cycle times and jaw and neck pain, and neck disability. Cases with high neck pain intensity had smaller jaw movement amplitudes compared to cases with low neck pain intensity (p=0.024).

    CONCLUSION: The results suggest that jaw-neck motor function may be affected in the acute stage after whiplash trauma, and more so in cases with higher neck pain intensity.

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  • 12.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Ali, David
    Malmö University, Faculty of Odontology (OD).
    Aljamal, Mustafa
    Malmö University, Faculty of Odontology (OD).
    Chrcanovic, Bruno Ramos
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Bruxism and dental implants: A systematic review and meta-analysis2024In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 51, no 1, p. 202-217Article in journal (Refereed)
    Abstract [en]

    Background: Overload from bruxism may affect survival of dental implants.

    Objectives: To evaluate implant failure and marginal bone loss (MBL) in patients presenting with probable bruxism compared to non-bruxers. The study was registered in PROSPERO (CRD42021238397).

    Methods: An electronic search September 2022 in PubMed/Medline, Web of Science and Science Direct was combined with a hand search. Two independent reviewers carried out abstract screening, full-text assessment, quality assessment (National Institutes of Health tool) and data extraction. Only studies that provided information on self-report and clinical examination needed for the diagnosis of at least 'probable' bruxism were included. A pairwise random-effect meta-analysis was carried out.

    Results: In total 1338 studies were identified, and after screening and full-text assessment 27 studies that presented data on 2105 implants in probable bruxers and 10 264 implants in non-bruxers were included, with 138 and 352 implant failures in respective groups. the meta-analysis showed that implants placed in probable bruxers had a higher risk of failure than in non-bruxers (OR 2.189; 95% CI 1.337, 3.583, p = .002). A meta-regression showed that follow-up time did not affect this OR. Eighteen studies provided general data on MBL but did not report results separated between bruxers and non-bruxers. Therefore, an analysis of MBL was not possible.

    Conclusion: The results of the present systematic review show that implants placed in probable bruxers present a significantly higher risk of failure than implants placed in non-bruxers. This should be considered in treatment planning and management of implant patients.

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  • 13.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Alstergren, Per
    Malmö högskola, Faculty of Odontology (OD).
    Davidson, T
    Malmö högskola, Faculty of Odontology (OD).
    Högestätt, ED
    Östlund, Pernilla
    Malmö högskola, Faculty of Odontology (OD).
    Tranaeus, Sofia
    Vitols, S
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Pharmacological treatment of oro-facial pain: health technology assessment including a systematic review with network meta-analysis.2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 10, p. 800-826Article in journal (Refereed)
    Abstract [en]

    This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients ≥18 years with chronic (≥3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

  • 14.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bechara, Christian
    Malmö University, Faculty of Odontology (OD).
    Pishdari, Brousk
    Malmö University, Faculty of Odontology (OD).
    Visscher, Corine M.
    Univ Amsterdam, Acad Ctr Dent Amsterdam, Dept Orofacial Pain & Dysfunct, Amsterdam, Netherlands; Vrije Univ, Amsterdam, Netherlands.
    Ekberg, EwaCarin
    Malmö University, Faculty of Odontology (OD).
    Impact of Catastrophizing in Patients with Temporomandibular Disorders: A Systematic Review2020In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 34, no 4, p. 379-397BArticle, review/survey (Refereed)
    Abstract [en]

    Aims: To assess the prevalence of catastrophizing in patients with temporomandibular disorders (TMD) and the possible associations between catastrophizing and treatment outcome. Methods: This review was registered in the Prospero database (CRD42018114233). Electronic searches were performed in PubMed, Scopus, and PsycINFO from the inception of each database up to October 26, 2018, and were combined with a hand search. Articles focusing on levels of catastrophizing and how catastrophizing affects pain levels and treatment outcomes for patients diagnosed with TMD were included, as well as studies reporting how treatment outcomes were affected by cognitive behavioral treatment as an addition to standard treatment for TMD. Reviews and case reports were excluded. Risk of bias was assessed with the Newcastle-Ottawa scale. Results: The literature search identified 266 articles. After screening of abstracts, the full texts of 59 articles were assessed. Of these, 37 articles, including 4,789 patients with TMD and 6,617 controls, met the inclusion criteria. Higher levels of pain catastrophizing were reported in patients with TMD, with a large effect size (Hedges' g = 0.86) compared to pain-free controls. Furthermore, associations of higher levels of catastrophizing with higher symptom severity and with poorer treatment outcome were reported together with indications of positive effects from cognitive behavioral therapy. Conclusion: The results suggest an association between catastrophizing and TMD that may affect not only symptom severity but also treatment outcome. Assessing levels of pain catastrophizing might therefore be valuable in the assessment and management of patients with TMD.

  • 15.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Ekberg, Ewa Carin
    Malmö University, Faculty of Odontology (OD).
    Ettlin, Dominik A
    Michelotti, Ambra
    Durham, Justin
    Goulet, Jean-Paul
    Visscher, Corine M
    Raphael, Karen G
    Mind the Gap: A Systematic Review of Implementation of Screening for Psychological Comorbidity in Dental and Dental Hygiene Education.2018In: Journal of Dental Education, ISSN 0022-0337, E-ISSN 1930-7837, Vol. 82, no 10, p. 1065-1076Article in journal (Refereed)
    Abstract [en]

    The biopsychosocial model is advocated as part of a more comprehensive approach in both medicine and dentistry. However, dentists have not traditionally been taught psychosocial screening as part of their predoctoral education. The aim of this systematic review was to provide an overview of published studies on the implementation of screening for psychological comorbidity in dental and dental hygiene education. The term "psychological comorbidity" refers to the degree of coexisting anxiety, depression, or other mental health problems in a patient presenting with a physical condition. The review followed a protocol registered in PROSPERO (CRD42016054083) and was carried out in accordance with the PRISMA guidelines. The methodological quality of the included studies was assessed using a ten-item tool developed for medical education. The electronic search in PubMed, Scopus, and PsycINFO from the inception of each database until December 31, 2016, together with a hand search, identified 1,777 articles. After abstracts were screened, 52 articles were reviewed in full text applying inclusion and exclusion criteria; four articles remained for the qualitative synthesis. Generally, the reported data on specific methods or instruments used for psychological screening were limited. Only one of the included articles utilized a validated screening tool. The results of this systematic review show that published data on the implementation of psychological patient assessment in dental and dental hygiene education are limited. To address this gap, the authors recommend short screening tools such as the Graded Chronic Pain Scale and the Patient Health Questionnaire for Depression and Anxiety. Educating dental and dental hygiene students about easy-to-use, reliable, and validated screening tools for assessing psychological comorbidity warrants more research attention and greater implementation in educational curricula.

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  • 16.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Jawad, Nora
    Malmö University, Faculty of Odontology (OD).
    Acuña, Xochitl
    Malmö University, Faculty of Odontology (OD).
    Visscher, Corine
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, Netherlands; University of Amsterdam & Vrije Universiteit, Amsterdam, Netherlands.
    Schiffman, Eric
    Department of Diagnostic and Biological Sciences, School of Dentistry University of Minnesota, Minneapolis, MN, USA.
    List, Thomas
    Malmö University, Faculty of Odontology (OD).
    Fear of Movement and Catastrophizing in Participants with Temporomandibular Disorders2022In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 36, no 1, p. 59-66Article in journal (Refereed)
    Abstract [en]

    Aims: To assess differences in catastrophizing and kinesiophobia in relation to areas of pain and somatic symptoms among participants with temporomandibular disorders (TMDs) and controls. Methods: In total, 401 participants (333 women, 68 men, mean age: 45.8 years) in the TMJ Impact Project were examined in accordance with the Diagnostic Criteria for TMD, including clinical examination (Axis I) and psychosocial assessment (Axis II) augmented with imaging of the temporomandibular joint (TMJ). Of these, 218 participants had a painful TMD pain diagnosis, 63 had a nonpainful TMD diagnosis, and 111 had no TMD. Nine participants had missing data. Participants completed the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Areas of Pain figure, and the Patient Health Questionnaire-15 for assessing somatic symptoms. Results: Compared to controls, participants with TMD pain showed higher levels of catastrophizing (P = .017), kinesiophobia (P < .001), areas of pain (P < .001), and somatic symptoms (P < .001). Participants with nonpainful TMD showed a higher level of kinesiophobia (P < .001) than controls. There was a positive correlation between catastrophizing and kinesiophobia for participants with TMD pain (r = 0.33, P < .001) and nonpainful TMD (r = 0.42, P < .001). Discussion: The results suggest more fear of movement, as well as an association between catastrophizing and fear of movement, in participants with TMD pain and in participants with nonpainful TMD compared to controls. Assessment and management of fear of movement as well as catastrophizing may be useful as part of individualized treatment strategies for patients with TMD.

  • 17.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lampa, E
    Marklund, S
    Wänman, A
    Pain and Disability in the Jaw and Neck Region following Whiplash Trauma2016In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, no 10, p. 1155-1160Article in journal (Refereed)
    Abstract [en]

    The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain.

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  • 18.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Westergren, Hans
    Axelsson, Susanna
    Temporomandibular disorder pain after whiplash trauma: a systematic review2013In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 27, no 3, p. 217-226Article in journal (Refereed)
    Abstract [en]

    AIMS: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. METHODS: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. RESULTS: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). CONCLUSION: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.

  • 19.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Liv, Per
    Ilgunas, Aurelija
    Visscher, Corine M
    Lobbezoo, Frank
    Durham, Justin
    Lövgren, Anna
    Increasing gender differences in the prevalence and chronification of orofacial pain in the population2020In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 161, no 8, p. 1768-1775Article in journal (Refereed)
    Abstract [en]

    Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course is lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, two screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010-2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least two consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (OR 2.58, 95% CI 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (IRR 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (IRR 2.56, 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.

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  • 20.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Lobbezoo, F.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands.
    Durham, J.
    School of Dental Sciences, Newcastle University, Newcastle, United Kingdom; Newcastle Hospitals’ NHS Foundation Trust, Newcastle, United Kingdom.
    Peck, C.
    Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Department of Rehabilitation Medicine, Skåne University Hospital, Malmö, Sweden.
    THE VOICE OF THE PATIENT IN OROFACIAL PAIN MANAGEMENT: The Voice of the Patient in Orofacial Pain Management2022In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 22, no 1, p. 1-7, article id 101648Article in journal (Refereed)
    Abstract [en]

    As pain cannot be measured objectively, the use of patient reported outcomes (PROs), and specifically dental PROs (dPROs), is essential for adequate assessment and management of the patient with orofacial pain. For orofacial pain conditions, some of the suitable PROs are specific to dentistry and hence can be labelled dPROs, whereas others are not. There is also a need to understand which outcomes and domains are most relevant to the patient with pain complaints within the context of the biopsychosocial model. Acute pain in the orofacial area is most often related to toothache, whereas the most common chronic orofacial pain are temporomandibular disorders. Other chronic pains in the orofacial area include neuropathic pain and unknown or idiopathic pain. PROs have been fundamental in the development of both screening procedures and diagnostic criteria in temporomandibular disorders. PROs are now often a prerequisite for the most common temporomandibular disorder pain diagnoses. Furthermore, PROs form the basis for decision-making with regard to treatment, prognostics, and referrals. Future areas of development include the standardized use of PROs in the screening and diagnostics of the less common orofacial pain conditions, together with development of core outcomes sets and standardized protocols for the use of PROs in evaluation of treatment including efficacy, compliance, adherence, and side-effects. © 2021 The Author(s)

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  • 21.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ohrbach, Richard
    Whiplash-Associated Disorders2017In: Clinical Cases in Orofacial Pain / [ed] Malin Ernberg, Per Alstergren, John Wiley & Sons, 2017, p. 154-160Chapter in book (Other academic)
    Abstract [en]

    Expand your knowledge and put it into practice with this unique, case-based guide Clinical Cases in Orofacial Pain is a valuable resource for undergraduate dental students as well as residents working towards board certification. Individual cases cover temporomandibular joint disorders, masticatory muscle disorders, headache, neuropathic pain, dental pain, tooth wear, and dystonia. Following the popular Clinical Cases series style, cases are presented with associated academic commentary, including background information, diagnostic criteria and fundamental points that might influence the diagnosis, treatment planning or management of the case. Well-illustrated throughout, each chapter features self-assessment study questions to help foster independent learning. Clinical Cases in Orofacial Pain is an excellent primer for undergraduate dental students and an invaluable study guide for postgraduate students and residents. Dental practitioners will also want to keep this unique, case-based guide as a ready reference in their working libraries.

  • 22.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rezvani, M
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Prevalence of whiplash trauma in TMD patients: a systematic review2014In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 41, no 1, p. 59-68Article, review/survey (Refereed)
    Abstract [en]

    The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 8·4% to 70% (median 35%) in TMD populations, compared with 1·7-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD

  • 23.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD). Umeå University.
    Visscher, C M
    Academic Centre for Dentistry Amsterdam, Amsterdam, the Netherlands.
    Wänman, A
    Umeå University.
    Ljótsson, B
    Karolinska Institute.
    Peck, C C
    The University of Sydney, Sydney, Australia.
    Lövgren, A
    Umeå University.
    Even mild catastrophic thinking is related to pain intensity in individuals with painful Temporomandibular Disorders2021In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 11, p. 1193-1200Article in journal (Refereed)
    Abstract [en]

    AIMS: Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophizing, i.e., exaggeration of negative consequences of a painful event. The aim was to investigate catastrophizing in individuals with painful TMD compared to controls and the association between catastrophizing and pain intensity, number of pain sites and functional limitations.

    METHODS: A community-based sample of 110 individuals (83 women; 20-69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD), and 190 age- and gender-matched controls (119 women; 20-69 yrs) from the Public Dental services in Västerbotten, Sweden participated. Associations between catastrophizing and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression. adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain Catastrophizing Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated.

    RESULTS: Levels of catastrophizing, were associated with TMD pain (OR 1.6, 95%CI 1.1-2.6). Among individuals with painful TMD, catastrophizing was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294-0.321, p≤0.002), but not to number of pain sites.

    CONCLUSION: Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophizing, and this catastrophizing was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophizing suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.

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  • 24.
    Häggman-Henrikson, Birgitta
    et al.
    Malmö University, Faculty of Odontology (OD).
    Wiesinger, Birgitta
    Wänman, Anders
    The effect of supervised exercise on localized TMD pain and TMD pain associated with generalized pain2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 6-12, article id 7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the effect of a supervised exercise program in patients with localized/regional temporomandibular disorder (TMD) pain and with TMD associated with generalized pain. MATERIAL AND METHODS: Consecutively referred patients with localized/regional TMD pain (n = 56; 46 women and 10 men, mean age 44 years) and TMD associated with generalized pain (n = 21; 21 women, mean age 41 years) participated. Patients underwent a 10-session structured supervised exercise program over 10-20 weeks that included relaxation, and coordination and resistance training of the jaw and neck/shoulders. The outcomes were jaw pain intensity on the Numerical Rating Scale, endurance time for jaw opening and protrusion against resistance and chewing, and effect of pain on daily activities. RESULTS: After the exercise program, a reduction in jaw pain was reported by the local (p = .001) and general (p = .011) pain groups. There were no significant differences in jaw pain intensity between the groups, before (p = .062) or after treatment (p = .121). Endurance time increased for both groups for jaw opening/protrusion (both p < .001) and chewing (both p = .002). The effect of jaw pain on daily activities decreased after exercise compared to baseline for both the local (p < .001) and general (p = .008) pain groups. CONCLUSIONS: Supervised exercise can reduce TMD pain and increase capacity in patients with TMD. The results suggest that activation of the jaw motor system with exercise has a positive effect in patients with localized/regional TMD pain and TMD associated with generalized pain.

  • 25.
    Ilgunas, A.
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden.
    Häggman-Henrikson, B.
    Malmö University, Faculty of Odontology (OD). Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden.
    Visscher, C.M.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Lobbezoo, F.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Durham, J.
    School of Dental Sciences, Newcastle University, Newcastle, UK;Newcastle Hospitals’ NHS Foundation Trust, Newcastle, UK.
    Liv, P.
    Section of Sustainable Health, Department of Public Health and Clinical Medicine, University of Umeå, Umeå, Sweden.
    Lövgren, A.
    Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden.
    The Longitudinal Relationship between Jaw Catching/Locking and Pain2023In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 102, no 4, p. 383-390, article id 002203452211385Article in journal (Refereed)
    Abstract [en]

    Orofacial pain and joint-related dysfunction can negatively affect daily jaw function. A common cause for limitations in jaw movements is joint-related dysfunction such as various forms of catching and locking. However, knowledge is limited regarding the development and natural course of joint-related jaw dysfunction and its relationship to the onset and course of orofacial pain. Therefore, the aim was to evaluate the incidence, prevalence, and gender differences in jaw catching/locking over time and in relation to orofacial pain in the general population. Data from 3 validated screening questions on orofacial pain and jaw catching/locking were collected from all routine dental checkups in the Public Dental Health Services in Västerbotten, Sweden, from 2010 to 2017. Logistic generalized estimating equation was used to account for repeated observations and Poisson regression for incidence analysis. In total, 180,308 individuals (aged 5–104 y) were screened in 525,707 dental checkups. In 2010, based on 37,647 individuals, the prevalence of self-reported catching/locking was higher in women than in men (3.2% vs. 1.5%; odds ratio, 2.11; 95% confidence interval [CI], 1.83–2.43), and this relationship and magnitude remained similar throughout the study period. The annual incidence rate was 1.1% in women and 0.5% in men. Women were at a higher risk than men for reporting both first onset (incidence rate ratio [IRR], 2.29; 95% CI, 2.11–2.49) and persistent (IRR, 2.31; 95% CI, 2.04–2.63) catching/locking. For the onset subcohort (n = 135,801), an independent onset of orofacial pain or jaw catching/locking exclusively was reported by 84.1%, whereas a concurrent onset was reported by 13.4%. Our findings of higher incidence, prevalence, and persistence in women than in men indicate that the gender differences seen for orofacial pain are evident also for jaw catching/locking. The findings also suggest independent onset of self-reported catching/locking and orofacial pain, which reinforces the pathophysiological differences between these conditions.

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  • 26.
    Ilgunas, Aurelia
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Fjellman-Wiklund, Anncristine
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Visscher, Corine M
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Durham, Justin
    School of Dental Sciences, Newcastle University, Newcastle, UK; Newcastle Hospitals’ NHS Foundation Trust, Newcastle, UK.
    Lövgren, Anna
    Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
    Patients' experiences of temporomandibular disorders and related treatment.2023In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 653Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Temporomandibular disorders (TMD) are common and therefore managed by dentists on a daily basis. However, patients with TMD consistently go undetected and therefore untreated in dentistry. The reasons for these shortcomings have not been fully explored, specifically with regard to patients' perspectives. Therefore, this study aimed to explore patients' experiences of TMD and related treatment, with special focus on the experiences of having TMD, factors related to seeking care, and perspectives on received treatment.

    METHODS: Purposive sampling was used to recruit adult patients at the Public Dental Health services (PDHS) in the Region of Västerbotten, Sweden, during 2019. Individual semi-structured interviews were conducted and analysed using Qualitative Content Analysis. Sixteen patients were interviewed (ten women and six men, 20-65 years). The interviews probed the patients' perspectives of having TMD, seeking care, and receiving treatment. All participants were also examined according to the Diagnostic Criteria for TMD (DC/TMD) and qualified for at least one DC/TMD diagnosis.

    RESULTS: The data analysis led to the main theme Seeking care when the situation becomes untenable, but dental care fails to meet all needs. The patients expressed worry and social discomfort because of the symptoms but still strived to have an as normal daily life as possible. However, severe symptoms and associated consequences compelled them to seek professional help. Experiences of distrust together with challenges to access the PDHS were identified and related to the patients' unfulfilled expectations.

    CONCLUSIONS: Patients' reported experiences indicate that receiving timely and appropriate care is more of an unfulfilled expectation than the current state of management of patients with TMD in dentistry.

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  • 27.
    Ilgunas, Aurelia
    et al.
    Malmö University, Faculty of Odontology (OD). Umeå University.
    Lövgren, Anna
    Umeå University.
    Fjellman-Wiklund, Anncristine
    Umeå University.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Karlsson Wirebring, Linnea
    Umeå University.
    Lobbezoo, Frank
    University of Amsterdam and Vrije Universiteit, The Netherlands.
    Visscher, Corine M
    University of Amsterdam and Vrije Universiteit, The Netherlands.
    Durham, Justin
    Newcastle University, UK.
    Conceptualizing the clinical decision-making process in managing temporomandibular disorders: A qualitative study2021In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 129, no 5, article id e12811Article in journal (Refereed)
    Abstract [en]

    Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process for TMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.

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  • 28.
    John, M. T.
    et al.
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minnesota, Minneapolis.
    Omara, M.
    Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.
    Su, N.
    Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Department of Rehabilitation Medicine, Skåne University Hospital, Sweden.
    Sekulic, S.
    Dental Division, Department for Prosthetic Dentistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Visscher, C. M.
    Department of Orofacial Pain and Disfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
    Bekes, K.
    Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Reissmann, D. R.
    Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Baba, K.
    Department of Prosthodontics, Showa University, Tokyo, Japan.
    Schierz, O.
    Department of Prosthodontics and Materials Science, University of Leipzig, Germany.
    Theis-Mahon, N.
    Health Sciences Libraries, University of Minnesota, Minneapolis, Minnesota.
    Fueki, K.
    Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
    Stamm, T.
    Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Oghli, Ibrahim
    Malmö University, Faculty of Odontology (OD). Department of Oral Basic Sciences, Taibah University, Medina, Saudi Arabia.
    van Wijk, A.
    Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    Larsson, Pernilla
    Malmö University, Faculty of Odontology (OD). Centre for Oral Rehabilitation, Folktandvården Östergötland, Linköping, Sweden.
    Recommendations for use and scoring of oral health impact profile versions2022In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 22, no 1, article id 101619Article in journal (Refereed)
    Abstract [en]

    Background: OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited. Aim: We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them. Methods: Data came from the “Dimensions of OHRQoL Project” and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions’ summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions’ domain scores or OHIP-5′s items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment. Results: Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91–0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively. Conclusion: Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP. 

  • 29.
    John, Mike T.
    et al.
    Department of Diagnostic and Biological Sciences School of Dentistry University of Minnesota Minneapolis MN USA;Division of Epidemiology &amp; Community Health School of Public Health University of Minnesota Minneapolis MN USA.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences Denmark.
    Sekulic, Stella
    Dental Division Department for Prosthetic Dentistry Faculty of Medicine University of Ljubljana Ljubljana Slovenia.
    Stamm, Tanja
    Section for Outcomes Research Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna Vienna Austria.
    Oghli, Ibrahim
    Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences Denmark;Department of Oral Basic Sciences Taibah University Medina Saudi Arabia.
    Schierz, Oliver
    Department of Prosthodontics and Materials Science University of Leipzig Leipzig Germany.
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences Denmark;Department of Rehabilitation Medicine Skåne University Hospital Malmö Sweden.
    Baba, Kazuyoshi
    Department of Prosthodontics Showa University Tokyo Japan.
    Bekes, Katrin
    Department of Pediatric Dentistry University Clinic of Dentistry Medical University of Vienna Vienna Austria.
    van Wijk, Arjen
    Department of Social Dentistry Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam &amp; Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Su, Naichuan
    Department of Social Dentistry Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam &amp; Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Reissmann, Daniel R.
    Department of Prosthetic Dentistry University Medical Center Hamburg‐Eppendorf Hamburg Germany.
    Fueki, Kenji
    Removable Partial Prosthodontics Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Bunkyo‐ku Japan.
    Larsson, Pernilla
    Centre for Oral Rehabilitation Folktandvården Östergötland Linköping Sweden.
    Theis‐Mahon, Nicole
    Health Sciences Libraries University of Minnesota Minneapolis MN USA.
    Omara, Maisa
    Section for Outcomes Research Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna Vienna Austria;Ludwig Boltzmann Cluster Arthritis and Rehabilitation Vienna Austria.
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Visscher, Corine M.
    Department of Orofacial Pain and Disfunction Academic Center for Dentistry Amsterdam (ACTA) University of Amsterdam and VU University Amsterdam Amsterdam The Netherlands.
    Mapping Oral Disease Impact with a Common Metric (MOM)—Project summary and recommendations2021In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 3, p. 305-307Article in journal (Refereed)
    Abstract [en]

    Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact—the dimensions of oral health-related quality of life—capture dental patients’ oral health problems worldwide and regardless of whether the patient currently suffers from oral diseases or intends to prevent them in the future. Using scores for these dimensions, the project Mapping Oral Disease Impact with a Common Metric (MOM) aims to provide four-dimensional oral health impact information across oral diseases and settings. In this article, project authors summarize MOM’s findings and provide recommendations about how to improve standardized oral health impact assessment. Project MOM’s systematic reviews identified four-dimensional impact information for 189 adult and 22 pediatric patient populations that were contained in 170 publications. A typical functional, pain-related, aesthetical, and psychosocial impact (on a 0-8 impact metric based on two items with a response format 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often, 4 = very often) was about 2 to 3 units. Project MOM provides five recommendations to improve standardized oral health impact assessment for all oral diseases in all settings. 

  • 30. Lampa, Ewa
    et al.
    Wänman, Anders
    List, Thomas
    Malmö University, Faculty of Odontology (OD).
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Relationship Between Psychosocial Factors and Pain in the Jaw and Neck Regions Shortly After Whiplash Trauma2019In: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 33, no 2, p. 213-219Article in journal (Refereed)
    Abstract [en]

    Aims: To assess jaw pain shortly after whiplash trauma in relation to neck pain, physical symptoms, depression, and jaw pain–related disability. Methods: A total of 181 cases (106 women and 75 men, mean ages 33.7 and 36.8 years, respectively) were examined within 1 month after a whiplash trauma and compared to 117 controls (68 women and 49 men, 34.2 and 30.9 years, respectively). Participants rated current jaw and neck pain intensity on a numeric rating scale and rated nonspecific physical symptoms and depression symptoms on subscales of the Symptom Checklist-90-Revised. The nonspecific physical symptoms were further analyzed with and without pain items. Disability related to jaw pain and neck pain was also assessed. Differences between groups were calculated using Mann-Whitney U test, and correlations were measured using Spearman correlation. Results: Compared to controls, cases reported higher current jaw and neck pain intensity (P < .0001), together with higher scores for physical nonpain and pain symptoms, depression, and jaw pain–related disability (P < .0001 for all). For cases, there were moderate correlations between nonspecific physical symptoms and jaw pain and neck pain, as well as between jaw pain–related disability and jaw pain and neck pain (r = 0.43 to 0.77, P < .0001 for all). Low correlations were observed between depression and jaw pain and neck pain (r = 0.34 to 0.39, both P < .0001). Conclusion: Shortly after a whiplash trauma, pain in the jaw and neck regions is associated with the severity of psychosocial factors. Thus, psychosocial factors may play a role in the development of pain in the jaw region after whiplash trauma.

  • 31. Lampa, Ewa
    et al.
    Wänman, Anders
    Nordh, E
    Häggman-Henrikson, Birgitta
    Malmö högskola, Faculty of Odontology (OD).
    Effects on jaw function shortly after whiplash trauma2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 12, p. 941-947Article in journal (Refereed)
    Abstract [en]

    Normal jaw function involves muscles and joints of both jaw and neck. A whiplash trauma may disturb the integrated jaw-neck sensory-motor function and thereby impair chewing ability; however, it is not known if such impairment is present shortly after a neck trauma or develops over time. The aim was to evaluate jaw function after a recent whiplash trauma. Eighty cases (47 women) were examined within 1 month after a whiplash trauma and compared to 80 controls (47 women) without neck trauma. Participants completed the Jaw disability checklist (JDC) and Neck Disability Index (NDI) questionnaires and performed a 5-minute chewing test. Elicited fatigue and pain during chewing were noted, and group differences were evaluated with Fisher's exact test and Mann-Whitney U-test. Compared to controls, cases had higher JDC (P < .0001) and NDI scores (15% vs 2%, P < .0001), and reported more fatigue (53% vs 31%, P = .006) and pain (30% vs 10%, P = .003) during the chewing test. Cases also had a shorter onset time for fatigue and pain (both P = .001) Furthermore, cases reporting symptoms during chewing had higher JDC and NDI scores compared to cases not reporting symptoms (both P = .01). Symptoms mainly occurred in the trigeminal area for both groups, but also in spinal areas more often for cases than for controls. Taken together, the results indicate that jaw-neck sensory-motor function is impaired already within 1 month after a whiplash trauma. The association between neck disability and jaw impairment underlines the close functional relationship between the regions, and stresses the importance of multidisciplinary assessment.

  • 32. Lampa, Ewa
    et al.
    Wänman, Anders
    Nordh, Erik
    Stålnacke, Britt-Marie
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    The course of orofacial pain and jaw disability after whiplash trauma: a 2-year prospective study2020In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 45, no 3, p. E140-E147Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Prospective cohort study OBJECTIVE.: To evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability and psychosocial factors at the acute stage and the chronic stage after whiplash trauma.Summary of Background Data Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma. METHODS: Within one month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, non-specific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined. RESULTS: Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain was correlated to non-specific physical symptoms and to depression. CONCLUSION: Orofacial pain and jaw disability related to neck pain is often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma. LEVEL OF EVIDENCE: 3.

  • 33.
    Larsson, Johan
    et al.
    Malmö University, Faculty of Odontology (OD).
    Westergren, Hans
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Ilgunas, Aurelija
    Wänman, Anders
    Malmström, Eva-Maj
    The feasibility of gym-based exercise therapy for patients with persistent neck pain2020In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 20, no 2, p. 261-272Article in journal (Refereed)
    Abstract [en]

    Background and aims Persistent neck pain is common and can be detrimental to the health of those who are affected. This is particularly common after neck trauma, where it poses a challenge to health care providers. In this paper, we present the design and results of a study aimed primarily at assessing the feasibility of a supervised exercise intervention for patients with persistent neck pain after trauma. As a secondary aim, we analyzed the results of the intervention. Methods We designed and conducted a feasibility study using a mixed methods design. Ten patients with persistent neck pain (nine with a history of neck trauma and one with sudden onset of neck pain) were recruited from a specialized pain rehabilitation center and underwent a gym-based individual exercise therapy intervention, supervised by a physical therapist. We assessed the feasibility of the exercise therapy intervention based on the experiences of the patients and physical therapists. We analyzed both quantitative and qualitative results using descriptive statistics, content analysis, and questionnaires. Results The study found the exercise therapy to be a feasible alternative for patients with persistent neck pain. Most of the practical aspects of the intervention and study were executed as planned, and the study was well received by the patients, who found it a valuable part of their rehabilitation. In the quantitative analysis, improvements were observed on the Neck Disability Index, numerical rating scale for pain, EuroQol 5D, and physical activity, with scores on the Neck Disability Index showing a statistically significant improvement. Scores on the Disability Rating Index showed a non-significant deterioration. The qualitative analysis uncovered one overarching theme and four themes for the patients and three themes for the physical therapist. Conclusions The exercise therapy intervention seems to be feasible with favorable outcomes for the patients. The quantitative and qualitative analyses demonstrated exercise therapy to be beneficial from several different perspectives. However, although structured, the training needs customization and individual adaption from a clinical reasoning perspective in order to meet each patient's individual needs. Implications This study shows that supervised gym-based exercise therapy is feasible for patients with severe, persistent neck pain. It facilitates and motivates the execution of a larger, controlled trial, which might then lead to a new and potentially effective addition to the toolbox of all health care providers treating patients with persistent neck pain.

  • 34.
    Larsson, Pernilla
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö University, Faculty of Odontology (OD).
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    The Impact of Orofacial Appearance on Oral Health Related Quality of Life: A Systematic Review2021In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 48, no 3, p. 271-281Article in journal (Refereed)
    Abstract [en]

    Esthetics in the orofacial region is important for perceived oral health and a common reason for treatment of discoloured, missing or crowded teeth. As one of the fundamental bricks of a patient's oral health, changes in the domain of orofacial esthetics resides within the Oral Health Related Quality of Life (OHRQoL) of an individual. Four main dimensions, Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, are suggested to cover the concept of OHRQoL. The aim of this systematic review was to map the impact from oral conditions with principal impact on the Orofacial Appearance dimension of OHRQoL (PROSPERO: CRD42017064033). Publications were included if they reported Oral Health Impact Profile (OHIP) mean or median domain scores for patients with esthetic treatment need relating to tooth wear, orthodontics, orthognathic surgery, frontal tooth loss or tooth whitening. A search in PubMed (Medline), EMBASE, Cochrane, CINAHL, and PsycINFO June 8, 2017 and updated January 14, 2019, identified 2,104 abstracts. After screening of abstracts, 1,607 articles were reviewed in full text and 33 articles included. These 33 articles reported OHIP-data for 9,409 patients grouped in 63 patient populations. Median orofacial appearance impact scores on a standardized 0 to 8 scale, for populations with treatment need relating to tooth wear, orthodontics, orthognathic surgery, frontal tooth loss and tooth whitening, ranged from 0.13 for tooth wear to 3.04 for tooth whitening populations. In conclusion, a moderate impact for the Orofacial Appearance dimension of OHRQoL was found in patients with different conditions with esthetically related treatment need.

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  • 35.
    Lobbezoo, F
    et al.
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Aarab, G
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Kapos, F P
    Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States.
    Dayo, A F
    Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
    Huang, Z
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Koutris, M
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Peres, M A
    National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore; Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore.
    Thymi, M
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    The Global Need for Easy and Valid Assessment Tools for Orofacial Pain2022In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 101, no 13, p. 1549-1553, article id 220345221110443Article in journal (Refereed)
    Abstract [en]

    The World Health Organization recently adopted a historic resolution (WHA74.5) on the urgent need for global oral health improvement. This resolution is particularly relevant in the perspective of the high prevalence of untreated oral diseases. However, one important aspect has been mentioned only in passing, namely that poor oral health often leads to orofacial pain, which is the most common reason for emergency dental visits worldwide. Therefore, an evidence-based decision-making process on oral health should include data related to orofacial pain complaints. To that end, the availability of reliable and valid assessment tools of orofacial pain and related treatment outcomes is essential. INfORM (International Network for Orofacial Pain and Related Disorders Methodology) of the International Association for Dental Research has been one of the driving forces behind the development and implementation of comprehensive sets of tools for such assessments. However, as a prerequisite for the desired global implementation, reliable and valid tools that are also brief, easy to translate, and culturally adaptable need to be further developed and tested. Some of the groundwork to facilitate this process has already been carried out. In addition, a working group within INfORM has developed a short clinical assessment tool for orofacial pain diagnostics that is near completion and will soon be ready for dissemination. Ultimately, reliable and valid orofacial pain assessment is a necessary step toward the development and implementation of appropriate "best buy" interventions that address this major driver of need for oral health care worldwide.

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  • 36.
    Lobbezoo, Frank
    et al.
    University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam 1081, Netherlands.
    Aarab, Ghizlane
    University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands..
    Kapos, Flavia P
    Seattle Children's Research Institute, Seattle, WA, USA.
    Dayo, Adeyinka F
    University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA..
    Koutris, Michail
    University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands.
    Thymi, Magdalini
    University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Leave no one behind: easy and valid assessment of orofacial pain2022In: The Lancet Global Health, E-ISSN 2214-109X, Vol. 10, no 2, article id e184Article in journal (Other academic)
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  • 37.
    Lövgren, A
    et al.
    Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    Fjellman-Wiklund, A
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden..
    Begic, A
    Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    Landgren, H
    Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    Lundén, V
    Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    Svensson, Peter
    Malmö University, Faculty of Odontology (OD). Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark..
    Österlund, C
    Faculty of Medicine, Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87, Umeå, Sweden..
    The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 3033-3040Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Pain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner.

    MATERIALS AND METHODS: Healthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0-10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant.

    RESULTS: In total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner.

    CONCLUSIONS: The gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual.

    CLINICAL RELEVANCE: In clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

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  • 38. Lövgren, A
    et al.
    Häggman-Henrikson, Birgitta
    Malmö högskola, Faculty of Odontology (OD).
    Visscher, CM
    Lobbezoo, Frank
    Marklund, S
    Wänman, Anders
    Temporomandibular pain and jaw dysfunction at different ages covering the lifespan: A population based study2016In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 20, no 4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Temporomandibular pain and jaw dysfunction can have a negative effect on daily life, but these conditions are not well recognized in the health care systems. The general aim was to examine the cross-sectional prevalence of frequent temporomandibular pain and jaw dysfunction in men and women across the lifespan. METHODS: The analysis was based on data from 137,718 individuals (mean age 35 years, SD 22.7) who answered three questions (3Q/TMD) included in the digital health declaration in the Public Dental Health care in the county of Västerbotten, Sweden; Q1: 'Do you have pain in your temple, face, jaw or jaw joint once a week or more?'; Q2: 'Does it hurt once a week or more when you open your mouth or chew?'; and Q3: 'Does your jaw lock or become stuck once a week or more?' RESULTS: The prevalence of frequent temporomandibular pain (Q1) was 5.2% among women and 1.8% among men (p < 0.0001). The prevalence of frequent pain on jaw movement (Q2) was 2.5% among women and 0.9% among men (p < 0.0001). The prevalence of frequent locking of the jaw (Q3) was 2.7% among women and 1.2% among men (p < 0.0001). CONCLUSIONS: The study shows that the cross-sectional prevalence of temporomandibular pain and jaw dysfunction varies during the lifespan. For men and women, respectively, symptoms increase during adolescence, peak in middle age and then gradually diminish. The prevalence of these symptoms is significantly higher among women except from the first and last decades of a 100-year lifespan.

  • 39.
    Lövgren, A.
    et al.
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden.;Dept Odontol Clin Oral Physiol, S-90186 Umeå, Sweden..
    Ilgunas, A.
    Malmö University, Faculty of Odontology (OD). Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Häggman-Henrikson, B.
    Malmö University, Faculty of Odontology (OD). Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Elias, B.
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    AL Roudini, O.
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Visscher, C. M.
    Univ Amsterdam, Acad Ctr Dent Amsterdam ACTA, Dept Orofacial Pain & Dysfunct, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Lobbezoo, F.
    Univ Amsterdam, Acad Ctr Dent Amsterdam ACTA, Dept Orofacial Pain & Dysfunct, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Wänman, A.
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Liv, P.
    Umeå Univ, Dept Publ Hlth & Clin Med, Sect Sustainable Hlth, Umeå, Sweden..
    Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors2023In: Journal of Evidence-Based Dental Practice, ISSN 1532-3382, E-ISSN 1532-3390, Vol. 23, no 3, article id 101888Article in journal (Refereed)
    Abstract [en]

    ObjectivesTemporomandibular disorders (TMDs) is a collective term for pain and functional disturbances related to the jaw muscles and the temporomandibular joint. In contrast to screening for orofacial pain, knowledge is limited on the association between patient-reported outcomes and screening for joint-related functional jaw disturbances. Therefore, our aim was to evaluate the association between a screening question for functional jaw disturbances, and disease-specific out-come measures for functional jaw limitations and oral behaviors.MethodsThis study included 299 individuals (201 women; 20-69 years, median 37.0) in a general population sample from Vasterbotten, Northern Sweden in 2014. A single screening question for functional jaw disturbances "Does your jaw lock or become stuck once a week or more?" was used to categorize individuals as cases or controls. Patient-reported outcomes on functional jaw disturbances were assessed with the 20-item jaw functional limitation scale (JFLS-20) and oral behaviors with the 21-item Oral Behaviors Checklist (OBC-21).ResultsThe strongest predictive probability to have a positive screening outcome was functional jaw limitations related to mobility (AUC(boot) = 0.78, 95 CI:0.71-0.86, P < .001), followed by limitations related to communication (AUC(boot) = 0.74, 95 CI:0.63-0.80, P < .001) and mastication (AUC(boot) = 0.73, 95 CI:0.66-0.81, P < .001). The frequency of oral behaviors was not significantly associated with a positive screening outcome (AUC(boot) = 0.65, 95 CI:0.55-0.72, P = .223).ConclusionsSelf-reported functional limitations, but not oral behaviors, are strongly associated with a single screening question for frequent functional jaw disturbances. This finding provides support for incorporating a question on jaw catching/locking once a week or more in screening instruments for TMDs.

  • 40. Lövgren, A.
    et al.
    Marklund, S.
    Visscher, C. M.
    Lobbezoo, F.
    Häggman-Henrikson, Birgitta
    Malmö högskola, Faculty of Odontology (OD).
    Wänman, A.
    Outcome of three screening questions for temporomandibular disorders (3Q/TMD) on clinical decision-making2017In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 44, no 8, p. 573-579Article in journal (Refereed)
    Abstract [en]

    Patients with temporomandibular disorders (TMD) seem to go undetected and not adequately managed within dentistry. To identify these patients, three screening questions (3Q/TMD) have been introduced within dentistry in parts of Sweden. It is not known whether 3Q/TMD affects the clinical decision-making for these patients. The aim of this study was to evaluate the outcome of 3Q/TMD on the clinical decision-making and to analyse whether gender, age and the fee system the individual was assigned to were related to prescribed TMD treatment. This cohort study was carried out within the Public Dental Health service in Vasterbotten, Sweden. As part of the routine dental check-up, a health declaration including 3Q/TMD was completed. The study population was randomly selected based on their 3Q/TMD answers. In total, 300 individuals with an affirmative answer to any of the 3Q/TMD, and 500 individuals with all negative answers were selected. The 3Q/TMD includes questions on weekly jaw-face-temple pain (Q1), pain on function (Q2) and catching/locking of the jaw (Q3). The 3Q/TMD was analysed in relation to prescribed treatment assessed from dental records. There was significantly more treatment performed or recommended for 3Q-positives (215%), compared to 3Q-negatives (22%) (P < 0001). The odds ratio for TMD-related treatment for 3Q-positives versus 3Q-negatives was 121 (95% CI: 63-234). Although affirmative answers to the 3Q/TMD was related to TMD treatment, the majority of individuals with a screen positive still did not, according to dental records, receive assessment or treatment. Further studies are needed to better understand the clinical decision-making process for patients with TMD.

  • 41. Lövgren, Anna
    et al.
    Karlsson Wirebring, Linnea
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Wänman, Anders
    Decision-making in dentistry related to temporomandibular disorders: a 5-yr follow-up study.2018In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 126, no 6, p. 493-499Article in journal (Refereed)
    Abstract [en]

    Temporomandibular disorders (TMDs) are common, but many patients with such disorders go undetected and under-treated. Our aim was to evaluate the outcome of using a screening tool (5 yr after it was first implemented), on the clinical decision-making for patients with TMDs. Adults who attended for a dental check-up at the Public Dental Health Services in Vasterbotten, Sweden, answered three screening questions (3Q/TMD) on frequent jaw pain, pain on jaw function, and catching/locking of the jaw. The dental records of a random sample of 200 individuals with at least one positive response to 3Q/TMD (3Q screen-positive patients) and 200 individuals with all negative responses (3Q screen-negative patients) were reviewed for TMD-related treatment decisions. A clinical decision related to TMD was absent in 45.5% of 3Q screen-positive patients. Treatment of TMDs was associated with a positive response to the screening question on jaw pain (OR = 6.7, 95% CI: 3.2-14.0) and was more frequent among 3Q screen-positive patients (24%) than among 3Q screen-negative patients (2%; OR = 15.5, 95% CI: 5.5-43.9), just as a female examiner was associated with more frequent treatment of TMDs (OR = 3.1, 95% CI: 1.2-8.4). The results indicate under-treatment of TMD within general dental practice and that male clinicians are less likely to initiate TMD treatment.

  • 42. Lövgren, Anna
    et al.
    Parvaneh, Hasti
    Lobbezoo, Frank
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Wänman, Anders
    Visscher, Corine Mirjam
    Diagnostic accuracy of three screening questions (3Q/TMD) in relation to the DC/TMD in a specialized orofacial pain clinic2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 6, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the diagnostic accuracy of three screening questions (3Q/TMD) in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), in a specialized clinic. Material and methods: Consecutive patients, >18 years, referred with a possible TMD complaint to the Orofacial Pain and Dysfunction clinic, Academic Centre for Dentistry Amsterdam, the Netherlands, were included in the study. All patients (n = 449; mean age 44 years; 72% females), answered the 3Q/TMD and the DC/TMD questionnaire before a DC/TMD examination. The 3Q/TMD constitutes of two questions on weekly pain from the jaw, face and temple region (Q1), and on function (Q2), and one function-related question on weekly catching and/or locking of the jaw (Q3). Q1 and Q2 were evaluated in relation to a DC/TMD pain diagnosis and Q3 in relation to a subgroup of DC/TMD intra-articular diagnosis, referred to as the reference standard. Results: In total, 44% of patients received a pain-related DC/TMD diagnosis and 33% an intra-articular reference DC/TMD diagnosis. Sensitivity for the two pain screening questions was high (0.83-0.94), whereas specificity was low (0.41-0.55). For the function-related question, sensitivity was low (0.48), whereas specificity was high (0.96). Conclusions: In a specialized pain clinic, the two pain questions (Q1, Q2) are positive in most patients with pain-related TMD. Therefore, in case of a positive response, further diagnostic procedures for TMD pain are warranted. For the functional screening question (Q3), a positive response is indicative for an intra-articular DC/TMD diagnosis, while in case of a negative outcome, an intra-articular TMD might still be present.

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  • 43. Lövgren, Anna
    et al.
    Visscher, Corine M
    Alstergren, Per
    Malmö University, Faculty of Odontology (OD).
    Lobbezoo, Frank
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Wänman, Anders
    The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia2020In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 24, p. 97-102Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis. METHODS: A study population (n = 300), randomly selected from the adult population in Vasterbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome. RESULTS: Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3-9.9). This association was confounded by concurrent myalgia (B = 1.737 --> B = 0.996, 42.7%). CONCLUSION: In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia. CLINICAL RELEVANCE: Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.

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  • 44. Lövgren, Anna
    et al.
    Visscher, Corine M
    Häggman-Henrikson, Birgitta
    Malmö högskola, Faculty of Odontology (OD).
    Lobbezoo, Frank
    Marklund, S
    Wänman, Anders
    Validity of three screening questions (3Q/TMD) in relation to the DC/TMD2016In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, no 10, p. 729-736Article in journal (Refereed)
    Abstract [en]

    Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 (JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management.

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  • 45.
    Lövgren, Anna
    et al.
    Univ Umea, Clin Oral Physiol, Fac Med, Dept Odontol, S-90187 Umea, Sweden..
    Visscher, Corine M.
    Univ Amsterdam, Acad Ctr Dent Amsterdam ACTA, Dept Orofacial Pain & Dysfunct, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Lobbezoo, Frank
    Univ Amsterdam, Acad Ctr Dent Amsterdam ACTA, Dept Orofacial Pain & Dysfunct, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Amsterdam, Netherlands..
    Yekkalam, Negin
    Univ Umea, Clin Oral Physiol, Fac Med, Dept Odontol, S-90187 Umea, Sweden..
    Vallin, Simon
    Umea Univ, Dept Publ Hlth & Clin Med, Northern Register Ctr, Umea, Sweden..
    Wänman, Anders
    Univ Umea, Clin Oral Physiol, Fac Med, Dept Odontol, S-90187 Umea, Sweden..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Univ Umea, Clin Oral Physiol, Fac Med, Dept Odontol, S-90187 Umea, Sweden..
    The association between myofascial orofacial pain with and without referral and widespread pain2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 7, p. 481-486Article in journal (Refereed)
    Abstract [en]

    Objectives Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain. Materials and methods Individuals at the Public Dental services in Vasterbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20-69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain. Results Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62-9.05 and OR 11.62 95% CI 5.18-27.88, respectively). Conclusion These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.

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  • 46.
    Manfredini, Daniele
    et al.
    Department of Biomedical Technologies, School of Dentistry University of Siena Siena Italy.
    Ahlberg, Jari
    Department of Oral and Maxillofacial, Diseases University of Helsinki Helsinki Finland.
    Aarab, Ghizlane
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Bender, Steven
    Department of Oral and Maxillofacial Surgery Texas A&amp;M School of Dentistry Dallas Texas USA.
    Bracci, Alessandro
    School of Dentistry University of Padova, Padova Italy.
    Cistulli, Peter A.
    Sleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia;Department of Respiratory &amp; Sleep Medicine Royal North Shore Hospital Sydney New South Wales Australia.
    Conti, Paulo Cesar
    Bauru School of Dentistry University of Sao Paulo Bauru Brazil.
    De Leeuw, Reny
    Department of Oral Health Science, Orofacial Pain Center, College of Dentistry University of Kentucky Lexington Kentucky USA.
    Durham, Justin
    Newcastle University's School of Dental Sciences Newcastle UK.
    Emodi‐Perlman, Alona
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel.
    Ettlin, Dominik
    Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Berne Berne Switzerland.
    Gallo, Luigi M.
    Clinic of Masticatory Disorders, Center of Dental Medicine University of Zurich Zurich Switzerland.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Hublin, Christer
    Finnish Institute of Occupational Health Helsinki Finland.
    Kato, Takafumi
    Department of Oral Physiology Osaka University Graduate School of Dentistry Suita Japan.
    Klasser, Gary
    Department of Diagnostic Sciences Louisiana State University School of Dentistry New Orleans Louisiana USA.
    Koutris, Michail
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Lavigne, Gilles J.
    Faculty of Dental Medicine Universite de Montréal Quebec Montréal Canada.
    Paesani, Daniel
    School of Dentistry University of Salvador/AOA Buenos Aires Argentina.
    Peroz, Ingrid
    Department for Prosthodontics, Gerodontology and Craniomandibular Disorders, Charité Centre for Oral Sciences Charité ‐ University Medicine of Berlin Berlin Germany.
    Svensson, Peter
    Malmö University, Faculty of Odontology (OD). Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health Aarhus University Aarhus Denmark.
    Wetselaar, Peter
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Standardised Tool for the Assessment of Bruxism2024In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 51, no 1, p. 29-58Article, review/survey (Refereed)
    Abstract [en]

    Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences.

    Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications.

    Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration.

    Conclusions: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.

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  • 47.
    Manfredini, Daniele
    et al.
    Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy..
    Ahlberg, Jari
    Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland..
    Aarab, Ghizlane
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
    Bracci, Alessandro
    School of Dentistry, University of Padova, Padova, Italy..
    Durham, Justin
    Newcastle University's School of Dental Sciences, Newcastle, UK..
    Emodi-Perlman, Alona
    Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel..
    Ettlin, Dominik
    Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland..
    Gallo, Luigi M
    Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden..
    Koutris, Michail
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
    Peroz, Ingrid
    Department for Prosthodontics, Charité-University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany..
    Svensson, Peter
    Malmö University, Faculty of Odontology (OD). Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark..
    Wetselaar, Peter
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
    The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map.2024In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 51, no 1, p. 15-28Article, review/survey (Refereed)
    Abstract [en]

    This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.

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  • 48. Marklund, S
    et al.
    Häggman-Henrikson, Birgitta
    Malmö högskola, Faculty of Odontology (OD).
    Wänman, Anders
    Risk factors associated with incidence and persistence of frequent headaches2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 788-794Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. MATERIALS AND METHODS: The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. RESULTS: The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). CONCLUSIONS: The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.

  • 49. Mienna, Christina Storm
    et al.
    Glas, Linnea
    Magnusson, My
    Ilgunas, Aurelija
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Wänman, Anders
    Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 7, p. 495-501Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate temporomandibular disorder (TMD) patients' experiences of a supervised jaw-neck exercise programme. Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n = 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n = 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open- and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of open-ended questions. Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p = .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment. Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with wide-spread pain.

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  • 50.
    Nilsson, Evelina
    et al.
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD).
    Domellöf, Erik
    Umeå Univ, Dept Psychol, Umeå, Sweden..
    Hellström, Fredrik
    Univ Gävle, Fac Hlth & Occupat Studies, Dept Occupat Hlth Sci & Psychol, Gävle, Sweden..
    Häger, Charlotte K.
    Umeå Univ, Dept Community Med & Rehabil, Physiotherapy, Umeå, Sweden..
    Österlund, Catharina
    Umeå Univ, Fac Med, Dept Odontol Clin Oral Physiol, Umeå, Sweden..
    Development of integrated jaw-neck motor function in children at 6, 10 and 13 years of age compared to adults: A kinematic longitudinal study2023In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 50, no 10, p. 1002-1011Article in journal (Refereed)
    Abstract [en]

    BackgroundThe functional integration of the jaw and neck motor systems, of great importance to everyday oral activities, is established in early childhood. Detailed characterisation of this developmental progress is largely unknown. ObjectiveTo establish developmental changes in jaw-neck motor function in children over the ages 6-13 years compared to adults. MethodsJaw and head movement kinematics during jaw opening-closing and chewing were longitudinally recorded in 20 Swedish children (8 girls) at 6 (6.3 & PLUSMN; 0.4), 10 (10.3 & PLUSMN; 0.3) and 13 (13.5 & PLUSMN; 0.7) years of age and 20 adults (9 women, 28.2 & PLUSMN; 6.7). Movement amplitudes, jaw movement cycle time (CT), coefficient of variation (CV) and head/jaw ratio for amplitudes were analysed. Linear mixed effect analysis and Welch's t-test were used. ResultsChildren showed pronounced movement variability and longer CT at 6 and 10 years old during opening and chewing (p < .001). Compared to adults, 6-year-olds showed higher head/jaw ratios (p < .02) and longer CT (p < .001) during opening and chewing, and higher CV-head (p < .001) during chewing. Whereas 10-year-olds showed larger jaw and head amplitudes (p < .02) and longer CT (p < .001) during opening, and longer CT (p < .001) and higher CV-head (p < .001) during chewing. For 13-year-olds, longer CT (p < .001) during chewing was found. ConclusionChildren showed pronounced movement variability and longer movement cycle time at 6-10 years and developmental progress in jaw-neck integration from 6 to 13 years, with 13-year-olds displaying adult-like movements. These results add new detailed understanding to the typical development of integrated jaw-neck motor function.

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