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  • 51.
    Ridell, Karin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Matsson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Mejàre, Ingegerd
    Malmö högskola, Faculty of Odontology (OD).
    Periapical status and technical quality of root-filled teeth in Swedish adolescents and young adults: A retrospective study2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 2, p. 104-110Article in journal (Other academic)
    Abstract [en]

    Objective. The aim was to study periapical status and the technical quality of root-filled teeth in Swedish adolescents and young adults in Malm, Sweden. Material and Methods. The sample, collected from dental records in the Public Dental Service, consisted of notes and radiographs of all root-filled permanent teeth in all 19-year-olds born in 1979 (mean age at root filling = 16.2 years). The sample for assessing periapical status and technical quality consisted of 124-153 teeth. The criterion for inclusion for assessing periapical status was a follow-up time of at least one year. Periapical status was assessed with the Periapical Index (PAI). Technical quality was analyzed from radiographs in two respects: sealing quality of the root canal and distance from the root filling to the radiographic apex. The radiographs were analyzed independently by two observers with inter-examiner kappa values of 0.82-0.85. Results. Apical periodontitis was found in 52% of the teeth and occurred significantly more often among molars than among anterior teeth. As judged radiographically, 51% of the teeth were inadequately sealed. In 38%, the distance to the apex was >2 mm and overfilling was registered in 14% of the teeth. Compared with anterior teeth, significantly more root fillings of molars had a distance to the apex of >2 mm. Technical quality was statistically significantly correlated with periapical status at follow-up. Conclusions. The technical quality and periapical status of root-filled teeth in adolescents and young adults were unsatisfactory in about half of the teeth.

  • 52.
    Rohlin, Madeleine
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Systematic reviews - avenues to improved quality in oral health care and research2009In: Programme and abstract book, 2009, p. 70-70, article id O70Conference paper (Other academic)
    Abstract [en]

    Introduction Systematic reviews comprise a synthesis of scientific evidence that is a key in three approaches to improve the quality of care - evidence-based medicine, health technology assessment, and clinical guidelines. Analysis of the scientific literature also reveals issues that require further research as knowledge gaps will be identified. These can be used to improve the research agenda in health care. Objectives To analyse evidence from systematic reviews on imaging methods in oral health care. Materials and methods Common features of five systematic reviews, which we performed, were analysed. The reviews elucidated methods used to diagnose chronic periodontitis (one review), jaw bone tissue in dental implant planning (two reviews), and temporomandibular joint disorders (two reviews). Our analysis of original studies included and excluded in the reviews focussed on the study design and outcomes using the Thornbury's ladder (1). Results Overall there is room for improvement. There was a wide heterogeneity in study design and reported outcome variables. Most studies reported outcomes on the level of diagnostic ability. No study presented how any diagnostic method influenced patient care in terms of changed treatment and change in patient outcome. Evidence was limited also on outcomes of combinations of imaging methods with other diagnostic methods as used in clinical care. Conclusions and discussion To improve the accuracy and completeness of studies on diagnostic methods, the Standards for Reporting of Diagnostic Accuracy (STARD) statement should be applied. Evidence to support clinical effectiveness of imaging methods is required to improve oral health care. (1) Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making 1991;11:88-94. Rohlin M1, Knutsson K1, Lindh C1, Petersson A1 1 Malmö University, Malmö, Sweden Introduction Systematic reviews comprise a synthesis of scientific evidence that is a key in three approaches to improve the quality of care - evidence-based medicine, health technology assessment, and clinical guidelines. Analysis of the scientific literature also reveals issues that require further research as knowledge gaps will be identified. These can be used to improve the research agenda in health care. Objectives To analyse evidence from systematic reviews on imaging methods in oral health care. Materials and methods Common features of five systematic reviews, which we performed, were analysed. The reviews elucidated methods used to diagnose chronic periodontitis (one review), jaw bone tissue in dental implant planning (two reviews), and temporomandibular joint disorders (two reviews). Our analysis of original studies included and excluded in the reviews focussed on the study design and outcomes using the Thornbury's ladder (1). Results Overall there is room for improvement. There was a wide heterogeneity in study design and reported outcome variables. Most studies reported outcomes on the level of diagnostic ability. No study presented how any diagnostic method influenced patient care in terms of changed treatment and change in patient outcome. Evidence was limited also on outcomes of combinations of imaging methods with other diagnostic methods as used in clinical care. Conclusions and discussion To improve the accuracy and completeness of studies on diagnostic methods, the Standards for Reporting of Diagnostic Accuracy (STARD) statement should be applied. Evidence to support clinical effectiveness of imaging methods is required to improve oral health care. (1) Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making 1991;11:88-94.

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

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

  • 54. Schiffman, E
    et al.
    Orbach, R
    Truelove, E
    Look, J
    Anderson, G
    Goulet, JP
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Gonzalez, Y
    Lobbezoo, F
    Michelotti, A
    Brooks, SL
    Ceusters, W
    Drangsholt, M
    Ettlin, D
    Gaul, C
    Goldberg, LJ
    Haythornthwaithe, JA
    Hollender, L
    Jensen, R
    John, MT
    De Laat, A
    de Leeuw, R
    Maixner, W
    van der Meulen, M
    Murray, GM
    Nixdorf, DR
    Palla, S
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Pionchon, P
    Smith, B
    Visscher, CM
    Zakrzewska, J
    Dworkin, Samuel
    Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group2014In: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 28, no 1, p. 6-27Article in journal (Refereed)
    Abstract [en]

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self report instrument sets. The screening instruments' 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations

  • 55. Sonnesen, Liselotte
    et al.
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Berg, Soren
    Svanholt, Palle
    Pharyngeal Airway Dimensions and Head Posture in Obstructive Sleep Apnea Patients with and without Morphological Deviations in the Upper Cervical Spine2017In: Journal of Oral & Maxillofacial Research, ISSN 2029-283X, E-ISSN 2029-283X, Vol. 8, no 3, article id e4Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to analyse differences in pharyngeal airway dimensions and head posture between obstructive sleep apnea patients with and without morphological deviations in the upper cervical spine and to analyse associations between pharyngeal airway dimensions and head posture in the total sample. Material and Methods: The sample comprised 53 obstructive sleep apnea (OSA) patients of which 32.1% had upper spine morphological deviations. Accordingly two groups were defined: 17 OSA patients with morphological deviations in the upper spine and 36 without upper spine deviations. Pharyngeal airway dimensions in terms of distances, cross-sectional areas and volume and upper spine morphological deviations were evaluated on cone-beam computed tomography. Head posture was evaluated on two-dimensional generated lateral cephalograms. Differences were analysed and adjusted for age and gender by multiple linear regression analysis. Results: OSA patients with upper spine morphological deviations had a significantly more backward and curved neck posture (OPT/HOR, P < 0.01; OPT/CVT, P < 0.05) compared to OSA patients without spine deviations. No significant differences were found in airway dimensions between patients with and without upper spine deviations. In the total group significant associations were found between head posture and pharyngeal airway distances and cross-sectional area at the nasal floor, epiglottis and hyoid bone level (P < 0.05, P < 0.01, P < 0.001). No significant association was found between head posture and airway volume. Conclusions: The results may contribute to differentiate obstructive sleep apnea patients and thereby may prove valuable in diagnosis and treatment planning of obstructive sleep apnea patients.

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  • 56. Takano, Yumi
    et al.
    Honda, Kazuya
    Kashima, Masahiro
    Yotsui, Yoritaka
    Igarashi, Chinami
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Magnetic Resonance Imaging of the Temporomandibular Joint: a Study of Inter- and Intraobserver Agreement2004In: Oral Radiology/Springer, ISSN 0911-6028, E-ISSN 1613-9674, Vol. 20, no 2, p. 62-67Article in journal (Other academic)
    Abstract [en]

    Objective. The purpose of this study was to estimate the inter- and intraobserver agreement for interpreting magnetic resonance (MR) images of the temporomandibular joint (TMJ). Methods. The study was based on MR images of 30 TMJs. The images were interpreted by seven observers for disk configuration, disk position, joint fluid, bone marrow changes, and diagnosis. The observers were not calibrated. Kappa statistics were used. Results. The kappa values were, for interobserver agreement of disk configuration, 0.10; for disk position in the sagittal plane with closed mouth, 0.35; for a combination of closed mouth and open mouth, 0.44; for disk position in the coronal plane, 0.17; for joint fluid 0.36; for bone marrow changes, 0.01; and for diagnosis, 0.39. Intraobserver agreement was generally higher than interobserver agreement. Conclusion. Agreement on disk position in the sagittal plane, on presence and amount of joint fluid, and on diagnosis was fair to moderate. Agreement on disk configuration, on disk position in the coronal plane, and on bone marrow changes was poor.

  • 57.
    Vallon, Danila
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Maria
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Long-term Follow-up of Intra-articular Injections into the Tem-poromandibular Joint in Patients with Rheumatoid Arthritis2002In: Swedish Dental Journal, ISSN 0347-9994, Vol. 26, no 4, p. 149-158Article in journal (Refereed)
    Abstract [en]

    A long-term (12 years) follow-up of treatment with intra-articular in-jections into the temporomandibular joint (TMJ) of steroid or non-steroid agents was performed in 21 patients with rheumatoid arthritis (RA) and symptomatic TMJs. The aim of the study was to compare symptoms, signs and radiological appearance of the TMJ initially and at the follow-up in this group of patients. Eleven patients were as-signed to a steroid group and 10 patients to a non-steroid group. Ini-tial and follow-up clinical and radiological examination procedures were the same. The radiological evaluation was based on a grading system using standard reference films. At follow-up, 14 patients re-ported no pain from the TMJ and positive changes in most clinical variables were found in both groups. Radiographic follow-up exami-nation was performed on 12 patients. Initially, all but 4 of the 24 joints had structural bone changes. At follow-up, 2 joints had lower, 11 joints had unchanged and 11 joints had higher radiological grades. Two out of 5 and 3 out of 10 joints in the steroid and non-steroid group, respectively, showed progression of structural bone changes. Among 9 untreated joints, 6 had higher radiological grades and 3 were unchanged. In the 11 TMJs with higher radiological grades at follow-up, there was in most cases moderate progression of erosive changes. The results suggest that the long-term development of symptoms and signs from the TMJ in patients previously treated was good and the long-term progression of joint destruction was low for both steroid and non-steroid agents in this patient group with RA.

  • 58. Wiese, Mie
    et al.
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Bakke, Merete
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Hintze, Hanne
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Wenzel, Ann
    Association Between Temporomandibular Joint Symptoms, Signs, and Clinical Diagnosis Using the RDC/TMD and Radiographic Findings in Temporomandibular Joint Tomograms2008In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 22, no 3, p. 239-251Article in journal (Refereed)
    Abstract [en]

    Aim: To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Methods: Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed fo the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatisation scores, graded chronic pain, and age and gender. Resluts: Coarse crepitus on opening/closing (odds ratio [OR] ≥ 3.12), on lateral excursions (odds ratio ≥ 4.06), and on protrusion (OR ≥ 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR ≥ 2.95) and so did increasing age (OR ≥ 1.03 per year) and the female gendera (OR ≥ 2.36). Maximal assisted opening and maximal opening without pain (< 40 mm) was associated with a posterior condyle-to-articular tubercle position (OR ≥ 2.60). No other significant associations were observed. Conclusion: Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with at posterior condyle-to-articular tubercle relation on opening.

  • 59. Wiese, Mie
    et al.
    Wenzel, A
    Hintze, H
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Bakke, M
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Influence of cross-sectional temporomandibular joint (TMJ) tomography on diagnosis and management of patients with temporomandibular disorders (TMD)2008Conference paper (Refereed)
    Abstract [en]

    Objectives: To describe changes in diagnosis and management of TMD patients after radiographic examination and to evaluate the associations between specific TMJ tomographic findings and changes in management. Methods: 204 adult patients (48 males, 156 females, mean age 40 years) with TMJ pain/sounds or problems with mandibular motion were examined according to the Research Diagnostic Criteria (RDC/TMD) by one of six calibrated orofacial pain specialists. Diagnoses and management strategy reached without the aid of radiographs were recorded. It was possible to select from seven management categories (pharmacology, physiotherapy, psychological, occlusal stabilization, surgical, other examinations and referrals) each with a number of sub-categories. Bilateral sagittal corrected TMJ tomograms in closed position were obtained using conventional film in a Cranex Tome or a Scanora tomographic X-ray unit. The tomograms were assessed for the presence of flattening, erosion, osteophyte and sclerosis in the TMJ components and the condyle-to-mandibular fossa relation by one of five calibrated oral radiologists blinded to the clinical diagnosis and initial management strategy. After gaining access to the results from the radiographic examination the orofacial pain specialists re-evaluated their diagnoses and management strategy. All changes were calculated. Logistic regression analyses (with odds ratio (OR) and significance level (p)) were performed with changes in management as the dependent variable and with age and radiographic findings as the independent variables. Results: 41% of the clinical arthralgia diagnoses were changed into osteoarthritis after radiographic examination and the number of osteoarthrosis diagnoses increased with 200% (from 13 to 39). One or more changes in the management strategy were found for 27% (55) of the patients. Most often changes occurred in pharmacology and physiotherapy (29 and 28 patients respectively) followed by changes in psychological (13 patients), occlusal stabilization (8 patients), referrals (7 patients), other examinations (6 patients) and surgical (2 patients). For pharmacology, physiotherapy and psychological the changes were adjustments within the sub-categories in 51 out of 70 patients. For the other management categories most of the changes were addition or omission of the management category (in 20 out of 23 patients). The chance of “any change” in management (removal or addition of one or more sub-categories in one or more management categories) was more than twice as high with a finding of flattening (OR=2.28) and erosion (OR=2.03) compared to not having these radiographic findings. Increased chance of “any change” in management was also found with >1 radiographic finding (regardless of type) (OR=2.64) compared to having no radiographic findings. The chance of change in pharmacology was increased more than three times with erosion (OR=3.60) and more than two times with flattening (OR=2.56). The chance of change in physiotherapy was increased with >1 radiographic finding (OR=2.79). No statistically significant (p≤0.05) associations between osteophyte, sclerosis and age and changes in management were found. Conclusion: 27% of the patients had changes in management after radiographic examination. Radiographic findings did increase the chance of changes in management. However, as the changes were mostly adjustments in sub-categories radiography may have a minor impact on management of most TMD patients.

  • 60. Wiese, Mie
    et al.
    Wenzel, Ann
    Hintze, Hanne
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Bakke, Merete
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Influence of cross-sectional temporomandibular joint tomography on daignosis and management decisions of patients with temporomandibular joint disorders2011In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 25, p. 223-231Article in journal (Refereed)
    Abstract [en]

    AIM: To assess whether changes in diagnoses and management of temporomandibular joint disorder (TMJD) patients are influenced by radiographic findings and if there is an association between specific radiologic alterations and management strategy changes. METHODS: A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Diagnoses and management were first decided without the aid of radiographs. Management categories were: pharmacology, physiotherapy, counseling and behavioral treatment, occlusal stabilization, surgery, additional examinations, and referrals, each with subcategories. Sagittal TMJ tomograms were assessed for the presence of flattening, erosion, osteophyte, and sclerosis in the TMJ components. Diagnoses and management were reevaluated after gaining access to the radiographs and radiographic classifications. Logistic regression analyses were performed with changes in management as the dependent variable and age and radiographic findings as the independent variables. RESULTS: Diagnosis was changed for 56 patients, mainly from arthralgia to osteoarthritis. Management was changed for 55 patients. Most changes occurred in pharmacology and physiotherapy followed by counseling and behavioral treatment, occlusal stabilization, referrals, additional examinations, and surgery. Changes were mostly within the categories, and the highest number of changes was seen in pharmacology, physiotherapy, and counseling and behavioral treatment. Radiographic degenerative findings increased the chance of change (any change) (odds ratio [OR] ⋝ 2.03) and the chance of change in pharmacology (OR ⋝ 2.56) and physiotherapy (OR = 2.48) separately. No other significant associations were found. CONCLUSION: Radiographic degenerative findings increased the chance of changes in management strategy. However, 73% of the TMJD patients had no changes in management after radiographic examination. In cases with changes, these were mainly adjustments within management categories.

  • 61. Wiese, Mie
    et al.
    Wenzel, Ann
    Hintze, Hanne
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Knutsson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Bakke, Merete
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings2008In: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, ISSN 1079-2104, E-ISSN 1528-395X, Vol. 106, no 2, p. 52-63Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    The objective of this study was to evaluate the impact of clinical TMJ diagnosis, gender, and age on the agreement between expected and actual radiographic findings. STUDY DESIGN: A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria (RDC/TMD). Expected radiographic findings were recorded. TMJ tomograms in closed and open mouth position were assessed for osseous changes and condyle position. Expected and actual findings were compared. Logistic regression analyses were performed with agreement on radiographic findings as the dependent variable and with clinical RDC/TMD diagnoses, gender and age as the independent variables. RESULTS: The number of radiographic findings was mostly underestimated. A clinical diagnosis of osteoarthritis and age increased the chance of overestimating osseous changes. Disc displacement and age decreased the chance of agreement on certain condyle positions. CONCLUSION: Tomography often revealed unexpected findings. It was not possible to select particular patient groups who would benefit more or less from a radiographic examination.

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