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Cederhag, J., Kadesjö, N., Nilsson, M., Alstergren, P., Shi, X.-Q. & Hellén-Halme, K. (2023). Comparison of absorbed doses and organ doses measured with thermoluminescent dosimeters and Gafchromic film for cone beam computed tomography examination of the posterior mandibular region in a head phantom. Oral surgery, oral medicine, oral pathology and oral radiology, 136(6), 769-776
Open this publication in new window or tab >>Comparison of absorbed doses and organ doses measured with thermoluminescent dosimeters and Gafchromic film for cone beam computed tomography examination of the posterior mandibular region in a head phantom
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2023 (English)In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 136, no 6, p. 769-776Article in journal (Refereed) Published
Abstract [en]

Objectives: We aimed to map the correlation between thermoluminescent dosimeters (TLDs) and Gafchromic film for measuring absorbed doses and to compare minimum, maximum, and mean absorbed doses over larger regions of interest and at various craniofacial organs and tissues during cone beam computed tomography (CBCT) exposure of the mandibular third molar region.

Study design: We positioned TLDs at 75 measurement points in a head phantom. Gafchromic film was cut to the same shape as the 5 levels of the phantom and was placed on top of the TLDs. Both dosimetry methods thus included the surface of each level simultaneously. CBCT scans were made using a 5 × 5 cm field of view and a rotation angle of 200°. Measurements included absorbed dose distributions, doses at all 75 points, and minimum, maximum, and mean doses within organs and tissues.

Results: The correlation of point-dose measurements at all TLD sites with doses measured on film was strong (R2 = 0.9687), with greatest correlation at lower doses (<2 mGy). Large deviations between TLD and film measurements of minimum and maximum doses and absorbed doses to the organs occurred at all 5 levels. TLD positioning failed to cover several organ sites; for these, only absorbed dose measurements from the film were available.

Conclusions: TLDs were unable to sample dose distributions and gradients accurately. The characteristics of Gafchromic LD-V1 film make it a favorable alternative in dental CBCT dosimetry.

Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-62210 (URN)10.1016/j.oooo.2023.07.006 (DOI)001133164600001 ()37625926 (PubMedID)2-s2.0-85168847369 (Scopus ID)
Available from: 2023-08-30 Created: 2023-08-30 Last updated: 2024-02-26Bibliographically approved
Durham, J., Ohrbach, R., Baad‐Hansen, L., Davies, S., De Laat, A., Goncalves, D. G., . . . Alstergren, P. (2023). Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing. Journal of Oral Rehabilitation
Open this publication in new window or tab >>Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing
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2023 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842Article in journal (Refereed) Epub ahead of print
Abstract [en]

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

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

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

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

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

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
facial pain, temporomandibular disorders, temporomandibular joint, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64863 (URN)10.1111/joor.13652 (DOI)001136362000001 ()38151896 (PubMedID)2-s2.0-85180920007 (Scopus ID)
Available from: 2024-01-08 Created: 2024-01-08 Last updated: 2024-02-05Bibliographically approved
Nilsson, I.-M., Ekberg, E., Michelotti, A., Al-Khotani, A., Alstergren, P., Conti, P. C., . . . Rongo, R. (2023). Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for children. Journal of Oral Rehabilitation, 50(2), 99-112
Open this publication in new window or tab >>Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations: Comprehensive and short-form adaptations for children
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2023 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 50, no 2, p. 99-112Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed.

OBJECTIVE: To present comprehensive and short-form adaptations of Axis I and II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings.

METHODS: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children.

RESULTS: The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire, and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, and (ii) adding anxiety and depression assessments that have been validated in children, and (iii) adding three constructs (stress, catastrophizing, and sleep disorders) to assess psychosocial functioning in children.

CONCLUSION: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
children, diagnostic criteria, dysfunction, pain, temporomandibular disorders
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-56161 (URN)10.1111/joor.13390 (DOI)000920751500001 ()36373958 (PubMedID)2-s2.0-85144152911 (Scopus ID)
Available from: 2022-11-22 Created: 2022-11-22 Last updated: 2024-02-05Bibliographically approved
Dimitrijevic Carlsson, A., Wahlund, K., Klintstrom, E., Salé, H., Kindgren, E., Starkhammar Johansson, C. & Alstergren, P. (2023). Juvenile idiopathic arthritis and the temporomandibular joint: a case-control study of magnetic resonance imaging findings in relation to clinical and psychosocial factors.. European Journal of Paediatric Dentistry, 24(1), 69-76
Open this publication in new window or tab >>Juvenile idiopathic arthritis and the temporomandibular joint: a case-control study of magnetic resonance imaging findings in relation to clinical and psychosocial factors.
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2023 (English)In: European Journal of Paediatric Dentistry, ISSN 1591-996X, E-ISSN 2035-648X, Vol. 24, no 1, p. 69-76Article in journal (Refereed) Published
Abstract [en]

AIM: In juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) is a particularly challenging joint to assess both clinically and with imaging. The aim of this article is to investigate TMJ magnetic resonance imaging (MRI) findings in relation to clinical and psychosocial factors in patients with JIA and healthy individuals related to TMJ arthritis in JIA.

MATERIALS: In total, 45 patients (6-16 years) with JIA and 16 healthy age- and sex-matched controls were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered questionnaires about psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophising, pain locations, and jaw function) and underwent bilateral MRI of the TMJ.

RESULTS: There were no significant differences between JIA patients and healthy individuals in any of the TMJ MRI findings. Moderate/severe changes among JIA patients were found only for effusion, synovial thickening, condylar flattening, and erosion, with no moderate/severe changes in healthy individuals. In JIA patients, orofacial pain intensity was related to TMJ bone marrow oedema, and pain in jaw muscles during jaw function was related to TMJ bone marrow oedema and erosion. There were no significant correlations between psychosocial aspects and MRI findings.

CONCLUSION: This study indicates a substantial overlap of TMJ MRI findings in both the inflammatory domain and the damage domain between JIA patients and healthy individuals. In JIA patients, the inflammatory MRI sign of bone marrow oedema seems to influence orofacial pain intensity.

Place, publisher, year, edition, pages
Società Italiana di Odontoiatria Infantile, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-58549 (URN)10.23804/ejpd.2023.24.01.12 (DOI)000945146900012 ()36853210 (PubMedID)2-s2.0-85149154015 (Scopus ID)
Available from: 2023-03-03 Created: 2023-03-03 Last updated: 2023-10-23Bibliographically approved
Stoustrup, P., Resnick, C. M., Abramowicz, S., Pedersen, T. K., Michelotti, A., Küseler, A., . . . Twilt, M. (2023). Management of orofacial manifestations of juvenile idiopathic arthritis: Interdisciplinary consensus-based recommendations.. Arthritis & Rheumatology, 75(1), 4-14
Open this publication in new window or tab >>Management of orofacial manifestations of juvenile idiopathic arthritis: Interdisciplinary consensus-based recommendations.
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2023 (English)In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 75, no 1, p. 4-14Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVES: Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, dysfunction and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management.

OBJECTIVES: 1) To develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA. 2) To create a future research agenda related to management of TMJ arthritis in children with JIA.

METHODS: The recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during two consensus-meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: Pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study.

RESULTS: Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to: diagnosis (n=4), treatment of TMJ arthritis (active TMJ inflammation) (n=2), treatment of TMJ dysfunction and symptoms (n=3), treatment of arthritis-related dentofacial deformity (n=2), and other related aspects to JIA (n=1). Additionally, a future interdisciplinary research agenda was developed.

CONCLUSIONS: These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-55211 (URN)10.1002/art.42338 (DOI)000890606100001 ()36041065 (PubMedID)2-s2.0-85139428988 (Scopus ID)
Available from: 2022-11-04 Created: 2022-11-04 Last updated: 2023-09-08Bibliographically approved
Cederhag, J., Iskanderani, D., Alstergren, P., Shi, X.-Q. & Hellén-Halme, K. (2023). Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT. Acta Odontologica Scandinavica, 81(6), 449-455
Open this publication in new window or tab >>Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 6, p. 449-455Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars.

MATERIAL & METHODS: Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT. Two CBCT scans of each site were made using a default protocol and a low-dose protocol (Veraviewepocs 3D F40, J Morita Corp, Kyoto, Japan). The low-dose protocol had the same tube potential (90 kV) and exposure time (9.4 s) as the default, but with reduced tube current, from 5 mA to 2 mA. Four observers evaluated the visibility of five relevant anatomical variables. Image quality was ranked on a 3-point scale as diagnostically acceptable, doubtful, or unacceptable. The Wilcoxon signed-rank test compared differences between the two protocols. The significance level was set at p ≤ .05.

RESULTS: No significant differences were found between the two protocols for any observer regarding the visibility of the relationship and proximity between the roots and the mandibular canal; root morphology; and possible root resorption of the second molar. The periodontal ligament differed significantly in visibility between the two protocols (p ≤ .05).

CONCLUSIONS: This study indicates that a low-dose CBCT protocol with a 60% reduction of the tube current provides, in most cases, acceptable image quality for pre-surgical assessment of mandibular third molars. Optimization of CBCT protocols should be a priority according to recommended guidelines.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Molar third, cone-beam computed tomography (CBCT), radiation
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-58540 (URN)10.1080/00016357.2023.2170462 (DOI)000928538300001 ()36748228 (PubMedID)2-s2.0-85147663038 (Scopus ID)
Available from: 2023-03-03 Created: 2023-03-03 Last updated: 2024-02-26Bibliographically approved
Alstergren, P. (2023). What and how: Workflow of the management of joint disorders in the clinical practice. Seminars in orthodontics
Open this publication in new window or tab >>What and how: Workflow of the management of joint disorders in the clinical practice
2023 (English)In: Seminars in orthodontics, ISSN 1073-8746Article in journal (Refereed) Epub ahead of print
Abstract [en]

This narrative review isl describing the most common TMJ conditions and suggest a straightforward, clinically relevant and feasible treatment workflow for each of these. The suggestions for treatment will be based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), the Swedish National Board of Health and Welfare National guidelines for general dentistry as well as the Swedish Academy for Temporomandibular Disorders’ National guidelines for TMD screening, diagnosis and treatment with the target audience of general practitioners.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Arthritis, Disk displacement, Inflammation, Osteoarthritis, Temporomandibular joint, nPain
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64753 (URN)10.1053/j.sodo.2023.11.005 (DOI)2-s2.0-85178582928 (Scopus ID)
Available from: 2023-12-27 Created: 2023-12-27 Last updated: 2023-12-27Bibliographically approved
Ulmner, M., Sugars, R., Naimi-Akbar, A., Alstergren, P. & Lund, B. (2022). Cytokines in temporomandibular joint synovial fluid and tissue in relation to inflammation. Journal of Oral Rehabilitation, 49(6), 599-607
Open this publication in new window or tab >>Cytokines in temporomandibular joint synovial fluid and tissue in relation to inflammation
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2022 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 6, p. 599-607Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Synovial tissue is known to be the origin of inflammation in joint disease. Despite this, synovial fluid is the main biological specimen of choice in temporomandibular joint (TMJ) inflammation and pathology biomarker research. No comparison of TMJ protein content between synovial fluid and synovial tissue has been made.

OBJECTIVES: To investigate if cytokine concentrations in synovial fluid can be related to cytokine concentrations in synovial tissue, and to analyse correlation of clinical parameters reflecting local inflammation to cytokine concentrations.

METHODS: Synovial tissue and fluid samples were obtained during the same surgical procedure from a cohort of 101 patients with TMJ disorders. Interleukin (IL) 1β, IL-6, IL-8, IL-10, and tumor necrosis factor α (TNF-α) were analysed in the samples and an intraindividual correlation made. Various patient-specific factors relating to TMJ inflammation were associated to the cytokine concentrations in synovial fluid and tissue.

RESULTS: No correlation between cytokine concentration in synovial fluid and synovial tissue was found, except for IL-8 (ρ=.284, P=.024). Synovial tissue cytokines correlated strongly to inflammation-related factors: diagnosis (IL-1β, P=.001; TNF-α, P=.000; IL-10, P=.000), TMJ palpation pain (IL-1β, P=.024; TNF-α, P=.025), synovitis score (IL-1β, P=.015), and subjective TMJ pain (TNF-α, P=.016). Synovial fluid cytokines showed no significant relations to inflammation.

CONCLUSIONS: The investigated cytokine concentrations showed weak correlations between synovial fluid and synovial tissue, besides IL-8. Synovial tissue appeared to reflect inflammation to a higher extent than synovial fluid. Thus, suggesting that synovial tissue research should complement synovial fluid in future explorations of TMJ pathology and inflammation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
Biomarkers, Cytokines, Interleukins, Synovial Fluid, Synovial Membrane, Temporomandibular Joint
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-51017 (URN)10.1111/joor.13321 (DOI)000779644900001 ()35342975 (PubMedID)2-s2.0-85127693140 (Scopus ID)
Available from: 2022-04-08 Created: 2022-04-08 Last updated: 2024-02-05Bibliographically approved
Rongo, R., Ekberg, E., Nilsson, I.-M., Al-Khotani, A., Alstergren, P., Conti, P. C., . . . Michelotti, A. (2022). Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II. Journal of Oral Rehabilitation, 49(5), 541-552
Open this publication in new window or tab >>Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II
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2022 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 541-552Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established.

OBJECTIVES: To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments.

METHODS: A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended.

RESULTS: The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience.

CONCLUSION: Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2022
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-49274 (URN)10.1111/joor.13301 (DOI)000759532100001 ()34951729 (PubMedID)2-s2.0-85125070022 (Scopus ID)
Available from: 2022-01-10 Created: 2022-01-10 Last updated: 2024-01-17Bibliographically approved
Cederhag, J., Truedsson, A., Alstergren, P., Shi, X.-Q. & Hellén-Halme, K. (2022). Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden. Clinical Oral Investigations, 26, 2073-2083
Open this publication in new window or tab >>Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden
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2022 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 2073-2083Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences.

MATERIALS AND METHODS: Members of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality.

RESULTS: The response rate was 64%. Panoramic radiographs were most commonly used in pre-surgical planning (response options: always or often), significant difference between professions (p = 0.039), and considered to facilitate treatment planning (87%), as was CBCT (82%); for 51%, CBCT reduced post-operative complications. Preferred modality for localizing the mandibular canal was fairly evenly distributed and for non-complex case, significant difference between subgroups of OMFS surgeons was found (p = 0.003) as to preference for intraoral radiographs.

CONCLUSIONS: A majority of respondents received a report within 2 weeks of their referral for CBCT and would read the report and view the images before surgery. Image modality preference differed depending on case complexity, with a greater perceived need for CBCT. Profession and practical experience affected choice.

CLINICAL RELEVANCE: Choice of imaging modality in mandibular third molar assessment is also important from dose delivery and social economy standpoints.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Clinical decision-making, Dental radiography, Oral surgical procedures, Third molar, Tooth extraction
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-46362 (URN)10.1007/s00784-021-04189-9 (DOI)000702617400003 ()34596771 (PubMedID)2-s2.0-85116101158 (Scopus ID)
Available from: 2021-10-15 Created: 2021-10-15 Last updated: 2024-02-26Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-8539-7742

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