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

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

  • 2.
    Al-Okshi, Ayman
    et al.
    Malmö University, Faculty of Odontology (OD). Sebha University, Sebha, Libya.
    Horner, Keith
    University of Manchester, UK.
    Rohlin, Madeleine
    Malmö University, Faculty of Odontology (OD).
    A meta-review of effective doses in dental and maxillofacial cone beam CT using the ROBIS tool.2021In: British Journal of Radiology, ISSN 0007-1285, E-ISSN 1748-880X, Vol. 94, no 1123, article id 20210042Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To apply the ROBIS tool for assessment of risk of bias (RoB) in systematic reviews (SRs) in a meta-review on effective doses (EDs) in dental and maxillofacial cone beam CT.

    METHODS: Three electronic databases and reference lists of included SRs were searched. Eligible SRs were classified as having low, high or unclear RoB. Findings of SRs were synthesised and data from primary studies combined to relate ED to field of view (FOV) and operating potential (kV).

    RESULTS: Seven SRs were included: three displayed low RoB, three high and one had unclear RoB. Only one SR related ED to image quality. Deficiencies in reporting of eligibility criteria, study selection and synthesis of results in SRs were identified. FOV height had a significant relationship with ED, explaining 27.2% of its variability. Median ED for three FOV categories differed significantly. Operating potential had a weak relationship with ED, with no significant difference in median ED between three operating potential groups.

    CONCLUSION: The ROBIS tool should have a role for meta-reviews of different aspects of radiology. The disappointing results for RoB might be remedied by developing standards to improve the quality of reporting of primary dosimetry studies and of SRs. Future dosimetry studies should always relate ED to image quality or diagnostic accuracy.

    ADVANCES IN KNOWLEDGE: This meta-review is the first to implement ROBIS for SRs of ED and identified that trustworthiness of some SRs is questionable. The percentage change in average ED per cm increase in FOV height could be calculated, emphasizing the importance of FOV as a determinant of ED in CBCT.

  • 3.
    Al-Okshi, Ayman
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Salé, Hanna
    Malmö högskola, Faculty of Odontology (OD).
    Gunnarsson, Mikael
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Effective dose of cone beam computed tomography (CBCT) of the facial skeleton: a systematic review2015In: British Journal of Radiology, ISSN 0007-1285, E-ISSN 1748-880X, Vol. 88, no 1045, article id 20140658Article, review/survey (Refereed)
    Abstract [en]

    Objective: To estimate effective dose of cone beam CT (CBCT) of the facial skeleton with focus on measurement methods and scanning protocols. Methods: A systematic review, which adhered to the preferred reporting items for systematic reviews (PRISMA) Statement, of the literature up to April 2014 was conducted. Data sources included MEDLINE®, The Cochrane Library and Web of Science. A model was developed to underpin data extraction from 38 included studies. Results: Technical specifications of the CBCT units were insufficiently described. Heterogeneity in measurement methods and scanning protocols between studies made comparisons of effective doses of different CBCT units and scanning protocols difficult. Few studies related doses to image quality. Reported effective dose varied across studies, ranging between 9.7 and 197.0 mSv for field of views (FOVs) with height #5cm, between 3.9 and 674.0 mSv for FOVs of heights 5.1–10.0 cm and between 8.8 and 1073.0 mSv for FOVs .10 cm. There was an inconsistency regarding reported effective dose of studies of the same CBCT unit with the same FOV dimensions. Conclusion: The review reveals a need for studies on radiation dosages related to image quality. Reporting quality of future studies has to be improved to facilitate comparison of effective doses obtained from examinations with different CBCT units and scanning protocols. A model with minimum data set on important parameters based on this observation is proposed. Advances in knowledge: Data important when estimating effective dose were insufficiently reported in most studies. A model with minimum data based on this observation is proposed. Few studies related effective dose to image quality.

  • 4.
    Al-Okshi, Ayman
    et al.
    Malmö University, Faculty of Odontology (OD).
    Paulsson, Liselotte
    Malmö University, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö University, Faculty of Odontology (OD).
    Ebrahim, Eman
    Malmö University, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö University, Faculty of Odontology (OD).
    Measurability and reliability of assessments of root length and marginal bone level in cone beam CT and intraoral radiography: a study of adolescents2019In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 48, no 5, p. 1-9, article id 20180368Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate measurability and reliability of measurements of root length and marginal bone level in CBCT, periapical (PA) and bitewing (BW) radiographs. Methods: CBCT of both jaws, PA of maxillary incisors and posterior BW radiographs of 10 adolescents (mean age 13.4) were selected. The radiographs comprised part of the baseline examinations of a trial of orthodontic treatment. Six raters assessed measurability and measured root length and marginal bone level. Three raters repeated their assessments. Measurability was expressed as frequency of interpretable sites and reliability as intraclass correlation coefficient (ICC). Results: Measurability was 100 % in CBCT and 95 % in PA of maxillary incisors for root length measurements. For marginal bone level, measurability was 100 % in CBCT, 76 % in PA and 86 % in posterior BW. Mean ICC for interrater reliability for root length measurements in CBCT was 0.88 (range 0.27-0.96 among different teeth) and 0.69 in PA of maxillary incisors. For marginal bone level measurements, mean ICC was 0.4 in CBCT, 0.38 in PA of maxillary incisors and 0.4 in posterior BW. Intrarater reliability varied among methods, root length or marginal bone level and among raters, except for root length measurements in CBCT, which presented high reliability (above 0.8) for all raters. Conclusions: As measurability and reliability were high for root length measurements in CBCT, this may be the method of choice for scientific analyses in orthodontics. For clinical praxis, we recommend PA following the "as low as diagnostically acceptable" principle, as clinical decisions seem to be influenced only when severe root resorption occurs.

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  • 5. Axelsson, Susanna
    et al.
    Davidsson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Håkansson, Kickan
    Jemt, Torsten
    Kedebring, Therese
    Lekholm, Ulf
    Lindholm, Jonas
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Nordenram, Gunilla
    Norlund, Anders
    Sunnegårdh-Grönberg, Karin
    Tranæus, Sofia
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Tandförluster: En systematisk litteraturöversikt2010Report (Other academic)
  • 6.
    Bahtsevani, Christel
    et al.
    Malmö högskola, Faculty of Odontology (OD). Malmö högskola, Faculty of Health and Society (HS).
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Levi, Ragnar
    Evidensbaserad vård - att använda vetenskaplig kunskap i det dagliga vårdarbetet2006In: Omvårdnadsmagasinet, ISSN 1652-0858, no 5, p. 18-24Article in journal (Other academic)
    Abstract [sv]

    En av de största utmaningarna just nu är att åstadkomma en evidensbaserad vård i det dagliga vårdarbetet. I princip handlar denna utmaning om att hantera en stor mäng föränderlig information, främst vetenskaplig sådan, och att systematiskt tillämpa den i det dagliga arbetet. Denna artikel avser dels att tydliggöra innebörden av begreppet evidensbaserad vård, dels att visa på möjliga vägar att åstadkomma en evidensbaserad vård.

  • 7.
    Bengmark, Daniel
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Dentists reflect on their problem-based education and professional satisfaction2012In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 16, no 1, p. e137-e145Article in journal (Refereed)
    Abstract [en]

    AIM: To determine the way in which Malmö University dental graduates perceive their problem-based dental education and evaluate their professional satisfaction. METHOD: The first five cohorts (graduating in years 1995-1999) of the problem-based curriculum were invited to participate. Of 166 graduates, 77% responded to a questionnaire comprising 20 questions on aspects of their dental education, professional situations and interest in postgraduate education. They were asked to rank their perception of their dental education and satisfaction with their professional situation on a visual analogue scale (VAS) with endpoints ranging from 'Not at all' (1) to 'Very well' (10). For other statements, the markings were made on a Likert scale from 1 (not important/not satisfied) to 5 (very important/very satisfied). There were also open-ended questions. RESULTS: Most respondents perceived their education to prepare them well for a career in dentistry (median score VAS 8), and 90% rated above six on a VAS for their professional satisfaction as dentists. Importance and satisfaction were highly correlated with principles of the curriculum: holistic view, oral health, lifelong learning, integration between theory and clinic, and clinical competence. Forty-five per cent of the graduates noted the problem-based learning approach as the most valuable asset of their education, and 19% cited training in oral surgery as a deficit. Of the respondents, 77% expressed interest in specialist training and 55% in research education

  • 8.
    Bengmark, Daniel
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Graduates' characteristics and professional situation: a follow-up of five classes graduated from the Malmö model2007In: Swedish Dental Journal, ISSN 0347-9994, Vol. 31, no 31, p. 129-135Article in journal (Refereed)
    Abstract [en]

    This study describes some characteristics of graduates of the five first classes from the Malmö dental programme, their overall experience of the programme, and their professional situation. Of 166 graduates (graduated 1995-1999) who were invited to participate, 128 responded (response rate 77%). The questionnaire queried participant characteristics, undergraduate education, and professional situation. The median age of the respondents at graduation was 26 years (range: 24-43 years, female: 56%). One-fourth of the respondents were born outside Sweden.Two-thirds of the respondents answered that they enrolled in the dental education because they wanted to become a dentist. Most respondents (97%) were working as a dentist, and a majority (82%) worked full-time. The respondents thought their dental education had prepared them well for their profession. About one-third of the respondents worked outside Sweden; the majority had been born outside of Sweden. The respondents' satisfaction with their professional situation, which was high overall, correlated to how much they were able to influence their work situation. About one-fourth expressed interest in specialist training. Respondents differed on the topic of research education: 64% of the female graduates and 42% of the male graduates were interested. We conclude that the respondents were satisfied with their professional situation as a dentist and that most were interested in postgraduate education.

  • 9. Bergqvist, B
    et al.
    Hansson, C
    Leisnert, Leif
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Persson, B
    Lärande för livet: verksamhetsförlagd utbildning2006In: Kvalitetsarbete på Malmö högskola då och nu: med sikte på framtiden, Malmö högskola, 2006, p. 89-102Chapter in book (Other academic)
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  • 10. Best, Helen A
    et al.
    Eaton, Kenneth A
    Plasschaert, Alphons
    Toh, Chooi Gait
    Grayden, Sharon K
    Senakola, Egita
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Continuing professional development - global perspectives: synopsis of a workshop held during the International Association of Dental Research meeting in Gothenburg, Sweden, 2003. Part 2: regulatory and accreditation systems and evidence for improving the performance of the dental team2005In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 9, no 2, p. 66-72Article in journal (Refereed)
    Abstract [en]

    This paper is the second in a series of two that report on continuing professional development (CPD). Details of the informants and the methodologies used were reported in the first paper. This paper reports the data and information presented on the topics of regulatory and accrediation systems for CPD and evidence that CPD improves the performance of the oral health team. By June 2003, participation in CPD was mandatory in most of the states of the USA, all Canadian Provinces, the UK and Latvia and was likely to become mandatory in a number of other countries in the near future. A variety of accreditation systems were reported including collecting CPD points, which in some countries were weighted depending on the type of CPD activity, and re-certification examinations. Very few studies for the effectiveness of dental CPD were identified. However, in general it was con-cluded that there is little evidence for the effectiveness of CPD for the oral health team. The main recommendation from this study is that a systematic review of the effectiveness of CPD in improving the performance of the oral health team and patient based outcomes be undertaken. A range of other research questions was also identified including: how can CPD be best matched to clinicians’ needs rather than demands?

  • 11. Best, Helen A
    et al.
    Eaton, Kenneth A
    Plasschaert, Alphons
    Toh, Chooi Gait
    Grayden, Sharon K
    Senakola, Egita
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Continuing professional development-global perspectives: synopsis of a workshop held during the International Association of Dental Research meeting in Gothenburg, Sweden, 2003. Part 1: access, funding and participation patterns2005In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 9, no 2, p. 59-65Article in journal (Refereed)
    Abstract [en]

    There appears to have been little previous research interest in continuing professional development* (CPD) of dentists and the oral health team. This paper presents data and information on the following aspects of CPD in 17 countries in Asia, Australasia, Europe and North America: availiability of different types of CPD, its providers, data on uptake of CPD courses and activities, and funding of CPD. The results indicate that lectures and hand-on skills courses were held in all 17 countries but the use of the Internet to deliver CPD was by no means universal. CPD was funded from a variety of sources including universities, governments and commercial companies. However, the only universal source of funding for CPD was dentists themselves. Data on participation were available from only three countries. Research issues based on these results will be listed in a second paper.

  • 12. Brown, George
    et al.
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Manogue, Michael
    Culture, collegiality and collaborative learning2003In: Effective teaching and learning in medical, dental and veterinary education / [ed] John Sweet; Sharon Huttly; Ian Taylor, Kogan page, 2003, p. 18-35Chapter in book (Other academic)
  • 13.
    Christell, Helena
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Birch, Stephen
    Hedesiu, Mihaela
    Horner, Keith
    Ivanauskaité, Deimante
    Nackaerts, Olivia
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    SEDENTEXCT consortium,
    Variation in costs of cone beam CT examinations among health care systems2012In: Dento-Maxillo-Facial Radiology, ISSN 0250-832X, E-ISSN 1476-542X, Vol. 41, no 7, p. 571-577Article in journal (Refereed)
    Abstract [en]

    Objectives: To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Methods: Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients’ and accompanying persons’ time, ‘‘out of pocket’’ costs for examination fee and visits). Results: The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range J148 000–227 000). Variation in indirect costs were mainly owing to examination fees (range J0–102.02). Conclusions: Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances.

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  • 14.
    Christell, Helena
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Birch, Stephen
    Horner, Keith
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Economic evaluation of diagnostic methods used in dentistry: a systematic review2014In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 42, no 11, p. 1361-1371Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVES: To review the literature of economic evaluations regarding diagnostic methods used in dentistry. DATA SOURCES: Four databases (MEDLINE, Web of Science, The Cochrane library, the NHS Economic Evaluation Database) were searched for studies, complemented by hand search, until February 2013. STUDY SELECTION: Two authors independently screened all titles or abstracts and then applied inclusion and exclusion criteria to select full-text publications published in English, which reported an economic evaluation comparing at least two alternative methods. Studies of diagnostic methods were assessed by four reviewers using a protocol based on the QUADAS tool regarding diagnostic methods and a check-list for economic evaluations. The results of the data extraction were summarized in a structured table and as a narrative description. RESULTS: From 476 identified full-text publications, 160 were considered to be economic evaluations. Only 12 studies (7%) were on diagnostic methods, whilst 78 studies (49%) were on prevention and 70 (40%) on treatment. Among studies on diagnostic methods, there was between-study heterogeneity methodologically, regarding the diagnostic method analysed and type of economic evaluation addressed. Generally, the choice of economic evaluation method was not justified and the perspective of the study not stated. Costing of diagnostic methods varied. CONCLUSIONS: A small body of literature addresses economic evaluation of diagnostic methods in dentistry. Thus, there is a need for studies from various perspectives with well defined research questions and measures of the cost and effectiveness. CLINICAL SIGNIFICANCE: Economic resources in healthcare are finite. For diagnostic methods, an understanding of efficacy provides only part of the information needed for evidence-based practice. This study highlighted a paucity of economic evaluations of diagnostic methods used in dentistry, indicating that much of what we practise lacks sufficient evidence.

  • 15.
    Christell, Helena
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Birch, Stephen
    Horner, Keith
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Economic evaluation in oral health care2009In: Programme and abstract book, 2009, p. 70-70, article id O69Conference paper (Other academic)
    Abstract [en]

    Introduction Economic evaluation attempts to weigh costs and effects of alternative interventions with the goal that available resources are used to achieve maximum benefits for patients in terms of health and quality of life. In emerging technologies this is particularly important to avoid inappropriate and excessive use. Objectives To analyse evidence on economic evaluation in oral health care, particularly on diagnostic imaging methods, by systematic review. Material and methods A search for literature was made starting with a hand made search according to the pearl growing model. This search strategy means that articles and relevant literature are retrieved by talking to renowned specialists in the subject area and by finding indexing and MeSH terms by looking at those articles and their reference lists. From seven articles indexing terms and MeSH terms were chosen and searches were made from PubMed, the Cochrane Library and Science Citations Index. The retrieved primary studies that according to the abstract contained a cost-effectiveness analysis were interpreted by two reviewers using a check-list for assessing economic evaluations (Drummond et al. 2005). Results The literature search yielded 258 titles and abstracts. Out of these, 93 studies were selected and read in full text. There was a vast heterogeneity in study design. No clear evidence was found. Methodology regarding the odontological part was acceptable in a few studies but the methodology for the economic evaluation was insufficient. Conclusions and discussion This review reveals a need for studies with improved quality in economic evaluation in oral health care. We will propose and discuss a model for economic evaluation of diagnostic methods that will contain information of how to (i) identify costs (ii) categorise costs and (iii) value costs. This model will be applied in the SEDENTEXCT project on Cone Beam Computed Tomography. Reference: Drummond MF, Sculpher MJ, Torrance GW, O´Brian BJ, Stoddart GL. Methods for the economic evaluation of health care programmes, Oxford, 2005, Oxford Medical Publications, 3rd ed. The research leading to these results has received funding from the European Atomic Energy Community’s Seventh Framework Programme FP7/2007-2011 under grant agreement no 212246 (SEDENTEXCT: Safety and Efficacy of a New and Emerging Dental X-ray Modality).

  • 16.
    Christell, Helena
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Birch, Stephen
    Horner, Keith
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    SEDENTEXCT consortium,
    A framework for costing diagnostic methods in oral health care: an application comparing a new imaging technology with the conventional approach for maxillary canines with eruption disturbances2012In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 40, no 4, p. 351-361Article in journal (Refereed)
    Abstract [en]

    Objectives: The aims were (i) to propose a framework for costing diagnostic methods in oral health care and (ii) to illustrate the application of the framework to the radiographic examination of maxillary canines with eruption disturbances. Methods: The framework for costing, following Drummond et al.(2005), includes three elements: (i) identification of different resources used in producing and delivering the service, (ii) measurement of the amount of each resource required and (iii) valuation of the resources in monetary terms. Four data collection instruments were designed – a protocol for apportioning the cost of capital equipment to each diagnostic procedure, separate forms for recording consumable items, for the time of different health care providers used for a diagnostic examination and a patient survey for calculation of the total cost to the patient associated with the examination. The framework was applied to the radiographic examination of maxillary canines with eruption disturbances comparing two imaging methods: (i) a new method with cone beam computed tomography and panoramic radiography and (ii) a conventional method using intraoral and panoramic radiography. The primary analysis was performed from the perspective of the health care system. A separate analysis included patient costs with health care system costs to provide a societal perspective. Comparison of the two perspectives allows consideration of whether any costs savings to the health care system are generated at the expense of greater costs for patients and their families. Data for the cost-analysis were retrieved from 47 patients (mean age 14 years) referred to a department of radiology for examination of maxillary canines. Results:Application of the framework for costing allowed us to compare the resources used to perform examinations of the two methods. The mean total cost per examination for the new method was 128.38€ and 81.80€ for the conventional method, resulting in an incremental cost per examination of the new method of 46.58€. Conclusions: The application of the framework demonstrates the feasibility of measuring and comparing the total costs as well as the distribution of total costs between providers and patients for different approaches to this common examination.

  • 17.
    Christersson, Cecilia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bengmark, Daniel
    Malmö högskola, Faculty of Odontology (OD).
    Bengtsson, H.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    A predictive model for alternative admission to dental education2015In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 19, no 4, p. 251-258Article in journal (Refereed)
    Abstract [en]

    AIM: To compare academic progress and performance of students admitted through two admission systems and to analyse the predictive power of different components in an alternative admission. SAMPLE AND METHODS: The subjects were students admitted to the dental programme at Malmö University, Sweden. The grade admission group was admitted on grades from secondary school (n = 126) and the alternative admission group via an alternative admission procedure (n = 157). The alternative admission procedure consisted of the following components: problem-solving matrices, spatial capacity tested with folding and tin models, manual dexterity, capacity for empathy and interview. Comparisons were made for academic progress (dropouts from the programme and study rate) and academic performance (examinations failed and outcomes of a comprehensive clinical examination). Spearman correlation was calculated for each component of the alternative admission procedure and academic progress as well as academic performance. Multivariate analyses were also carried out. RESULTS: Compared to the grade admission group, the alternative admission group presented lower rate of dropouts (3% vs. 20%, P < 0.001) and a larger proportion graduated within the expected time (88% vs. 60%, P < 0.01). There was no difference between the groups concerning academic performance. Capacity of empathy was correlated with study rate and outcomes of the clinical examination. The matrices predicted low proportion failed examinations and high students' self-assessments in the clinical examination. Predictive power of folding was limited and so was that of the interview. Manual dexterity was not correlated with academic progress or performance. CONCLUSIONS: Results support further development of admission selection criteria, particularly emphatic capacity that predicts important student academic achievements.

  • 18. Davidson, Thomas
    et al.
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Hultin, Margareta
    Jemt, Torsten
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Sunnegardh-Gronberg, Karin
    Tranæus, Sofia
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Reimbursement systems influence prosthodontic treatment of adult patients2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 6, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.

  • 19. Ellervall, Eva
    et al.
    Björklund, Fredrik
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Vinge, Ellen
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Antibiotic Prophylaxis in Oral Health Care: Administration Strategies of General Dental Practitioners2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 6, p. 321-329Article in journal (Refereed)
    Abstract [en]

    Objective. To examine the strategies that general dental practitioners (GDPs) use to administer antibiotic prophylaxis and to study the agreement between the administration strategies of GDPs and local recommendations. Methods. Postal questionnaires in combination with telephone interviews were used. Two hundred GDPs in two Swedish counties, Skåne and Örebro, were asked to participate. The response rate was 51 % (n=101). The GDPs were presented with eight simulated cases of patients with different medical conditions for which antibiotic prophylaxis might be considered necessary when performing dental procedures (scaling, tooth removal, root canal treatment). The administration strategies of the GDPs were compared with local recommendations. Results. In general, the variation in the administration strategies of the GDPs was large. For two medical condi-tions, type 1 diabetes that was not well controlled and hip prosthesis, significantly more GDPs in Skåne than in Örebro administered antibiotic prophylaxis for tooth removal. Agreement between the administration strategies of the GDPs and local recommendations was low. Differences between the two counties were non-significant. Furthermore, within Örebro, GDPs who did not have formal access to local recommendations did not differ in their administration strategies from those who did. The choice of substance was seldom in agreement with the substance recommended, while the majority followed the recommended duration of treatment. Conclusion. Although recommendations existed, their impact appeared to be limited. This is significant, since the implementation of recommendations is crucial in making clinical practice more effective and in promoting the health of patients.

  • 20. Ellervall, Eva
    et al.
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Vinge, Ellen
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Antibiotic prophylaxis in oral healthcare - the agreement between Swedish recommendations and evidence2010In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 208, no 3, article id E5Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence. MATERIAL AND METHODS: We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was carried out using a pre-defined protocol. In the end, one case-control study was included for evaluation of evidence. RESULTS: The case-control study included patients with specific cardiac conditions. The study reported a 49% protective efficacy (odds ratio: 0.51) of antibiotic prophylaxis for first-time episodes of endocarditis within 30 days of procedure. This result was not statistically significant. The quality of the evidence was low. No studies were evaluated on patients with other medical conditions. The recommendations included several cardiac and other medical conditions for which there is a lack of evidence or no evidence to support the use of antibiotic prophylaxis. CONCLUSIONS: There is a lack of evidence to support the use of antibiotic prophylaxis. To avoid the risk of adverse events from antibiotics and the risk of developing resistant bacterial strains, the use of antibiotic prophylaxis should be minimised and recommendations in Sweden should be revised to be more evidence-based.

  • 21. Eriksen, Harald M
    et al.
    Dimitrov, Vladimir
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Svensäter, Gunnel
    Malmö högskola, Faculty of Odontology (OD).
    The oral ecosystem: implications for education2006In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 10, no 4, p. 192-196Article in journal (Refereed)
    Abstract [en]

    We propose a model that is applicable to oral health education. The model describes the oral cavity in a complexity-based ecological context. This concept includes the premise that factors from different organisational levels (biological, individual, community, society) interact in a complex way with the potential to 'stress' the ecosystem and thereby provoke changes. This mode of action complies with the understanding of the oral cavity as a complex adaptive system. An ecological model is actively used in the undergraduate problem-based curriculum at the Faculty of Odontology, Malmo University, Sweden and has recently been applied as a conceptual basis for the new dental curriculum being established at the University of Tromso in Northern Norway. The purpose is to encourage and promote an ecological, health-oriented view and to stimulate reflections on premises for oral health and diseases in an integrated context.

  • 22. Ernberg, Malin
    et al.
    Bergenholtz, Gunnar
    Dahlén, Gunnar
    Ekman, Agneta
    Eriksson, Per-Olof
    Grøndahl, Kerstin
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lerner, Ulf
    Magnusson, Tomas
    Matsson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Pälvärinne, Raimo
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Examina och utbildning inom svensk odontologisk forskning: lägesrapport2003In: Tandläkartidningen, ISSN 0039-6982, Vol. 95, no 9, p. 54-59Article in journal (Other academic)
    Abstract [sv]

    En internationell utvärdering visade för några år sedan att Sverige riskerar att förlora sin position som världsledande nation inom odontologisk forskning. För att få en uppfattning om förändringarna inom forskarutbildningen och den postdoktorala meriteringen samlades data för 1990–2001 in från fakulteterna, Statistiska Centralbyrån samt Högskoleverket. Avsikten var att undersöka antalet forskarutbildade tandläkare, mångfalden bland doktoranderna och de som disputerat samt deras nuvarande anställningsform. Materialet jämfördes sedan med tidigare data. I medeltal avlade 25 personer per år doktorsexamen åren 1990–2001. Antalet har minskat under senare år. En majoritet av dem som avlade doktorsexamen hade odontologisk bakgrund. Relativt få har meriterat sig för en fortsatt akademisk karriär. 32 studerande påbörjade forskarutbildning åren 1991–2001. Andelen doktorander med annan akademisk grundexamen än odontologisk ökar. Sedan 1999 har forskningsvolymen minskat med motsvarande en hel fakultets forskningsvolym. Vi drar därför slutsatsen att kunskapsutvecklingen inom svensk odontologi riskerar att stagnera samt att fakulteternas behov av lärare till högre akademiska tjänster liksom folktandvårdens behov av handledare inom specialistutbildningen inte kommer att kunna tillgodoses i framtiden.

  • 23.
    Fransson, Helena
    et al.
    Malmö University, Faculty of Odontology (OD). University of Gothenburg.
    Davidson, Thomas
    Linköping University.
    Rohlin, Madeleine
    Malmö University, Faculty of Odontology (OD).
    Christell, Helena
    Helsingborg Hospital.
    There is a paucity of economic evaluations of prediction methods of caries and periodontitis: A systematic review2021In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 7, no 3, p. 385-398Article in journal (Refereed)
    Abstract [en]

    Objectives: Direct cost for methods of prediction also named risk assessment in dentistry may be negligible compared with the cost of extensive constructions. On the other hand, as risk assessment is performed daily and for several patients in general dental practice, the costs may be considerable. The objective was to summarize evidence in studies of economic evaluation of prognostic prediction multivariable models and methods of caries and periodontitis and to identify knowledge gaps (PROSPERO registration number: CRD42020149763). Material and methods: Four electronic databases (PubMed, Web of Science, The Cochrane Library, NHS Economic Evaluation Database) and reference lists of included studies were searched. Titles and abstracts were screened by two reviewers in parallel. Full-text studies reporting resources used, costs and cost-effectiveness of prediction models and methods were selected and critically appraised using a protocol based on items from the CHEERS checklist for economic evaluations and the CHARMS checklist for evaluation of prediction studies. Results: From 38 selected studies, six studies on prediction fulfilled the eligibility criteria, four on caries and two on periodontitis. As the economic evaluations differed in method and perspective among the studies, the results could not be generalized. Our systematic review revealed methodological shortcomings regarding the description of predictive models and methods, and particularly of the economic evaluation. Conclusions: The systematic review highlighted a paucity of economic evaluations regarding methods or multivariable models for prediction of caries and periodontitis. Our results indicate that what we currently practice using models and methods to predict caries and periodontitis lacks evidence regarding cost-effectiveness.

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  • 24. Gustafsson, Pernilla
    et al.
    Devlin, Hugh
    Horner, Keith
    Jacobs, Reinhilde
    Karyianni, K
    Van der Stelt, Paul F
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Will image quality influence diagnostic accuracy efficacy when diagnosing osteoporosis by intraoral radiography?2009In: Programme and abstract book, 2009, p. 67-67, article id O66Conference paper (Other academic)
    Abstract [en]

    Introduction In 2003-2005, the OSTEODENT study was performed with the aim of identifying the most valid and effective radiographic index for diagnosis of osteoporosis to be used in oral health care. One of the proposed indices was based on visual assessment of the trabecular pattern in intraoral periapical radiographs. Although strict quality criteria were used, the quality of the intraoral radiographs differed due to film placement and projection errors (Lindh et al 2008). Objectives To investigate if the diagnostic accuracy of visual assessment of the trabecular pattern to diagnose osteoporosis in intraoral radiography increased for images with optimal image quality. Material and methods One hundred intraoral radiographs of the upper and lower premolar regions with optimal image quality were chosen from the original sample of 600 images. The trabecular pattern was assessed by four observers and classified into one of three groups (i) dense homogenous trabecular patter, (ii) heterogeneous trabecular pattern, or (iii) sparse homogenous trabecular pattern. The criterion standard was comprised of osteoporosis as measured by DXA. Sensitivity, specificity, odds ratio, and inter- and intra-observer agreement for the assessment of the 100 images with optimal quality were compared to the values obtained from the assessment of the original sample. Results Sensitivity of images of optimal quality increased in the upper jaw as compared to that of the original sample. The odds ratios of images with optimal image quality were higher for both the upper and the lower jaw. The median intraobserver agreement (weighted Kappa) was also slightly higher for both jaws whilst the median interobserver agreement was comparable for the two samples. Conclusions and discussion Although image quality of intraoral radiography influenced the diagnostic accuracy efficacy in osteoporosis diagnosis to some extent, optimal image quality might not be necessary for the usability of the proposed classification in clinical practice. Reference: Lindh C, Horner K, Jonasson G, Olsson P, Rohlin M, Jacobs R , Karayianni K, van der Stelt P, Adams J, Marjanovic E, Pavitt S, Devlin H. The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod 2008;106:285- 93

  • 25.
    Haghparast, Hajdir
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Ghorbani, Amir
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Dental students' perception of their approaches to learning in a PBL programme2017In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 21, no 3, p. 159-165Article in journal (Refereed)
    Abstract [en]

    AIM: To compare dental students' perceptions of their learning approaches between different years of a problem-based learning (PBL) programme. The hypothesis was that in a comparison between senior and junior students, the senior students would perceive themselves as having a higher level of deep learning approach and a lower level of surface learning approach than junior students would. This hypothesis was based on the fact that senior students have longer experience of a student-centred educational context, which is supposed to underpin student learning. PARTICIPANTS AND METHODS: Students of three cohorts (first year, third year and fifth year) of a PBL-based dental programme were asked to respond to a questionnaire (R-SPQ-2F) developed to analyse students' learning approaches, that is deep approach and surface approach, using four subscales including deep strategy, surface strategy, deep motive and surface motive. The results of the three cohorts were compared using a one-way analysis of variance (ANOVA). A P-value was set at <0.05 for statistical significance. RESULTS: The fifth-year students demonstrated a lower surface approach than the first-year students (P = 0.020). There was a significant decrease in surface strategy from the first to the fifth year (P = 0.003). No differences were found concerning deep approach or its subscales (deep strategy and deep motive) between the mean scores of the three cohorts. CONCLUSIONS: The results did not show the expected increased depth in learning approaches over the programme years.

  • 26.
    Havsed, Kristian
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden; Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Hänsel Petersson, Gunnel
    Malmö University, Faculty of Odontology (OD).
    Isberg, Per-Erik
    Department of Statistics, Lund University, Lund, Sweden.
    Pigg, Maria
    Malmö University, Faculty of Odontology (OD). Malmö University, Foresight.
    Svensäter, Gunnel
    Malmö University, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö University, Faculty of Odontology (OD).
    Multivariable prediction models of caries increment: a systematic review and critical appraisal.2023In: Systematic Reviews, E-ISSN 2046-4053, Vol. 12, no 1, article id 202Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Multivariable prediction models are used in oral health care to identify individuals with an increased likelihood of caries increment. The outcomes of the models should help to manage individualized interventions and to determine the periodicity of service. The objective was to review and critically appraise studies of multivariable prediction models of caries increment.

    METHODS: Longitudinal studies that developed or validated prediction models of caries and expressed caries increment as a function of at least three predictors were included. PubMed, Cochrane Library, and Web of Science supplemented with reference lists of included studies were searched. Two reviewers independently extracted data using CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) and assessed risk of bias and concern regarding applicability using PROBAST (Prediction model Risk Of Bias ASessment Tool). Predictors were analysed and model performance was recalculated as estimated positive (LR +) and negative likelihood ratios (LR -) based on sensitivity and specificity presented in the studies included.

    RESULTS: Among the 765 reports identified, 21 studies providing 66 prediction models fulfilled the inclusion criteria. Over 150 candidate predictors were considered, and 31 predictors remained in studies of final developmental models: caries experience, mutans streptococci in saliva, fluoride supplements, and visible dental plaque being the most common predictors. Predictive performances varied, providing LR + and LR - ranges of 0.78-10.3 and 0.0-1.1, respectively. Only four models of coronal caries and one root caries model scored LR + values of at least 5. All studies were assessed as having high risk of bias, generally due to insufficient number of outcomes in relation to candidate predictors and considerable uncertainty regarding predictor thresholds and measurements. Concern regarding applicability was low overall.

    CONCLUSIONS: The review calls attention to several methodological deficiencies and the significant heterogeneity observed across the studies ruled out meta-analyses. Flawed or distorted study estimates lead to uncertainty about the prediction, which limits the models' usefulness in clinical decision-making. The modest performance of most models implies that alternative predictors should be considered, such as bacteria with acid tolerant properties.

    TRIAL REGISTRATION: PROSPERO CRD#152,467 April 28, 2020.

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  • 27.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Dental digital radiography: a survey of quality aspects2005In: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, no 2, p. 81-87Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the experiences of Swedish general dental practitioners (GDPs) with digital radiography and their opinion on the same, particularly regarding quality issues. A letter was sent to all GDPs in private care in Region Skåne, Sweden, asking whether they used digital radiography (n=513). The response rate was 79%. The number of private GDPs who replied that they used digital radiography was 106. The Public Dental Service in Region Skåne listed 33 GDPs who worked with digital radiography. Based on these answers, a questionnaire was sent to the GDPs working with digital radiography (n=139). The questionnaire comprised 27 questions about the dentists, the system of intra-oral digital radiography, and the GDPs’ experiences of and opinions on issues regarding image quality and quality control. The response rate to the questionnaire was 94%. Almost all, 92%, worked with charge-coupled device (CCD) and complementary metal oxide semiconductor (CMOS) sensors. Most GDPs were satisfied with their digital radiographic system. The majority (65%) experienced problems. Detector failure and trouble with the software were common. The GDPs wrote that they used lower exposure times in digital radiography than traditional film radiography. The estimated reduction in exposure time was said to be between 51% and 75%. Thirtyfive per cent continued to use film parallel with digital radiography. The answers indicated that less than half of the equipment (40%) underwent quality control. Quality controls, when conducted, were undertaken once or twice a year, mainly by technicians from the companies that had sold the digital equipment. Based on the results of the questionnaire, there seems to be a need to improve the maintenance and the quality of digital radiography. It is also important that the GDPs become more aware of the problems that can occur when a new technique is introduced and that they develop the skills to handle these problems.

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

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

  • 29. Ivanauskaite, Deimante
    et al.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rangne, Klara
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Comparison between Scanora panoramic radiography and bitewing radiography in the assessment of marginal bone tissue2006In: Stomatologija, Baltic Dental and Maxillofacial Journal, ISSN 1392-8589, E-ISSN 1822-301X, Vol. 8, no 1, p. 9-15Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare panoramic radiographs made with the Scanora dental program and bitewing radiographs in the assessment of marginal bone tissue. MATERIALS AND METHODS: Panoramic and posterior bitewing radiographs were made for 96 consecutive patients. Six observers assessed marginal bone level, and five observers identified the presence or absence of vertical bone defects and furcation involvements. Observer agreement was calculated. RESULTS: Assessments of the marginal bone level with the two methods were identical for 57% of the sites. If a difference of one score was allowed, assessments for 95% of the sites were in agreement. Vertical bone defects and furcation involvement were detected with an agreement of 93%. Ranges of kappa indexes for intra-observer agreement on assessments of the marginal bone level were 0.37-0.46 in panoramic radiography and 0.31-0.55 in bitewing radiography. Ranges for agreement on detection of vertical bone defects were 0.52-0.63 and 0.47-0.56 and on detection of furcation involvements 0.64-0.79 and 0.66-0.77, respectively. The kappa index for inter-observer agreement on marginal bone level was 0.28 for panoramic and 0.29 for bitewing radiography. Corresponding figures for detection of vertical bone defects were 0.38 and 0.35 and for detection of furcation involvement 0.56 and 0.67. CONCLUSIONS: For those sites or teeth that are possible to assess, the diagnostic information available with Scanora panoramic radiography is comparable to that with bitewing radiography for marginal bone tissue. Therefore, Scanora dental panoramic radiography is a valuable diagnostic alternative in the primary examination of the periodontal status.

  • 30. Ivanauskaité, Deimante
    et al.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Observer performance based on marginal bone tissue visibility in Scanora panoramic radiography and posterior bitewing radiography2008In: Stomatologija, Baltic Dental and Maxillofacial Journal, ISSN 1392-8589, E-ISSN 1822-301X, Vol. 10, no 1, p. 36-43Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate image quality for marginal bone tissue assessment on panoramic radiographs taken with the Scanora dental programme and on posterior bitewing radiographs. METHODS: Panoramic and bitewing radiographs were taken of 96 patients. Six observers rated marginal bone level visibility as excellent, acceptable, or unacceptable. Five observers assessed image quality for detection of vertical bone defects and furcation involvements as acceptable or unacceptable. Observer agreement was calculated as overall agreement and kappa values. RESULTS: Image quality of 36% of the panoramic and 6% of the bitewing sites was rated unacceptable for marginal bone loss assessment in the maxillae while 8% of the panoramic and bitewing sites in the mandible were unacceptable. For detecting vertical bone defects, image quality was unacceptable at one-third of the maxillary sites and 5% of the mandibular sites on the panoramic radiographs. Detection of furcation involvement was acceptable at most sites on both types of radiographs. Kappa values for intra- and inter-observer agreement were higher for panoramic than for bitewing radiographs. The kappa value for marginal bone loss assessment by several observers was moderate (0.45) for panorama and fair (0.28) for bitewing radiography. Corresponding kappa values for detection of vertical bone defects were substantial (0.62) and fair (0.25). CONCLUSION: Image quality as evaluated by visual grading analysis is adequate for marginal bone tissue assessment in mandibular molar and premolar regions and unacceptable in maxillary molar and premolar regions on panoramic radiographs taken with the Scanora technique compared to bitewing radiography.

  • 31.
    Johansson, Kristina
    et al.
    Östersund Hospital.
    Lindh, Christina
    Malmö University, Faculty of Odontology (OD).
    Paulsson, Liselotte
    Malmö University, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö University, Faculty of Odontology (OD).
    A tool for assessment of risk of bias in studies of adverse effects of orthodontic treatment applied in a systematic review on external root resorption2021In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 43, no 4, p. 457-466, article id cjaa072Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Systematic reviews (SRs) are considered to provide reliable estimates, but flaws in designs, methods of monitoring effects, and outcomes have the potential to bias results. There are several tools for assessing risk of bias (RoB), most of them designed for SRs of beneficial effects. To our knowledge, there is no tool that is adapted specifically to assess RoB in studies of adverse effects associated with orthodontic treatment. To address this, the aim of this study was first to introduce a tool for assessment of RoB in studies of adverse effects associated with orthodontic treatment and, second, to apply it in an SR of external root resorption (ERR) associated with orthodontic treatment with fixed appliance.

    MATERIALS AND METHODS: The approach with domains supported by signalling questions was used for the tool. Domains and signalling questions were tailored to the review questions of the SR of studies of ERR after orthodontic treatment using periapical radiography or cone beam computed tomography. Duplicate study selection, data extraction, and RoB assessment using the tool, followed by meta-analyses, were performed.

    RESULTS: Using the tool for the assessment of RoB identified shortcomings and report deficiencies of primary studies concerning the presentation of orthodontic treatment, identification of ERR, and analysis of outcomes. RoB assessment resulted in 12 of 32 studies read in full text being included. Reported severe ERR varied across studies between 2 and 14 per cent for all incisors and 10 and 29 per cent for maxillary incisors. Results of ERR related to patients' age and sex, orthodontic diagnosis, and treatment were contradictory. Quality of evidence evaluated by GRADE was low due to study limitations, imprecision, and inconsistency of study results.

    CONCLUSIONS: As the tool and its application highlight important issues to consider when planning, conducting, and reporting research, the tool may have a valuable role for quality enhancement of future studies of outcomes of orthodontic treatment. The tool may also serve for authors when planning SRs. Our SR identified a need for studies that use rigorous methodology and transparent reporting.

    REGISTRATION: PROSPERO (ID = CRD42018084725).

  • 32. Koh, Kwang-Joon
    et al.
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Relationship between clinical and magnetic resonance imaging diagnoses and findings in degenerative and inflammatory temporomandibular joint diseases: a systematic literature review2009In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 23, no 2, p. 123-139Article in journal (Refereed)
    Abstract [en]

    AIM: To describe evidence for a relationship between diagnoses and findings of clinical examination and diagnoses and findings of magnetic resonance imaging (MRI) examination for degenerative and inflammatory temporomandibular joint diseases. METHODS: PubMed and the Cochrane Library were searched using specific indexing terms and reference lists were hand-searched. Included publications satisfied pre-established criteria. Primary studies were interpreted using a modification of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 219 titles and abstracts. Eighty-two studies were selected and read in full-text. After data extraction and interpretation with the QUADAS tool, 23 studies remained. There was a vast heterogeneity in study design, clinical examination methods, and diagnostic criteria. No clear evidence was found for a relationship between clinical and MRI diagnoses and findings. Several studies reported a relationship between clinical pain and internal derangements diagnosed with MRI, but the calculated odds ratio (OR) for this relationship was generally low (1.54-2.04). ORs for the relationship between pain and disc displacement without reduction (4.82) or between crepitation and disc displacement without reduction (3.71) were higher. CONCLUSION: This review reveals a need for studies with improved quality in reporting of samples, examination techniques, findings, and definitions and rationales for cutoffs, categories, and diagnoses. We recommend that standardized protocols such as the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) and the Standards for Reporting of Diagnostic Accuracy (STARD) statement be implemented in future studies.

  • 33. Konishi, Masara
    et al.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Tanimoto, Keiji
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Important technical parameters are not presented in reports of intraoral digital radiography in endodontic treatment: recommendations for future studies2012In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 114, no 2, p. 251-258Article, review/survey (Refereed)
    Abstract [en]

    Abstract OBJECTIVES: The aims of this study were to review the literature on intraoral digital radiography in endodontic treatment with focus on technical parameters and to propose recommendations for improving the quality of reports in future publications. STUDY DESIGN: Two electronic databases were searched. Titles and abstracts were selected according to preestablished criteria. Data were extracted using a model of image acquisition and interpretation. RESULTS: The literature search yielded 233 titles and abstracts; 61 reports were read in full text. Recent reports presented technical parameters more thoroughly than older reports. Most reported important parameters for the x-ray unit, but for image interpretation only about one-half of the publications cited resolution of the display system and fewer than one-half bit depth of the graphics card. CONCLUSIONS: The methodologic quality of future publications must be improved to permit replication of studies and comparison of results between studies in dental digital radiography. Our recommendations can improve the quality of studies on diagnostic accuracy.

  • 34.
    Liedholm, Rolf
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Henricsson, Vincent
    Lysell, Leif
    Norlund, Anders
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Rosenquist, Bo
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Patient Flows in the Care Process of Mandibular Third Molar Surgery2005In: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, no 3, p. 97-104Article in journal (Other academic)
    Abstract [en]

    Our aim was to describe patient flows in mandibular third molar surgery at oral and maxillofacial specialist units. Our hypothesis was that there are variations in how care is delivered and that the variations could be explained by inter-individual variations in surgeons’ practice, the quality of the radiographs appended to the referral, and the staffing of the specialist units. A flow chart was constructed to simulate all possible patient flows in the care process. The chart begins with treatment planning, which was drawn up based on documents from the referring dentist or another caregiver; continues with the care process at the oral and maxillofacial surgery unit, including surgical consultations and radiological examinations; and ends with surgery. Surgeons at four oral and maxillofacial surgery units in the National Health Service in southern Sweden participated. The intention was to collect data on at least 100 patients who had undergone mandibular third molar surgery at each unit. Data on 361 patients were collected. The radiographs appended to the referral were judged to be inappropriate for the majority of the patients (61%). For 13% of these patients, supplementary radiographic examinations were made at the radiology clinic included in the unit, whilst 48% were examined at the oral and maxillofacial surgery clinic. There were eight different patient flow patterns. In one unit with three surgeons, eight different flow patterns were recorded, indicating an interindividual variation among the surgeons. In a second unit, six different flow patterns were recorded. In the last two units, the patient flows appeared to be the same at each unit, although the predominant patient flows in these two units differed. The number of patient visits to the specialist units ranged between one and three. In three specialist units, most patients were called twice whilst in one specialist unit most patients were called only once, to have the third molar removed. Differences existed in the care process. Overall, the number of patient visits seemed not to depend on whether the preoperative radiographic examination was judged to be appropriate or whether the additional radiographs were made at the radiology clinic.

  • 35.
    Liedholm, Rolf
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Lysell, L
    Department of Oral Surgery, Central Hospital, Kristianstad.
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Mandibular third molars: oral surgeons' assessment of the indications for removal1999In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 37, no 6, p. 440-443Article in journal (Refereed)
    Abstract [en]

    The aim was to examine oral surgeons' assessment of the indications for removal of mandibular third molars. Questionnaires were distributed to seven oral and maxillofacial surgery clinics. The oral surgeons were asked to record whether or not there was associated disease. Three other factors were recorded: patient's age, and angular position and extent of eruption of the molars. The strength of the indication for removal was rated on a visual analogue scale (VAS) where 0 = weakest and 100 = strongest indication for removal. The results were based on data from 666 molars: 118 (18%) had no disease, 465 (70%) had one associated disease, 77 (11%) had two and 6 (1%) had three. The indication for removal as expressed by the mean VAS for molars with no disease was assessed to be weaker (P < 0.05) than that for molars with one, two, or three diseases. The only; factor that influenced the indication for removal in molars with no disease was the patient's age.

  • 36.
    Liedholm, Rolf
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Lysell, Leif
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Brickley, Mark
    Shepherd, Jonathan P
    The outcomes of mandibular third molar removal and non-removal: a study of patients' preferences using a multi-attribute method2000In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 58, no 6, p. 293-298Article in journal (Refereed)
    Abstract [en]

    The aim was to study patients' preferences about outcomes of mandibular third molar removal and non-removal using multi-attribute utility (MAU) methodology. The study comprised three stages. Stage 1: Elicitation of domains, i.e. main areas of patients' lives which could be affected by third molar removal and non-removal. Stage 2a: Interdomain weighting was obtained by relative weighting of the domains elicited in Stage 1. Stage 2b: Intradomain weighting obtained by patients' designation of values for different health slates of each domain. Stage 3: Rating of outcomes. The patients were asked to imagine experiencing a variety of outcomes of mandibular third molar removal and non-removal, described in 19 short vignettes. The numbers of patients interviewed for the three stages were 30, 78, and 55, respectively. Five domains were identified. The mean relative weightings were approximately equal for the domains "Home and social life" and "General health and well-being", followed in order of importance by "Job and studies" and "Health and comfort of mouth, teeth and gums". "Your appearance" received the lowest mean relative weighting. The vignette, which described the presence of a fluid-filled sac and suggested that this tooth must be removed, received the highest mean preference (least effect on patients' lives). The lowest mean preference (most effect on patients' lives) was generated by the vignette, which stated that the jaw was broken and that the teeth must be wired together for 6 weeks. We conclude that, from the patient's perspective, outcomes of non-removal were preferable to outcomes of mandibular third molar removal.

  • 37.
    Liedholm, Rolf
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lysell, Leif
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Brickley, Mark
    Shepherd, Jonathan
    Third molar treatment outcome: a comparison of patients' preferences in Sweden and Wales2005In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 199, no 5, p. 287-291Article in journal (Refereed)
    Abstract [en]

    Aim: To elucidate and compare patients’ outcome preferences with regard to removal and retention of mandibular third molars in Sweden and Wales. Subjects and Method: The subjects comprised patients referred for and scheduled for removal of one or both mandibular third molars in both Sweden and Wales. To study patients’ preferences for outcomes of removal and retention of the mandibular third molar, the Multi-attribute utility (MAU) methodology was applied to these patients. Results: Relative weighting of domains was similar in the two countries. “Home and social life” received the highest relative weighting in Sweden and “General health and well-being” in Wales. “Your appearance” received the lowest relative weighting in Sweden and Wales. In both Sweden and Wales operative jaw fracture was considered to be the outcome with most impact and dentigerous cyst and imbricated incisors the least impact. Outcome ranking was similar in the two countries and operative outcomes were considered by patients to be more detrimental to health than retention outcomes. Conclusions: This European comparison showed that patients’ preferences in Sweden and Wales were similar and that the outcomes of surgery were considered worse after third molar removal than retention. Patient-orientated treatment decisions are less subject to variation than clinician-orientated decisions.

  • 38.
    Limchaichana, Napat
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    The efficacy of magnetic resonance imaging in the diagnosis of degenerative and inflammatory temporomandibular joint disorders: a systematic literature review2006In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 102, no 4, p. 521-536Article, review/survey (Other academic)
    Abstract [en]

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

  • 39.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Isaksson, Sten
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Käkarnas benvävnad: tandläkarens undersökning och bedömning av stor betydelse2008In: Tandläkartidningen, ISSN 0039-6982, Vol. 100, no 9-10, p. 59-62Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Röntgenbilder som tas i kliniken är av stor betydelse. Röntgenbilden kan resultera i en diagnos, användas till att göra en prognos, att förutsäga framtida händelser men är även viktig vid utvärdering av ett behandlingsresultat.

  • 40.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lindberg, Pia
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Specialist Training at the Faculty of Odontology, Malmö University2006In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 10, no 2Article in journal (Other academic)
    Abstract [en]

    Aim To describe the specialist training at the Faculty of Odontology in Malmö for eight specialities that are certified in Sweden and report the results of a questionnaire among former specialist trainees. Material and Method The objectives of the specialist training are set on three levels: the national level according to the Swedish National Board for Health and Welfare, the faculty level, the so called Malmö model, and finally the specialist subject level. The specialist training in Malmö is implemented in collaboration with the Public Dental Health Care in southern Sweden. The Postgraduate Education Board of the faculty scrutinizes and approves each trainee’s individualized specialist training programme. The clinical part of the training is to be shared between the collaborating units and the theoretical part is the prime responsibility of the faculty. During the three-year-programme, seven core courses are held for all trainees irrespective of specialist subject parallel to the clinical training. Every semester there are two joint seminars: one seminar on a current odontological theme and one on the following subjects; epidemiology, ethics, migration and ethnic relations, environment, gender, leadership. A written and oral programme evaluation is performed yearly by the Chair of the Postgraduate Education Board together with a representative of the Public Dental Health Care. As part of the 2003 evaluation a questionnaire was sent to 31 specialist graduates trained between 2000 and 2003. Twenty-four specialists responded, 13 graduates from Malmö and 11 from other Swedish specialist institutions. Results and Conclusion A majority of the 24 responding graduates express that the work as specialists suit them very well and that the education well serve the purpose to work as a specialist. A majority of the graduates from Malmö were positive to the joint courses during their training. Some thought that there should be more joint activities among trainees of different subject specialities.

  • 41.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Olsson, P
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Jonasson, G
    Devlin, H
    Jacobs, R
    Karayianni, K
    van der Stelt, P
    Harisson, E
    Adams, Judith
    Pavitt, S
    Horner, K
    Trabecular pattern in intraoral radiographs as a sign of osteoporosis: the OSTEODENT study2006Conference paper (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate if the trabecular pattern in intraoral radiographs, assessed by five observers, could serve as an indicator of osteoporosis. Methods: Six hundred and seventy one women (45 - 70 yrs) from four European centers were included in the study and examined with intraoral radiographs in the right upper and lower premolar region. The patients also underwent examinations with central dual energy X-ray absorptiometry (DXA) of the hip and lumbar spine. Five observers assessed the trabecular pattern in the intraoral radiographs into one of three classes: dense, heterogeneous or sparse trabecular pattern. The assessments were made with the aid of reference images and the observers underwent a calibration procedure before starting their assessments. The classifications were compared with the true diagnosis of osteoporosis measured using DXA. Results: The sensitivity and specificity for five observers’ assessments of the intraoral radiographs with sparse trabecular pattern as indicative of osteoporosis at either hip or spine are given in the table below. The values are calculated for patients diagnosed as having osteoporosis at any of the examined sites. Upper jaw Lower jaw Observer Sensitivity Specificity Sensitivity Specificity 1 22.2 90.2 13.2 94.5 2 22.6 94.8 15.8 94.2 3 26.5 91.6 28.1 86.7 4 36.3 87.4 30.2 82.4 5 35.3 93.7 39.1 95.6 If the cut-off included either “heterogeneous” or “sparse” trabeculation then a higher sensitivity was achieved (90.6 – 73.7) but a lower specificity (49.4 – 26.2). Conclusion: Assessment of sparse trabecular pattern on intraoral radiographs offered a combination of low sensitivity but high specificity for osteoporosis diagnosis. If it is assumed that high specificity is preferred for osteoporosis assessment by dentists, then this method may have potential for clinical use, although inter-observer variability may be a problem. This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).

  • 42.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Clinical assessment of jaw bone tissue prior to endosseous dental implant palcement: a systematic literature review2006Conference paper (Refereed)
    Abstract [en]

    Objectives: The aim was to evaluate the evidence for diagnostic accuracy of clinical methods to assess bone density, bone quantity or bone quality prior to and during dental implant placement. Methods: A PubMed literature search with specific indexing terms and a hand search were made. Three reviewers read retrieved titles and abstracts using inclusion and exclusion criteria. Included articles were read in full text and data extracted. Then, relevant original studies were assessed with the aid of QUADAS (Quality Assessment of Diagnostic Accuracy Studies) tool. Results: The literature search yielded 145 titles, of which 71 were selected based on including/excluding criteria and read in full text. After that only 13 original studies, which elucidated the efficacy of clinical methods, remained. Six studies presented the results of the test method as compared to those of a reference method. Four presented their results as diagnostic accuracy expressed as relevant measures. Diagnostic imaging methods were the only method used to assess bone tissue prior to implant placement. The other clinical methods reviewed evaluated the bone tissue but at the time of implant placement. Conclusions: Considering the few number of original studies that had a reference method, there is insufficient evidence for the diagnostic accuracy of clinical methods to assess bone density, bone quantity and bone quality prior to or during endosseous dental implant placement.

  • 43.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Definitions of bone tissue characteristics presented in studies on dental implant planning and placement. A systematic review2007Conference paper (Refereed)
  • 44.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement: a systematic literature review2007In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 22, no 2, p. 289-300Article, review/survey (Other academic)
    Abstract [en]

    PURPOSE: To evaluate the evidence for the diagnostic accuracy of clinical methods to assess bone density, quantity, or quality prior to and during dental implant placement. MATERIALS AND METHODS: A PubMed literature search with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, 3 reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 145 titles and abstracts, of which 71 were selected and read in full text. Seven studies were judged relevant. In 1 study, no method was presented as the test method. In 6 studies, the results of the test method were compared to those of a reference method. However, only 1 study presented the results in terms of percentage of correct diagnoses. In that study, the use of periapical radiography together with reference images yielded correct assessment of the trabecular pattern of the mandible in 3 categories in 58% of the sites. The kappa index of interobserver agreement was 0.35 and intraobserver agreement was 0.67. Corresponding kappa values for 4 classes of bone quality presented by Lekholm and Zarb were 0.33 and 0.43, respectively. No study examined the accuracy of the method originally described by Lekholm and Zarb. CONCLUSION: The evidence for the efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement is sparse. This emphasizes the need for studies that incorporate accepted methodologic criteria for diagnostic efficacy. PMID: 17465355 [PubMed - indexed for MEDLINE]

  • 45.
    Lindh, Christina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Takano, Y
    Diagnostic Efficacy of Direct Digital Intraoral Radiography Prior to and During Endodontic Treatment. A systematic literature review2007Conference paper (Refereed)
  • 46. Nakamoto, T
    et al.
    Taguchi, A
    Ohtsuka, M
    Suei, Y
    Fujiya, M
    Tanimoto, K
    Tsuda, M
    Sanada, M
    Ohama, K
    Takahashi, J
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners’ diagnostic performance2003In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 14, no 8, p. 659-664Article in journal (Other academic)
    Abstract [en]

    The detection of postmenopausal women with low bone mineral density (BMD) is an important strategy to reduce the incidence of osteoporotic fracture. Recent studies suggested that incidental findings on dental panoramic radiographs may be used as a tool to detect women with low BMD. However, little is known whether this finding is sufficiently assessed by untrained general dental practitioners (GDPs). The purpose of this study was to investigate: (1) the observer agreement and (2) the diagnostic efficacy in detecting women with low BMD, when untrained GDPs assess the appearance (normal or eroded) of the mandibular inferior cortex on dental panoramic radiographs of postmenopausal women. Twenty-seven GDPs were asked to classify the appearance of the mandibular inferior cortex on dental panoramic radiographs of 100 postmenopausal women who had completed BMD assessments of the lumbar spine and of the femoral neck. Intra- and inter-observer agreements were analyzed with kappa statistics. The diagnostic efficacy (sensitivity, specificity and predictive values) was analyzed by comparing two groups classified by the mandibular inferior cortex (women with normal and women with eroded mandibular inferior cortex) with those classified by BMD (women with normal BMD and women with osteopenia or osteoporosis). The mean sensitivity and specificity were 77 % and 40 %, respectively, when BMD of the lumbar spine was used as standard and 75 % and 39 %, respectively, when BMD of the femoral neck comprised the standard. Nineteen untrained GDPs (70 %) presented a moderate to almost perfect intra-observer agreement. We conclude that dental panoramic radiograph may be used in clinical dental practice to identify postmenopausal women who have undetected low BMD and should undergo further testing with bone densitometry.

  • 47. Nordenram, Gunilla
    et al.
    Davidson, Thomas
    Gynther, Göran
    Helgesson, Gert
    Hultin, Margareta
    Jemt, Torsten
    Lekholm, Ulf
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Norlund, Anders
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Sunnegårdh-Grönberg, Karin
    Tranæus, Sofia
    Malmö högskola, Faculty of Odontology (OD).
    Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: A systematic review with meta-synthesis2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 937-951Article in journal (Refereed)
    Abstract [en]

    Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.

  • 48.
    Olsson, Helena
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Formation of a hard tissue barrier after pulp cappings in gumans. A systematic review2006In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 39, no 6, p. 429-442Article, review/survey (Other academic)
    Abstract [en]

    Aim To evaluate the evidence on the formation of a hard tissue barrier after pulp capping in humans. Methodology A PubMed and CENTRAL literature search with specific indexing terms and a hand search were made. The authors assessed the level of evidence of each publication as high, moderate or low. Based on this, the evidence grade of the conclusions was rated as strong, moderately strong, limited or insufficient. Results The initial search process resulted in a total of 171 publications. After reading the abstracts and hand searching the reference lists of the retrieved publications, 107 studies were retrieved in full-text and interpreted. After the interpretation, 21 studies remained and were included in the systematic review and given a level of evidence. No study had a high level of evidence, one study had moderate and 20 studies had a low level of evidence. There was heterogeneity between the studies; therefore, no meta-analysis was performed. The majority of studies on pulp capping using calcium hydroxide based materials reported formation of hard tissue bridging, studies on other pulp capping materials such as bonding agents presented inferior results. The evidence grade was insufficient. Conclusions Insufficient evidence grade does not necessarily imply that there is no effect of a pulp capping procedure or that it should not be used. Rather, the insufficient evidence underpins the need for high-quality studies.

  • 49. Rawski Åkerblom, Anna
    et al.
    Brehmer, Berndt
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Reit, Claes
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    The major factors that influence endodontic retreatment decisions2003In: Swedish Dental Journal, ISSN 0347-9994, Vol. 27, no 1, p. 23-29Article in journal (Refereed)
    Abstract [en]

    The presence of a new or persistent periapical radiolucency adjacent to a rootfilled tooth is often used as a criterion of endodontic treatment “failure”. However, clinicians’ suggested management of such cases is subject to substantial interindividual variation. Several components that might influence endodontic retreatment decision making have been explored, but data on which factors dentists actually think they consider, are missing. The aim was to interview 20 general dental practitioners (GPDs) and 20 endodontists about factors they thought would influence the prescription of endodontic retreatment. Six simu-lated cases were presented as cartoons accompanied with a clinical his-tory. In two of the cases the teeth were planned to serve as an abut-ment tooth in a fixed prosthodontic construction. The status of the periapical bone tissue and the quality of rootfilling seal were varied. Between 1 and 6 factors per case were reported to influence decision making. In cases not planned to serve as abutment teeth most dentists considered that the periapical condition was the most important fac-tor, whilst they considered the fixed prosthodontic construction to be the most important factor in cases planned as abutment teeth. Gener-ally, endodontists seem to be more inclined to retreat and act on the mere presence of a periapical lesion regardless of size than GDPs. In a real clinical setting in direct contact with patients, additional factors like economy and patients’ preferences might be expected to exert a major influence. The majority of the dentists stated that they thought that their colleagues would make similar decisions as they did them-selves.

  • 50. Ribero-Rotta, Rejane Faria
    et al.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Pereira, Andrea Castro
    Rohlin, Madeleine
    Malmö högskola, Faculty of Odontology (OD).
    Ambiguity in bone tissue characteristics as presented in studies on dental implant planning and placement: a systematic review2011In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 22, no 8, p. 789-801Article in journal (Refereed)
    Abstract [en]

    Objectives: To survey definitions of bone tissue characteristics and methods of assessing them in studies of dental implant planning and placement. Material and methodology: Three databases were searched using specified indexing terms. Three reviewers selected from the titles and retrieved abstracts in accordance with inclusion and exclusion criteria. Descriptions of bone tissue characteristics (bone quality, density and quantity) used before or during dental implant placement were searched for and categorized. Results: The search yielded 488 titles. One hundred and fort-nine publications were selected and read in full text. One hundred and eight were considered relevant. There were many different definitions and classification systems for bone tissue characteristics and examination protocols. Approximately two-third of the included publications reported the Lekholm & Zarb classification system for bone quality and quantity. However, only four studies implemented the Lekholm & Zarb system as originally proposed. A few publications described bone quality in accordance with the Misch or Trisi and Rao classifications systems. Assessment methods were often described only briefly (or not at all in one-fifth of the publications). Only one study presented the diagnostic accuracy of the assessment method, while only two presented observer performance. Conclusion: The differing definitions and classification systems applied to dental implant planning and placement make it impossible to compare the results of various studies, particularly with respect to whether bone quality or quantity affect treatment outcomes. A consistent classification system for bone tissue characteristics is needed, as well as an appropriate description of bone tissue assessment methods, their diagnostic accuracy and observer performance. To cite this article: 
Ribeiro-Rotta RF, Lindh C, Pereira AC, Rohlin M. Ambiguity in bone tissue characteristics as presented in studies on dental implant planning and placement: a systematic review.
Clin. Oral Impl. Res. xx, 2010; 000-000.

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