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  • 1.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Henriksson, T
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Alterations of temporomandibular disorders and headache before and after orthognathic surgery: A systematic review2006Conference paper (Refereed)
  • 2.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Alterations of temporomandibular disorders before and after orthognathic surgery2007In: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 77, no 4, p. 729-734Article, review/survey (Other academic)
    Abstract [en]

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

  • 3.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Sunzel, Bo
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    TMD in Consecutive Patients Referred for Orthognathic Surgery2009In: Swedish Dental Journal, ISSN 0347-9994, Vol. 33, no 4, p. 201-226, article id 25Article in journal (Other academic)
    Abstract [en]

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

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

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

  • 5.
    Abrahamsson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Henrikson, Thor
    Malmö högskola, Faculty of Odontology (OD).
    Bondemark, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Masticatory function in patients with dentofacial deformities before and after orthognathic treatment: a prospective, longitudinal, and controlled study2015In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 37, no 1, p. 67-72Article in journal (Refereed)
    Abstract [en]

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

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

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

  • 7.
    Al-Harthy, Mohammad
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Al-Bishri, Awwad
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Temporomandibular disorder pain in adult Saudi Arabians referred for specialised dental treatment2010In: Swedish Dental Journal, ISSN 0347-9994, Vol. 34, no 3, p. 149-158Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the frequency of Temporomandibular Disorders (TMD) pain in Saudi Arabians,aged 20-40, who were referred to the Specialist Dental Centre in Makkah. The material included 325 patients (135 males,190 females) who answered a history questionnaire. Patients reportingTMD pain in the last month were offered a clinical examination. History questionnaires and clinical examinations were done according to the Arabic version of the Research Diagnostic Criteria for TMD (RDC/TMD). Fifty-eight patients (18%) reported TMD pain; 46 were clinically examined. Mean age of clinically examined TMD pain patients was 30 +/- 7 years with a male-female ratio of 1:6 (P < 0.001). All TMD pain patients had a diagnosis of myofascial pain, and 65% had diagnoses of arthralgia or osteoarthritis. Headaches or migraines in the last 6 months and headaches in the last month were reported in high frequencies in the TMD pain group, 93% and 71% respectively, with differences (P < 0.001) between the TMD pain and non-TMD pain groups. Graded Chronic Pain Scale assessments classified 45% of the TMD pain patients in grade 1, 53% in grade II, 2% in grade III, and 0% in grade IV. Severe depression scores were found in 38% of the TMD pain patients and severe somatisation scores in 60% with differences (P < 0.001) between the TMD pain and non-TMD pain groups. In conclusion, the study found a frequency of TMD pain in this Saudi Arabian cohort of 18%. The TMD pain group presented high scores of depression and somatisation but low disability grades on the Graded Chronic Pain Scale.

  • 8.
    Al-Harthy, Mohammad
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Al-Bishri, Awwad
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Temporomandibular Disorders per RDC/TMD in Adult Saudi Arabians Referred for Specialized Dental Treatment2008Conference paper (Other academic)
    Abstract [en]

    Objective: The aim of this study was to determine frequency of Temporomandibular Disorders (TMD) pain in Saudi Arabians, ages 20 to 40, which were referred to a dental specialist clinic in Makkah. Materials and Methods: 325 referred patients (135 males, 190 females) answered history questionnaires. Patients reporting TMD pain in these questionnaires were clinically examined. History questionnaires and clinical examinations were done per Axis I and Axis II of the Arabic version of Research Diagnostic Criteria for TMD (RDC/TMD). Results: The male-female ratio of the study group was 1:1.4. Fifty-eight patients (18%) had TMD pain; 46 were clinically examined. Mean age of examined TMD pain patients was 30 years (±7) with a male-female ratio of 1:6. All TMD pain patients had a diagnosis of myofascial pain and 65% had diagnoses of arthralgia or osteoarthritis. Graded chronic pain severity was reported to be grade I in 45%, grade II in 53%, grade III in 2% and grade IV in none of the patients. Psychological status assessment showed that 38% of the TMD pain patients had severe depression scores and 60% severe somatization scores. Conclusion: The present study showed a high frequency of TMD pain in this Saudi Arabian cohort, and 18% of the patients met criteria for subdiagnoses of TMD. Depression and somatization per Axis II had significantly higher scores in the TMD pain group compared to the non-pain group.

  • 9. Al-Harthy, Mohammad
    et al.
    Al-Bishri, Awwad
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    TMD in Adult Saudi Arabians According to RDC/TMD2008Conference paper (Refereed)
    Abstract [en]

    Objective: To examine the frequency of pain-related TMD in Saudi Arabians 20 to 40years old referred to a d specialist clinic in Makka. Materials and Methods: 325 referred patients (135 males, 190 females) filled in history questionnaires. Patients reporting pain-related TMD were clinically examined. The history and clinical examinations were performed according to an Arabic version of RDC/TMD Axis I and Axis II (Dworkin et al 1992). Results: All patients had a male-female ratio of 1:1.4. TMD pain patients were found to be 18% (n=58), out of which 46 were clinically examined. The 46 TMD pain patients had a mean age of 30 years (±7) with a male-female ratio of 1:6. All TMD pain patients had a diagnosis of myofascial pain and 66% had diagnoses of arthrogenous origin. The graded chronic pain was reported to be grade I in 45%, grade II in 53%. Axis II assessment of psychological status showed that 38% of the TMD pain patients yielded severe depression scores and 60% high nonspecific physical symptom scores. Conclusion: The present study showed a high frequency of TMD pain in this Saudi Arabian cohort and 18% of the patients met criteria for subdiagnoses of TMD. Depression and somatization according to SCL-90R had significantly higher scores in the pain group compared to the non-pain group. The high frequency of pain-related TMD found among the patients referred to specialized dental clinics should make health planners considering TMD/orofacial pain as specialty in dentistry in Saudi Arabia.

  • 10. Al-Harthy, Mohammad
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Pain related temporomandibular disorders in adult Saudi arabians referred for specialized dental treatment2007In: Pain related temporomandibular disorders in adult Saudi arabians reffered for specialized dental treatment.Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    The aim of the present study was to examine the frequencies of pain-related symptoms of TMD in patients in the age of 20-40 years referred for specialized dental treatments in Makkah, Saudi Arabia by using Research Diagnostic Criteria for TMD (RDC/TMD). Three hundred and twenty-five consecutive Saudi patients in the age of 20-40 years: 135 males and 190 females were interviewed according to the RDC/TMD history questionnaire. The results revealed that pain related TMD and orofacial pain were found among 58 (18%) patients. All other patients formed the non-pain group (267,82%). In the pain group, there were 79% females compared to 21% males (P<0.01). Both genders in the pain group reported high frequencies of both migraines in the last six months and headache moderately to extremely in the last month showing significant difference in comparison with the non-pain group (P<0.01). Symptoms of TMD were significantly more prevalent in the pain group than in the non-pain group. The most common pain related TMD symptoms were TMJ clicking, TMJ crepitation, TMJ locking, stiff jaw, tinnitus, bruxism and uncomfortable bite. Regarding Graded Chronic Pain severity in the pain group, most patients reported their pain to be grade I and II. Jaw disability checklist according to RDC/TMD showed that four or more disturbed jaw activities were found in 31 patients (53%) while 13 patients (22%) had not affected mandibular functions. In conclusion, the findings of the present study showed high frequencies of pain related TMD in this Saudi arabian patient population.

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

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

  • 12.
    Bijelic, Tessa
    et al.
    Malmö University, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö University, Faculty of Odontology (OD).
    Willman, Ania
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Nilsson, Ing-Marie
    Malmö University, Faculty of Odontology (OD). Center for Oral Rehabilitation, Norrköping, Sweden.
    Expectations and Experiences of Internet-Based Therapy for Adolescents with TMD Pain2022In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 36, no 3, p. 237-252Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate expectations and experiences of internet-based therapy (IBT) in adolescents with temporomandibular disorder (TMD) pain. Methods: Seven adolescents were strategically selected for this study. All patients had received IBT for their TMD pain in a previous randomized controlled trial. Oneon- one interviews were conducted in a nonclinical setting. The interviews were semi-structured, following an interview guide with six domains. The recorded interviews were transcribed, and a qualitative inductive content analysis was then performed. Results: Content analysis indicated that the expectations of the adolescents and their experiences of IBT as a treatment for TMD pain can be understood in light of three main categories: (1) To become better; (2) An ambivalent experience; and (3) A personal challenge. The adolescents expressed expectations of less TMD pain after treatment, but also of improvement in general well-being and everyday life. Although their experiences of IBT varied, adolescents described having mixed feelings about treatment and feeling that it was personally challenging. Conclusion: Gained understanding of expectations and experiences is a necessary basis for revising the IBT program to meet the demands of adolescents and to improve treatment adherence. Furthermore, the content of the three categories clarifies the values of adolescents, and this understanding can in turn contribute to the development of new patient-centered treatment programs.

  • 13.
    Bondemark, Lars
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Wolf, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Funktionsstörningar och smärta2008In: Tandläkartidningen, ISSN 0039-6982, Vol. 100, no 9-10, p. 64-68Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

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

  • 14.
    Brogårdh-Roth, Susanne
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Månsson, Johanna
    Ridell, Karin
    Malmö högskola, Faculty of Odontology (OD).
    Alward, Lubna
    Malmö högskola, Faculty of Odontology (OD).
    Hellén-Halme, Kristina
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Five years' follow-up of dental fear and anxiety, experience of dental care and oral health behaviour in Swedish preterm and full-term adolescents2017In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 17, article id 145Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is rising concern about how preterm birth affects long-term health later in life. The various effects that preterm birth have on developmental outcomes, cognitive profiles and medical health may also affect levels of cooperation in the dental care situation in addition to general oral health and other oral health-related habits. Oral health is an integral part of one's general health and well-being; however, less is known about how prematurity affects oral health and other related areas such as dental care, and including dental fear and anxiety (DFA) in individuals during adolescence and adulthood. This is considered of special interest to study, as preterm children during the preschool and school period were reported to have behavioural problems during dental treatments and less than favourable oral hygiene. METHODS: A questionnaire was used of self-report design and structured into behavioural aspects relating to dental treatment, oral health-related factors, and medical health. This questionnaire at 17-19 years of age was a follow-up from 12 to 14 years of age and considered a predictor for planning future dental care for this group of patients. The 145 participating adolescents were all preterm, born between 23 and 32 weeks of gestation and 140 full-term controls, born ≥37 weeks of gestation. RESULTS: Dental fear and anxiety, oral health behaviour, and intake of sweets and sugary drinks of 17-19-year old adolescents born preterm was comparable to that of the full-term control group. Medical health problems as well as the intake of sweets and sugary drinks increased from the time of early adolescence to late adolescence in both groups. CONCLUSIONS: Preterm as well as full-term adolescents between 17 and 19 years of age are satisfied with their dental care and display low prevalence of dental fear and anxiety (DFA). The findings in this study indicate that adolescents born very preterm and extremely preterm are well prepared for transition to dental care in adult life with expectations of being able to take responsibility for their oral health. KEYWORDS: Adolescent; Born preterm; Dental care; Oral health behaviour

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  • 15.
    Brogårdh-Roth, Susanne
    et al.
    Malmö University, Faculty of Odontology (OD).
    Paulsson, Liselotte
    Malmö University, Faculty of Odontology (OD).
    Larsson, Pernilla
    Malmö University, Faculty of Odontology (OD). Folktandvården Östergötland.
    Ekberg, EwaCarin
    Malmö University, Faculty of Odontology (OD).
    Do preterm-born adolescents have a poorer oral health-related quality of life?2021In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 21, no 1, article id 440Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To evaluate oral health-related quality of life (OHRQoL) over a period of five years using the Oral Health Impact Profile (OHIP-14) questionnaire in a population of Swedish adolescents born preterm and full term.

    METHODS: In a longitudinal study of adolescents aged 12-14 and 17-19, changes over time in OHRQoL were measured by using OHIP-14. The OHIP-14 score, self-reported chronic illness, temporomandibular disorder (TMD pain) and subjective orthodontic treatment need were compared between 98 extremely and very preterm born (< 32 gestational week) and 93 full-term controls (≥ 37 gestational week) at two ages. The chi-square test was used for comparisons within the extremely-, very-, and full-term control groups, and to contrast the differences of mean scores of OHIP-14, the ANOVA test was used for comparisons within the study groups of extremely preterm, very preterm and full term-born adolescents.

    RESULTS: All adolescents reported a good self-perceived OHRQoL. No significant differences in the comparisons of the total mean scores were revealed between the groups, between gender or in domain-specific scores over the 5-year period. Very preterm adolescents with reported chronic illness at 12-14 years of age showed significantly higher mean scores of OHIP-14 compared with those without chronic illness (p = 0.015). At age 17-19, significantly higher mean scores of OHIP-14 were reported by very preterm adolescents with TMD pain compared to those without TMD pain (p = 0.024). Significantly higher mean scores of OHIP-14 were found among the extremely preterm (p = 0.011) and very preterm born adolescents (p = 0.031) with a subjective need of orthodontic treatment compared with those without orthodontic treatment need.

    CONCLUSIONS: Poor OHRQoL measured with OHIP-14 in very preterm adolescents aged 12-14 was related to chronic illness and aged 17-19 to TMD pain. In addition, extremely and very preterm-born adolescents with subjective orthodontic treatment need at 17-19 years of age also reported poor OHRQoL. To improve the dentist-patient relationship and achieve more successful treatment results, it is important for dental clinicians to understand the impact that chronic illness, TMD pain and orthodontic treatment need has on OHRQoL in preterm-born adolescents.

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  • 16. Christidis, N
    et al.
    Doepel, M
    Ekberg, Ewacarin
    Malmö högskola, Faculty of Odontology (OD).
    Ernberg, M
    Le Bell, Y
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Effectiveness of a prefabricated occlusal appliance in patients with temporomandibular joint pain: a randomized controlled multicenter study2014In: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 28, no 2, p. 128-137Article in journal (Refereed)
    Abstract [en]

    AIMS: To evaluate the effectiveness of a prefabricated appliance and compare it to the effectiveness of a stabilization appliance in patients with temporomandibular joint (TMJ) pain. METHODS: This randomized, controlled multicenter study comprised 48 patients diagnosed with TMJ arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders. The effectiveness of a prefabricated appliance (Relax), worn by half of the patients (referred to as the R group), was compared to the effectiveness of a stabilization appliance, worn by the other half of patients (S group). Treatment outcome was assessed according to the recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. To analyze the differences between groups, the chi-square test and the Mann-Whitney U test were used, while the Friedman analysis of variance (ANOVA) on ranks was used for the analyses between baseline data and follow-up measurements, all with a significance level set at P < .05. RESULTS: There were no differences between the groups at baseline. A 30% reduction of pain intensity was reported by 62.5% of the R group and 58.3% of the S group at the 10-week follow-up; 58% and 50.3%, respectively, at the 6-month follow-up; and 41.7% in both groups at 12 months. At the 12-month follow-up, pain intensity had decreased and physical function had improved in both groups (P < .005 and P < .016, respectively), without significant group differences. Emotional function (depression and nonspecific physical symptoms) did not change. Overall improvement of "better" to "symptom-free" was observed in 67% of the R group and 58% of the S group. No side effects occurred. CONCLUSION: The effectiveness of the prefabricated appliance seems to be similar to that of the stabilization appliance in alleviating TMJ pain. Since the prefabricated appliance requires only one visit for construction, it is convenient for both the general practitioner and for the patient

  • 17. Dahl, Sara
    et al.
    Lessmark, Karin
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Can sense of coherence be a predictor for treatment outcome in patients with TMD-pain?2011In: Svenska tandläkaresällskapets 47:e odontologisk riksstämma 2011, Svenska tandläkaresällskapet , 2011, p. 110-110Conference paper (Other academic)
    Abstract [en]

    Aims. To investigate whether SOC (sense of coherence) changed after twelve months of treatment of TMD-pain, and if any such change could be correlated with treatment outcome. Another objective was to examine whether SOC was correlated with grade of depression and somatisation. Materials and Methods. 73 patients participated in the double-blind randomized controlled trial. The TMD-treatment was active for at least ten weeks and consisted of either a resilient or a non-occluding control appliance. Patients were diagnosed according to RDC/TMD and completed the SOC-29 at baseline and after twelve months. Treatment outcome was evaluated as a reduction of pain registered as characteristic pain intensity. No difference was found between the resilient appliance and the control appliance in reducing pain at the 12-months follow-up. Therefore the material was pooled together. Results. Of the 73 participating TMD-pain patients, a total of 44 patients filled in the SOC-29 at both baseline and after twelve months, and 42 of them also stated values for depression and somatisation. There was no correlation between high SOC and treatment outcome. No differences were found in the mean value of SOC for patients younger and older than 30 respectively 40 years. Significant correlations were found between mean differences of SOC and grade of depression, and between mean differences of grade of depression and somatisation. Conclusion. Our results showed that SOC was not a predictor for treatment outcome in TMD-pain patients previously treated with an appliance. SOC seems to be correlated to grade of depression.

  • 18. Doepel, M.
    et al.
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Le Bell, Y.
    Long-term effectiveness of a prefabricated oral appliance for myofascial pain2012In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 39, no 4, p. 252-260Article in journal (Refereed)
    Abstract [en]

    Summary  The long-term effectiveness of a prefabricated oral appliance (R) was compared with a stabilisation appliance (S) in patients with myofascial pain. Sixty-five patients diagnosed with myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomised controlled trial using Research Diagnostic Criteria for Temporomandibular Disorders, with history questionnaires and clinical examinations performed by blinded examiners at baseline and at 6- and 12-month follow-ups. Patients were randomly assigned either to the R or the S group. Treatment outcome was measured according to IMMPACT for four chronic pain outcome domains: pain intensity, overall improvement, physical functioning and emotional functioning. Physical functioning was classified for Graded Chronic Pain severities and assessed by the Jaw Functional Limitation scale. Emotional functioning composed of scores of non-specific physical symptoms and depression. There were no differences between groups at baseline. At both follow-ups, all outcome domains showed significant within-group improvement, without significant differences between groups. At 12 months, 72% of all patients reported a 30% reduction in worst pain and 63% of the patients a 50% reduction in worst pain. Overall improvement ‘better’ to ‘symptom-free’ was observed in 81% in the R and 64% in the S group at the 12-month follow-up. Graded Chronic Pain, Functional Limitation of the Jaw, non-specific physical symptoms and depression showed statistically significant reduction at 12-month follow-up. Results support the hypothesis that the effectiveness of the prefabricated appliance is similar to that of the stabilisation appliance in the long-term when treating patients with myofascial pain.

  • 19. Doepel, Marika
    et al.
    Le Bell, Yrsa
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Effectiveness of Prefabricated Occlusal Appliance in TMD Patients with Headache2010Conference paper (Other academic)
    Abstract [en]

    Objectives: To compare the short- and long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance for the treatment of headache in myofascial pain patients. Methods: Sixty-five myofascial pain patients of whom 57 reported headache were included in a randomized controlled trial at two centres for Stomatognathic Physiology in Sweden and Finland. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization appliance group (S-group, 31 women 2 men, mean age 37 years). RDC/TMD was used for history-taking and clinical examination. Frequency and intensity of headache were assessed using a verbal scale (1=continuous, 2=recurrent, 3=rarely) and a numeric rating scale (NRS) respectively at baseline, 10-week, 6-and 12-month follow-ups. Results: At baseline there were no differences between the groups regarding frequency and intensity of headache. At the follow-ups a statistically significant decrease in both frequency and intensity was observed within the two groups without any differences between the groups. At baseline 72% and 70% in the R and S groups reported recurrent or continuous headache which decreased significantly (p< .01) within both groups to 44% and 31% at 10-week and to 26% and 18% at the 12-month follow-up. Mean intensity (NRS) of headache at baseline decreased within both groups from 6 to 3 at 10-week follow-up and to 2 and 3 in the R and S groups respectively (p< .001) at 12-month follow-up. Conclusions: In both short- and long-term the prefabricated appliance seemed to have a similar effectiveness in the treatment of headache in myofascial pain patients.

  • 20. Doepel, Marika
    et al.
    Söderling, Elin
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Le Bell, Yrsa
    Salivary cortisol and IgA levels in myofascial pain patients treated with occlusal appliances in a short term perspective (Stockholm)2008Conference paper (Other academic)
    Abstract [en]

    Objectives: In many studies the endocrinological response of individuals to different kind s of stresses has been tested. There seems to be widespread agreement that stress, depression, disability and dysfunctional illness behaviors are critical aspects of patients suffering from TMD (temporomandibular disorders) symptoms like pain. We wanted to explore treatment-induced changes in salivary cortisol, IgA and flow rate values in TMD patients suffering from myofascial pain. Methods: TMD paitents (n=39) were randomized into two groups and treated with two different occlusal appliances. Percieved stress regarding family work, economy, relationships, general health and stress in general was wvaluated at baseline according to a verbal scale. Paraffin stimulated saliva samples were collected before treatment and during follow-up at 6 and 10 weeks. Flow rate was measured immediately after the saliva collection while salivary sortisol, and IgA were determined from -70° C-stored samples. Results: No clear association between reported stress and cortisol or IgA values could be observed at baseline. At 10 weeks´ follow-up 92% of the patients felt better-much better-symptom free and no difference was found between the two appliance groups. Cortisol, IgA and flow-rate values showed no systematic between-appliance groups differences. All salivary parameters showed interindividual differences but stayed intraindividually on a similar level throughout the study and no statistically significant changes could be observed when comparing before and after treatment levels. Conclusion: To conclude, there were no treatment induced changes in saliva parameters despite successful appliance therapy in myofascial pain patients.

  • 21.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Kommentar till: EMG nattetid med bettskena på plats2007In: Ajour Odont, ISSN 1400-5395, no 1, p. 7-7Article in journal (Other academic)
  • 22.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Brodén, A
    Elgström, S
    Olsson, S
    A seven years follow-up of appliance therapy in pateints with TMD pain. A prospective and longitudinal study2006Conference paper (Other (popular science, discussion, etc.))
  • 23.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Doepel, Marika
    Le Bell, Yrsa
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Effectiveness of a prefabricated occlusal appliance, Relax, in the long-term (Helsinki)2009Conference paper (Other academic)
    Abstract [en]

    Objectives: To compare the long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance in myofascial pain patients. Methods: Sixty-five patients with the diagnosis myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomized controlled trial. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization group (S-group, 31 women 2 men, mean age 37 years). General practitioners performed the treatment. History and clinical examination was performed according to RDC/TMD. At the 6 months- and 1 year follow-up the treatment outcome regarding pain according to the visual analogue scale and overall rating of pain according to the verbal scale was evaluated. Results: At baseline there were no differences between the groups regarding frequency of myofascial pain, number of years suffering from the pain, worst or mean pain during the last six months. At the 12-months follow-up 30% and 50% pain relief in the R- and S-groups were reported in 24 and 21 patients and 23 and 17 patients respectively. According to a verbal scale 26 and 21 patients in the two groups reported themselves to be better, much better or symptom-free. All calculations were done per protocol. An increased open bite was registered in one patient. Conclusions: In a long-term perspective both appliances seemed to have an equal effectiveness in the treatment of patients suffering from myofascial pain. The prefabricated appliance, Relax, can be recommended as a long-term treatment modality when used night time only. Frontal open bite should be regarded as a contraindication.

  • 24.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Doepel, Marika
    Le Bell, Yrsa
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Effectiveness of a prefabricated occlusal appliance, Relax, in the long-term (Miami)2009Conference paper (Other academic)
    Abstract [en]

    Objectives: To compare the long-term effectiveness of a prefabricated occlusal appliance with a stabilization appliance in myofascial pain patients. Methods: Sixty-five patients with the diagnosis myofascial pain at two centres for Stomatognathic Physiology in Sweden and Finland were included in a randomized controlled trial. Patients were randomly assigned to a prefabricated appliance (R-group, 27 women, 5 men, mean age 38 years) or a stabilization group (S-group, 31 women 2 men, mean age 37 years). General practitioners performed the treatment. History and clinical examination was performed according to RDC/TMD. At the 6 months- and 1 year follow-up the treatment outcome regarding pain according to the visual analogue scale and overall rating of pain according to the verbal scale was evaluated. Results: At baseline there were no differences between the groups regarding frequency of myofascial pain, number of years suffering from the pain, worst or mean pain during the last six months. At the 12-months follow-up 30% and 50% pain relief in the R- and S-groups were reported in 24 and 21 patients and 23 and 17 patients respectively. According to a verbal scale 26 and 21 patients in the two groups reported themselves to be better, much better or symptom-free. All calculations were done per protocol. An increased open bite was registered in one patient. Conclusions: In a long-term perspective both appliances seemed to have an equal effectiveness in the treatment of patients suffering from myofascial pain. The prefabricated appliance, Relax, can be recommended as a long-term treatment modality when used night time only. Frontal open bite should be regarded as a contraindication.

  • 25.
    Ekberg, Ewacarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Hansson, Lars-Göran
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Sahlström, Lotta
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Can MRI Observations Predict Treatment Outcome of Lavage in Patients with Painful TMJ Disc Displacement without Reduction?2015In: Journal of Oral & Maxillofacial Research, ISSN 2029-283X, E-ISSN 2029-283X, Vol. 30, no 1, article id e5Article in journal (Refereed)
    Abstract [en]

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

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  • 26.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Johnsson, Gunilla
    Millman, Gunilla
    Short-term evaluation of a standardized pain-school program in patients with TMD pain.2011Conference paper (Other academic)
    Abstract [en]

    Introduction: Systematic reviews have concluded that behavioral therapy is effective in treating TMD pain. However, most of the studies included different treatment modes, making it difficult to determine which part of the treatment was most important. It has also been found that patients with TMD pain and major psychological disturbances were in need of a combined therapeutic approach. Aim: The purpose of this descriptive study was to evaluate a standardized pain-school program in patients with TMD pain Material and methods: During 2006 and 2011, 99 patients with TMD pain were referred for treatment with a 5-session pain-school program. The patients were examined according to RDC/TMD, at the Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University. The program consisted of a standardized program where the patients underwent treatment individually for 7 weeks by two special trained dental assistants. Three to four weeks after the last visit an evaluation of the treatment outcome were performed by the same dentist as before treatment. Results: Out of 99 patients 85 patients with a mean age of 39 ± 1.9 years (min 13 years-max 78 years) fulfilled the whole program. Patients fulfilling the program 74 patients were women (mean age 38 years) and 11 were men (mean age 52 years). All patients had at least one pain diagnoses, where 67 patients had myofascial pain, 44 patients had arthralgia/osteoarthritis, 22 patients had headache, and 7 patients had other pain conditions (whiplash, neuralgia, burning mouth syndrome and atypical odontalgia). Most of the patients (74%) had more than one pain diagnosis. 54 patients (67%) were responders and 28 patients were non-responders (33%) to the program. 53 (72%) women and 4 (36%) men reported benefit of the program. Seventy of the patients had had two or more treatments previous to the pain-school, where the most common treatments were information and counseling, and appliance therapy. These treatments had not given sufficient pain relief. In the group having three or more treatments previously 75% of the patients were responders compared to 60% among patients having only information and counseling. Among the 28 non-responders, 5 patients were younger than 20 years of age (10), 7 patients were men (11), 10 patients had high scores of depression according to RDC/TMD (23). Conclusion: This 5-session pain-school intervention seems to be effective in alleviating TMD pain in patients previously treated with usual therapies. The results of this evaluation indicate that there is a need of RCTs evaluating the effectiveness of this program in a short and a long term perspective.

  • 27.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    A 6- and 12-month follow-up of appliance therapy in TMD patients: a follow-up of a controlled trial2002In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 15, no 6, p. 564-570Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study compared the long-term effects of treatment with a stabilization appliance and treatment with a control appliance in patients with temporomandibular disorders (TMD). MATERIALS AND METHODS: In a controlled trial, 60 TMD patients with tem-poromandibular joint (TMJ) pain were evaluated after 10 weeks of treatment with either a stabilization appliance or a control appliance. At the 10-week follow-up, the 60 patients were assigned to one of three groups according to their demand for treatment. Group T, the treatment group, comprised 30 patients treated with a stabilization appliance; group C, the control group, comprised nine patients treated with a control appliance; and group M, the mixed treatment group, comprised 21 patients treated with first a control appliance and then a stabilization appliance. Signs and symptoms were evaluated in all three groups at 6- and 12-month follow-ups. RESULTS: At the 6- and 12-month follow-ups, a significant reduction in TMJ pain as measured on a visual analogue scale was found in all three groups, and a significant decrease in signs and symptoms was found in groups T and M. CONCLUSION: After 6 and 12 months of use, the stabilization appli-ance was found to still be effective in the alleviation of signs and symptoms in patients with TMD. Many patients in group C changed to a stabilization appliance at the 1 0-week follow-up, which significantly reduced the number of patients in this group. Most patients reported positive change in overall subjective symptoms in this trial. The stabilization appliance can therefore be recommended for patients with TMD.

  • 28.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Treatment Outcome of Appliance Therapy in Temporomandibular Disorder Patients with Myofascial Pain after 6 and 12 Months2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 6, p. 343-349Article in journal (Refereed)
    Abstract [en]

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

  • 29.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Treatment outcome of short- and long-term appliance therapy in patients with TMD of myogenous origin and tension-type headache2006In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 33, no 10, p. 713-721Article in journal (Refereed)
    Abstract [en]

    The aim was to compare the short- and long-term effect of a stabilization appliance with a control appliance in myofascial pain patients suffering from episodic or chronic tension-type headache. Sixty patients (mean age 29 +/- 12 years) with temporomandibular disorders (TMD) of myogenous origin and headache were studied in this prospective controlled study. Seventy-seven per cent of the patients reported episodic and 23% chronic tension-type headache at the start of the study. The 60 patients were randomly assigned to a treatment group (stabilization appliance) or to a control group (control appliance). The patients were interviewed regarding symptoms of headache and myofascial pain and clinically examined for masticatory muscle tenderness. At the 10-week and the 6- and 12-month evaluations of appliance therapy, the treatment outcome of tension-type headache was studied. At the 10-week evaluation, 17 patients dropped-out from the control group by requesting another appliance and receiving a stabilization appliance. Another patient in the control group dropped out later during the trial. In an intent-to-treat analysis, significant differences in improvement of headache between treatment and control groups were found at the follow-ups. A 30% reduction of muscles tender to palpation correlated significantly to improvement of headache at all follow-ups. The stabilization appliance seems to have a positive effect on tension-type headache, both in a short- and in a long-term perspective in patients with TMD with pain of myogenous origin.

  • 30.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Doepel, M
    Le Bell, Y
    The effectiveness of a prefabricated occlusal appliance in a long-term perspective (Finland)2007Conference paper (Other (popular science, discussion, etc.))
  • 31.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Doepel, M
    Le Bell, Y
    The effectiveness of a prefabricated occlusal appliance in a long-term perspective (Sweden)2007Conference paper (Other (popular science, discussion, etc.))
  • 32.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Doepel, M
    Söderling, E
    Selovuo, K
    Le Bell, Y
    Salivary cortisol and lgA levels in myofascial pain patients treated with occlusal appliances in a short term perspective (Naantali)2007Conference paper (Refereed)
  • 33.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Visscher, CM
    Lobbezoo, F
    de Laat, A
    Michelotti, A
    Farella, M
    Naeije, M
    A multicenter study to the concurrent validity of diagnostic TMD tests in TMD-pain patients, dental pain patients and pain-free subjects2007Conference paper (Other (popular science, discussion, etc.))
  • 34.
    Ekberg, EwaCarin
    et al.
    Malmö University, Faculty of Odontology (OD).
    Nilsson, Ing-Marie
    Malmö University, Faculty of Odontology (OD). Center for Oral Rehabilitation, FTV Östergötland, Norrköping, Sweden.
    Michelotti, Ambrosina
    chool of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
    Al-Khotani, Amal
    Dental Department, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia; Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.
    Alstergren, Per
    Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Dental Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden .
    Conti, Paulo Cesar Rodrigues
    Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, Brazil; Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil.
    Durham, Justin
    Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
    Goulet, Jean-Paul
    aculty of Dental Medicine, Laval University, Quebec, Canada.
    Hirsch, Christian
    Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany.
    Kalaykova, Stanimira
    Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
    Kapos, Flavia P
    Department of Epidemiology, University of Washington, Seattle, Washington, USA; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
    King, Christopher D
    Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Pediatric Pain Research Center (PPRC), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
    Komiyama, Osamu
    Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Japan.
    Koutris, Michail
    Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences, Malmö, 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;.
    Ohrbach, Richard
    Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA.
    Palermo, Tonya M
    Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine; Seattle Children's Research Institute, Seattle, Washington, USA.
    Peck, Christopher C
    Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
    Penlington, Chris
    Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
    Restrepo, Claudia
    CES-LPH Research Group, Universidad CES, Medellin, Colombia.
    Rodrigues, Maria Joao
    Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
    Sharma, Sonia
    Malmö University, Faculty of Odontology (OD). Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA.
    Svensson, Peter
    Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, 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.
    Wahlund, Kerstin
    Department of Orofacial Pain and Jaw Function, Kalmar County Hospital, Kalmar, Sweden.
    Rongo, Roberto
    International Network for Orofacial Pain and Related Disorders Methodology (INfORM), a Network within the International Association for Dental Research (IADR).
    Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for adolescents.2023In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 50, no 11, p. 1167-1180Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.

    OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.

    METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.

    RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers, and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents, and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.

    CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

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  • 35.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Vallon, Danila
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    The Efficacy of Appliance Therapy in Patients with Temporomandibular Disorders of Mainly Myogenous Origin. A Randomized, Controlled, Short-term Trial2003In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 17, no 2, p. 133-139Article in journal (Refereed)
    Abstract [en]

    Aims: To compare the short-term efficacy of treatment with a stabilization appliance compared with that of a non-occlusal, control appliance in patients with temporomandibular disorders (TMD) of mainly myogenous origin. Methods: A randomized, controlled trial was performed with 60 patients suffering from myofascial pain. Patients were randomly assigned to a treatment or a control group. The treatment group was treated by means of a stabilization appliance and the control group by means of a non-occlusal appliance. Symptoms and signs were registered before and after 10 weeks of treatment. Results: Improvement of overall subjective symptoms was reported in both groups, but significantly more often in the treatment group than in the control group (P = .000). The prevalence of daily or constant pain showed a significant reduction in the treatment group (P = .028) compared with the control group. There was a significant decrease in the number of tender masticatory muscles in the treatment group (P = .018) compared with the control group. Conclusion: The results of this short-term evaluation suggest that the stabilization appliance is more effective in alleviating symptoms and signs in patients with TMD of mainly myogenous origin than a control, non-occlusal appliance. The stabilization appliance can therefore be recommended for the therapy of these patients.

  • 36.
    Ekberg, EwaCarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Vallon, Danila
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Treatment Outcome of Headache After Occlusal Appliance Therapy in a Randomised Controlled Trial Among Patients with Temporomandibular Disorders of Mainly Arthrogenous Origin2002In: Swedish Dental Journal, ISSN 0347-9994, Vol. 26, no 3, p. 115-124Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate headaches before and after treatment with a stabilisation appliance and a control appliance in a randomised controlled trial in patients having temporomandibular disorders (TMD) of mainly arthrogenous origin. The effect of treatment was evaluated both in a short and in long-term perspective. 60 patients (mean age 30 years) with TMD of mainly arthrogenous origin were studied. The patients were selected from patients referred for treatment of TMD during a 3-year period to the Department of Stomathognathic Physiology, Faculty of Odontology, Malmo University. The 60 patients included in the study were randomly assigned to a treatment (T) or a control (C) group. The study was performed as a randomised controlled trial including evaluation of treatment effect on tension-type headache after 10 weeks, 6 and 12 months. At the 10 weeks follow-up, the patients who reported a negative treatment outcome and/or discomfort associated with the use of the appliances had their appliances readjusted. Patients who demanded further treatment received a stabilisation appliance (21 patients from the C-group), creating a new mixed (M) group. All the 60 patients reported frequency of headache from rarely up to daily at the start of the study. In the T-group 76% and in the C-group 83% of the patients reported headache at least once a week or more before treatment. At the 10 weeks follow-up, a statistically significant difference was found regarding headache several times a week or more between the T- and C-groups and within the T-group. At the 6 months follow-up, a statistically significant reduction was found in headache several times a week or more in the T- and M-groups. The number of patients with headache once a week or more decreased significantly in the T- and M-groups at the 12 months follow-up. We conclude that the stabilisation appliance seems to have an effect on the frequency of tension-type headache both in a short and in a long-term perspective in patients with TMD of mainly arthrogenous origin.

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

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

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

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

  • 39. Erixon, Caroline L.
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Self-perceived effects of occlusal appliance therapy on TMD patients: an eight-year follow-up2013In: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, no 1, p. 13-22Article in journal (Refereed)
    Abstract [en]

    There are few long-term follow-up studies of treatment of temporomandibular disorders (TMD).The aim of this questionnaire study was to evaluate eight-year outcomes of appliance therapy in patients suffering from arthralgia/osteoarthritis and/or myofascial pain. The subjects comprised 120 patients, originally randomly assigned to treatment with an occlusal or a control (palatal) appliance. Eight years later, a questionnaire was sent to 118 eligible patients: 90 (76%) responded. The outcome measures were intensity and frequency of pain, physical and emotional functioning, and overall improvement of pain and headache. Maximum pain intensity had decreased by > 30% in 54 patients (60%); frequency of pain had also decreased significantly. A majority, 57/90, reported improved physical function. Fifty-nine patients reported moderate to severe depression and 61 reported non-specific physical symptoms. Sixty-eight patients reported an overall improvement in TMD pain and 61 perceived overall improvement in severity of headaches. In the intervening years, 57 patients had undergone further treatment, most frequently in the form of another occlusal appliance. The majority of respondents reported improvement in TMD pain and headache. However, it is difficult to evaluate the long-term outcome of appliance therapy as more than 60% of the patients had additional treatments during the eight years.

  • 40. Eskafi, Mahmoud
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Cline, Charles
    Israelsson, Bo
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Use of a Mandibular Advancement Device in Patients with Con-gestive Heart Failure and Sleep Apnoea2004In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 21, no 2, p. 100-107Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the practical use of the mandibular advancement device (MAD) for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) over 1 year. Subjects: Twentyfive patients aged 66 ± 8 years (mean ± SD) met the inclusion criteria and were included in the study. Design: In a prospective, clinical trial, the apnoea-hypopnoea index (AHI), a measure of SA, was determined with a portable device. Failure to enter treatment and compliance, adverse events and signs and symptoms of temporomandibular disorders (TMD) were examined before intervention and 4-6 weeks, 6 months and 1 year after intervention. Results: Six patients had removable dentures of whom four had complete dentures. Before treatment, eight patients reported minor symptoms of TMD. The AHI fell from 19.3 ± 12.1 to 11.8 ± 9.5 (p = 0.004) with use of the device. In most patients, use of the MAD had no severe effects on the signs and symptoms of TMD. Adverse events such as pain in the temporomandibular joints, soreness in the teeth, and tiredness in the jaws were reported by ten patients. Dental complications were observed in two patients. Sixtyfour per cent of the patients were still using the MAD at the 1-year follow-up. Conclusion: both the general and oral health of CHF patients were important in treatment with a MAD. The MAD therapy had no severe effect on the masticatory system and edentulous patients could be treated.

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

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

  • 42.
    Gillborg, Susanna
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    TMD-pain among adults in the county of Scania2009Conference paper (Other academic)
    Abstract [en]

    Introduction: The prevalence of TMD has been shown in epidemiological studies to be 10-15 % and it is most often women in their 20-40´s, but also men, children and elderly have TMD. The most common reason for seeking care for TMD seems to be pain. In a recently published meta-analysis of the epidemiological literature the need for TMD treatment was estimated to be about 15 % among adults. Objectives: This study evaluates the prevalence of TMD-pain in adults in the county of Scania. Methods: A questionnaire was 2006 mailed to a randomized selected sample of 10000 individuals in the county of Scania. If the subjects answered yes to one or both of following questions, the subject was classified as having TMD-pain (1) “ Do you have pain in your temples, face, jaw joint or jaws once a week or more?” and (2) “Do you have pain when you open your mouth wide or chew once a week or more?”. Results: 6123 subjects (64%) answered the questionnaire. 1210 subjects (20,4 %) reported TMD-pain. Mean age was 47 years, with a female-male ratio of 7:5. A higher prevalence of TMD-pain was found for the ages 20-59 with the highest figure for the ages between 20 and 29 years. TMD-pain was reported by 19–21 % of subjects born in Sweden or another Nordic country compared to 32 % of the subjects born in another country. Length of education was not related TMD-pain. A higher prevalence of reported TMD-pain was found for subjects being unemployed, retired or were on sick leave compared to other occupations. TMD-pain was reported by 19 % of married subjects, 23 % of not married subjects compared to 27 % of subjects with another family-situation. Conclusion: The study found a high prevalence (20,4 %) of TMD-pain among adults in the county of Scania.

  • 43.
    Gillborg, Susanna
    et al.
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö University, Faculty of Odontology (OD).
    Tooth wear in Swedish adults: A cross-sectional study2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 2, p. 235-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Tooth wear has been recognised as a growing oral health problem in children and adolescents, with erosion often cited as the main cause of the tooth wear. Most studies on tooth wear have been conducted on children and adolescents, and only few studies focus on adults. Our aim was to study the prevalence of different types of tooth wear in an adult population and investigate related factors to tooth wear.

    METHODS: A total of 831 adults in Sweden participated in the study by completing a questionnaire about oral health, a clinical examination, saliva sample and intraoral photographs. Tooth wear was estimated according to the Basic Erosive Wear Examination index, and the aetiology was determined based on the clinical appearance.

    RESULTS: Almost 80% of the individuals had signs of erosion, and over 90% had signs of attrition. A high level of tooth wear was found in 4.6% of the individuals, few of who reported having received information about both attrition and erosion. Significantly, more men had tooth wear. Daily consumption of fruit had a stronger correlation to tooth wear than acidic drinks.

    DISCUSSION & CONCLUSION: A high level of tooth wear was found in 4.6% of the individuals, and it was more common in men than women. Aside from attrition, tooth wear due to erosion was a frequent finding in adults. Only a few of the individuals with a high level of tooth wear reported to have received information about tooth wear from their dentist or dental hygienist.

  • 44.
    Gillborg, Susanna
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, Ewa Carin
    Malmö högskola, Faculty of Odontology (OD).
    Temporomandibular Disorder Pain and Related Factors in an Adult Population: A Cross-Sectional Study in Southern Sweden2017In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 31, no 1, p. 37-45Article in journal (Refereed)
    Abstract [en]

    Aims: To measure the prevalence of temporomandibular disorder (TMD) pain and examine its association with gender and other factors in an adult population in southern Sweden. Methods: In 2006, a questionnaire was sent to randomly selected individuals (n = 10,000) aged 20 to 89 years. Two specific questions were used to screen individuals with TMD pain, and an additional 16 questions were analyzed regarding the subjects' relation to TMD pain. The chi-squared test was used to compare the distribution of categorical variables, and factors possibly related to TMD pain were analyzed by using logistic regression models with a likelihood-ratio test. Results: The response rate was 63%. The prevalence of TMD pain (once a week or more) was 11.0% (95% confidence interval [CI]: 10.2% to 11.8%). Women reported experiencing TMD pain more frequently than men. Further, the prevalence of TMD pain increased significantly in adults < 50 years of age. Those with TMD pain reported headaches much more frequently than those without TMD pain, and individuals with TMD pain self-reported poorer general health than those without it. Individuals with TMD pain also had higher scores on the oral health impact profile (OHIP-14). Moreover, the TMD pain group was three times more likely to have had a dentist or hygienist comment on their tooth wear than the non TMD pain group. Conclusion: The prevalence of TMD pain in the adult population in southern Sweden was 11%. Factors related to TMD pain were female gender, age < 50 years, headaches, self-reported poor general health, high scores on the OHIP-14, and tooth wear. Age was the only factor that showed a significant difference between genders for TMD pain.

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

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

  • 46. Henrikson, Thor
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Can orthodontic treatment improve mastication? A controlled, prospective and longitudinal study2009In: Swedish Dental Journal, ISSN 0347-9994, Vol. 33, no 2, p. 59-65Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To prospectively and longitudinally evaluate the self-perceived masticatory ability and the tested masticatory efficiency in orthodontically treated and untreated groups. DESIGN: Prospective observational cohort. SUBJECTS AND METHODS: Three groups of age matched adolescent girls were included. Sixty-five Class II subjects received orthodontic treatment fixed appliance treatment (Orthodontic group), 58 subjects were orthodontically untreated (Class II group) and 60 subjects had a normal occlusion (Normal group).The self-perceived masticatory ability was assessed on a visual analogue scale while the masticatory efficiency was evaluated with a masticatory efficiency test using round silicon tablets. Registrations were performed at the start and after two years when all subjects in the Orthodontic group had finished orthodontic treatment. RESULTS: Over the two-year period the self-perceived masticatory ability increased significantly in the Orthodontic group. After treatment, the Orthodontic group perceived their masticatory ability as high as the Normal group did. The masticatory efficiency increased significantly, during the two years, in all three groups. However,the normal occlusion group presented a significantly better masticatory efficiency than both the Orthodontic group and the Class II group on both registrations. CONCLUSIONS: Orthodontic treatment was beneficial for the self-perceived masticatory ability. The masticatory efficiency increases with age during adolescence. Normal occlusion subjects had a better masticatory efficiency than subjects with orthodontically treated as well as untreated Class II malocclusion.

  • 47.
    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.

  • 48.
    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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  • 49.
    Iskanderani, Durer
    et al.
    Malmö University, Faculty of Odontology (OD).
    Alstergren, Per
    Malmö University, Faculty of Odontology (OD).
    Ekberg, Ewa Carin
    Malmö University, Faculty of Odontology (OD).
    Shi, Xie-Qi
    Malmö University, Faculty of Odontology (OD).
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    Web-based educational programme for temporomandibular joint assessment with cone-beam computed tomography.2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 11, p. 1330-1336Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To develop and evaluate an educational web-based program for temporomandibular joint (TMJ) assessment using cone-beam computed tomography (CBCT).

    METHODS: A web-based educational program was designed for TMJ assessment using CBCT images. Fifteen CBCT cases of the TMJ (three-dimensional reconstructed volumes) and an assessment module based on image analysis criteria in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were added to the program. Thirty-six undergraduate dental students were invited to test the program by assessing all cases twice: before and after 2 months of training. Participants submitted written subjective evaluations of the program.

    RESULTS: The web-based program can be accessed on Malmö University webpage (www.cbct-tmj.mau.se). Despite limited CBCT learning in their undergraduate training and not using the program in the 2-month interval, the students were able to correctly diagnose 80% of the cases at the second assessment. Their diagnoses, however, did not differ significantly from the first assessment. Overall, the students were satisfied with the program and considered it user friendly.

    CONCLUSION: The web-based educational program that was developed in the present study and tested by dental students could be a useful educational tool for TMJ assessment using CBCT.

  • 50.
    Limchaichana, Napat
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Håkan
    Malmö högskola, Faculty of Odontology (OD).
    Is there an agreement between clinical diagnoses and MRI findings in patients with TMD pain?2006Conference paper (Refereed)
    Abstract [en]

    Is there an agreement between clinical diagnoses and MRI findings in patients with TMD pain?

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