Malmö University Publications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 47) Show all publications
Eriksson, L. B., Gordh, T., Karlsten, R., LoMartire, R., Thor, A. & Tegelberg, Å. (2024). Intravenous S-ketamine’s analgesic efficacy in third molar surgery: A randomized placebo-controlled double-blind clinical trial. British Journal of Pain, 18(2), 197-208
Open this publication in new window or tab >>Intravenous S-ketamine’s analgesic efficacy in third molar surgery: A randomized placebo-controlled double-blind clinical trial
Show others...
2024 (English)In: British Journal of Pain, ISSN 2049-4637, Vol. 18, no 2, p. 197-208Article in journal (Refereed) Published
Abstract [en]

Background: In most cases, a combination of paracetamol and ibuprofen are the optimal treatment for postoperative pain in third molar surgery. If stronger analgesia is required, opioids are traditionally administered. In day-case, surgery; however, opioids should be avoided. Thus, the anaesthetic agent S-ketamine in analgesic doses might be preferred.

Methods: The study was designed as a randomized placebo-controlled double-blind clinical trial. The study enrolled healthy subjects according to the American Society of Anaesthesiologists classification; I or II (ASA), aged 18 to 44 years, with a body weight between 50 and 100 kg. The patients were randomized into three groups where two doses of S-ketamine were compared (high: 0.25 mg/kg or low: 0.125 mg/kg) with placebo (saline).

Results: A primary outcome of the study was that VAS at 4 h postoperatively, showed no significant difference between the placebo and high-dose S-ketamine group or in the low-dose group. We found a significant difference between the groups for the first 24 h, with a lower VAS-score in the high-dose S-ketamine group. The time to when 50% had taken their first rescue medication was 12 min later in the high-dose ketamine group.

Conclusions: Pre-emptive S-ketamine 0.25 mg/kg gave a global significant reduction of pain by VAS during the first 24 h postoperatively. The time from end of surgery to first rescue medication were longer in the high-dose ketamine group compared to both low-dose ketamine and placebo groups.

Place, publisher, year, edition, pages
Sage Publications, 2024
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:mau:diva-64755 (URN)10.1177/20494637231222327 (DOI)001125533900001 ()38545499 (PubMedID)2-s2.0-85179947499 (Scopus ID)
Available from: 2023-12-27 Created: 2023-12-27 Last updated: 2024-04-26Bibliographically approved
Flink, H., Hedenbjörk-Lager, A., Liljeström, S., Nohlert, E. & Tegelberg, Å. (2023). Identification of caries-active individuals in longitudinal data a methodological study using a national registry. Acta Odontologica Scandinavica, 1-6
Open this publication in new window or tab >>Identification of caries-active individuals in longitudinal data a methodological study using a national registry
Show others...
2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, p. 1-6Article in journal (Refereed) Epub ahead of print
Abstract [en]

ObjectiveThe aim was to identify caries active individuals among adults by using a trajectory model of longitudinal data from the Swedish national registry (SKaPa) and comparing them with published data from the Dunedin cohort.Materials and methodsData from two different age groups (30- and 40-year-olds) followed for 10 years were retrieved from SKaPa and were compared with published longitudinal birth-cohort data from the Dunedin study. Using the trajectory model, the subjects were divided into three different trajectories according to their caries development over time (i.e. high, 15%; moderate, 45%; low, 40%).ResultsCaries experience, as measured by mean decayed, missing, and filled surfaces (DMFS) index, revealed significant differences among the three trajectories in both age groups. The patterns were similar to those observed in the Dunedin cohort. The mean increase in DMFS during the 10-year follow-up period from SKaPa was significantly higher for the high trajectories in both age groups compared with the moderate and low trajectories.ConclusionsThe method using three trajectories for presentation of caries experience over time, may be a useful tool to identify subjects with different disease activities. Identification of subjects in the high caries experience trajectory may increase the possibility to explore and evaluate more effective caries prevention for this group in the future.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Caries experience, caries prevention, dental care plan, disease progression, epidemiology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-63501 (URN)10.1080/00016357.2023.2265474 (DOI)001081233400001 ()37831434 (PubMedID)2-s2.0-85174074328 (Scopus ID)
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2023-11-13Bibliographically approved
Tegelberg, Å., Nohlert, E., List, T. & Isacsson, G. (2023). Oral appliance influence on jaw function in obstructive sleep apnea. American Journal of Orthodontics and Dentofacial Orthopedics, 164(5), 682-689, Article ID S0889-5406(23)00302-5.
Open this publication in new window or tab >>Oral appliance influence on jaw function in obstructive sleep apnea
2023 (English)In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 164, no 5, p. 682-689, article id S0889-5406(23)00302-5Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Oral appliance (OA) therapy in obstructive sleep apnea (OSA) could be a risk factor for normal jaw function, given the prolonged effect of an OA in keeping the mandible in a protruded position away from a normal position. This study aimed to assess changes in symptoms and clinical findings related to jaw function after 1 year of treating OSA with an OA.

METHODS: In this follow-up clinical trial, 302 patients with OSA were assigned to treatment with either monobloc or bibloc OA. Baseline and 1-year follow-up assessment included using the Jaw Functional Limitation Scale, self-reported symptoms and signs related to jaw function. The clinical examination of jaw function included mandibular mobility, dental occlusion, and tenderness in the temporomandibular joints and masticatory muscles. Descriptive analyses of variables are presented for the per-protocol population. To evaluate differences between the baseline and the 1-year follow-up, paired Student t tests and the McNemar change test was used.

RESULTS: One-hundred and ninety-two patients completed the 1-year follow-up (male 73%, mean aged 55 ± 11 years). There was no change in the Jaw Functional Limitation Scale score at the follow-up (nonsignificant). The patients described no change in symptoms at the follow-up, except for improvements in morning headache (P <0.001) and increased frequency of difficulties in opening the mouth or chewing on awakening (P = 0.002). Subjectively reported changes in dental occlusion during biting/chewing increased significantly at the follow-up (P = 0.009).

CONCLUSIONS: No changes in measurements of jaw mobility, dental occlusion, or pain on palpation of the temporomandibular joints or masticatory muscles were seen at the follow-up. Thus, using an OA in treating OSA had limited influence on jaw functions and related symptoms. Moreover, the risk of developing pain and functional impairment in the masticatory system was infrequent, indicating that this treatment is safe and can be recommended.

Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-61987 (URN)10.1016/j.ajodo.2023.04.018 (DOI)001102708900001 ()37318425 (PubMedID)2-s2.0-85162059140 (Scopus ID)
Available from: 2023-08-18 Created: 2023-08-18 Last updated: 2023-12-04Bibliographically approved
Wolf, E., Leonard, K., Vidigsson, M., Tegelberg, Å. & Koch, M. (2022). Adoption of change in endodontic practice after an educational program: A qualitative study. Clinical and Experimental Dental Research, 8(3), 781-792
Open this publication in new window or tab >>Adoption of change in endodontic practice after an educational program: A qualitative study
Show others...
2022 (English)In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 3, p. 781-792Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to define the characteristics of successful implementation of new clinical endodontic routines within a public dental health organization, following an educational program. Materials and Methods: Fifteen staff members were strategically selected for the interview. All had completed a theoretical educational intervention including a complementary endodontic treatment strategy and, for the dentists, comprising training in the nickel-titanium-rotary-technique. All experienced the successful acceptance of new clinical routines. Two thematic in-depth audiotaped interviews were conducted, wherein the informants described the implementation process in their own words. The interviews were transcribed verbatim and analyzed according to Qualitative Content Analysis. Results: A theme was identified: A multiple flexible process with governance support and gradual reinforcement of motivation, with the following main categories: Firstly, contextual facilitation, with two subcategories (i) a multifaceted organizational foundation and (ii) a tolerance of flexibility. Secondly, emotional facilitation, with two subcategories (i) an experience of simplification and (ii) an experience of improvement. Conclusion: The results improve the understanding of a multifaceted process underlying the acceptance of changes to clinical endodontic procedures by dentists in a public dental health organization. Important contributing factors identified were governance support, a committed resource person with contextual knowledge, tolerance of flexibility in implementation, and permissive informal communication channels within the local workplace. These findings might be a valuable contribution to an evidence base, facilitating the selection of the most appropriate educational strategy and structure for a specified purpose.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
implementation, rotary endodontics
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-50457 (URN)10.1002/cre2.542 (DOI)000757406200001 ()35179317 (PubMedID)2-s2.0-85124716128 (Scopus ID)
Available from: 2022-03-08 Created: 2022-03-08 Last updated: 2023-12-27Bibliographically approved
Hedberg, P., Nohlert, E. & Tegelberg, Å. (2021). Effects of oral appliance treatment on inflammatory biomarkers in obstructive sleep apnea: A randomised controlled trial. Journal of Sleep Research, 30(4), Article ID e13253.
Open this publication in new window or tab >>Effects of oral appliance treatment on inflammatory biomarkers in obstructive sleep apnea: A randomised controlled trial
2021 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 30, no 4, article id e13253Article in journal (Refereed) Published
Abstract [en]

Obstructive sleep apnea (OSA) may lead to increased circulating concentrations of inflammatory biomarkers and treatment may change these. We aimed to assess the effect of oral appliance (OA) therapy on inflammatory biomarkers in a randomised controlled pilot trial. A total of 71 patients with OSA and systemic hypertension were randomly allocated to an active, mandible protruded (OAa) or a passive, mandible non-protruded device (OAp) treatment. Serum concentrations of the inflammatory biomarkers white blood cells, high-sensitivity C-reactive protein, interleukin 6, interleukin 10, and tumour necrosis factor-α were measured at baseline and after 3 months of OA treatment. The differences between treatment groups in biomarker concentration change during the treatment were presented as the Vargha and Delaney effect size and evaluated with the Wilcoxon-Mann-Whitney test. This effect size expresses the probability of a higher value in a random participant from one group compared with a random patient from the other group, and a value of 0.5 means stochastically equal groups. After 3 months of treatment, there was a significant reduction of the apnea-hypopnea index in the OAa group compared with the OAp group (effect size 0.258, 95% confidence interval 0.146-0.386, p < .001). There were no significant differences between the groups in any of the inflammatory markers' concentration changes during the treatment period (effect sizes between 0.488 and 0.524; all p values ≥.737). Thus, OA treatment for 3 months did not affect circulating concentrations of some common inflammatory markers in patients with OSA and systemic hypertension.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
C-reactive protein, inflammation, interleukins, mandibular advancement device, obstructive sleep apnea
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-37662 (URN)10.1111/jsr.13253 (DOI)000596790100001 ()33300239 (PubMedID)2-s2.0-85097420306 (Scopus ID)
Available from: 2020-12-21 Created: 2020-12-21 Last updated: 2024-02-05Bibliographically approved
Tegelberg, Å., Nohlert, E., Bornefalk-Hermansson, A., Fransson, A. & Isacsson, G. (2020). Respiratory outcomes after a 1-year treatment of obstructive sleep apnoea with bibloc versus monobloc oral appliances: a multicentre, randomized equivalence trial. Acta Odontologica Scandinavica, 78(6), 401-408
Open this publication in new window or tab >>Respiratory outcomes after a 1-year treatment of obstructive sleep apnoea with bibloc versus monobloc oral appliances: a multicentre, randomized equivalence trial
Show others...
2020 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 6, p. 401-408Article in journal (Refereed) Published
Abstract [en]

Objective: The benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that these types of appliances would be equally effective.

Material and methods: In this multicentre, randomized equivalence trial, patients with OSA received one type of bibloc or one type of monobloc treatment. At baseline, a 1-night polygraphy study was done, and this was repeated after 1 year. The outcome was any change in the apnoea–hypopnoea index (AHI) and the limits of equivalence between the two devices were set at ±5 AHI units.

Results: Of 302 patients, 146 were randomly assigned to bibloc and 156 to monobloc appliances. In 88 and 104 patients, respectively, there were significant reductions in the AHI (p < .001) with a mean change of −16.7 (95% CI −19.4 to −14.1) in the bibloc and −11.8 (−14.9 to −8.7) in the monobloc groups. The proportions of responders defined as having an AHI <10 were 68% and 65% for the bibloc and monobloc groups, respectively. Treatment-related adverse events were mild, transient and the dropouts were more frequent in the bibloc group.

Conclusions: Both types of treatments positively and significantly reduced respiratory disturbances, but at the 1-year follow-up, they were not significantly different in treating OSA, with a numerically greater reduction of the AHI value with the bibloc appliance. However, the higher proportion of treatment-related adverse events and higher proportion of dropouts among bibloc users should be balanced against the advantage of a greater reduction in the AHI.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Breathing, follow-up study, mandibular advancement, obstructive sleep apnoea, randomized controlled trial
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-14206 (URN)10.1080/00016357.2020.1730436 (DOI)000518321200001 ()32125197 (PubMedID)2-s2.0-85081295304 (Scopus ID)
Available from: 2020-03-31 Created: 2020-03-31 Last updated: 2024-02-05Bibliographically approved
Flink, H., Tegelberg, Å., Arnetz, J. E. & Birkhed, D. (2020). Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults.. Acta Odontologica Scandinavica, 78(3), 229-235
Open this publication in new window or tab >>Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults.
2020 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 3, p. 229-235Article in journal (Refereed) Published
Abstract [en]

Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Dental caries, general health, hyposalivation, oral health, xerostomia
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-14275 (URN)10.1080/00016357.2019.1690677 (DOI)000496636700001 ()31729277 (PubMedID)2-s2.0-85075332222 (Scopus ID)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-06-17Bibliographically approved
Feldman, I., Helgason, A. R., Johansson, P., Tegelberg, Å. & Nohlert, E. (2019). Cost-effectiveness of a high-intensity versus a low-intensity smoking cessation intervention in a dental setting: long-term follow-up (ed.). BMJ Open, 9(8), 1-8, Article ID e030934.
Open this publication in new window or tab >>Cost-effectiveness of a high-intensity versus a low-intensity smoking cessation intervention in a dental setting: long-term follow-up
Show others...
2019 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 8, p. 1-8, article id e030934Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to conduct a cost-effectiveness analysis (CEA) of a high-intensity and a low-intensity smoking cessation treatment programme (HIT and LIT) using long-term follow-up effectiveness data and to validate the cost-effectiveness results based on short-term follow-up. DESIGN AND OUTCOME MEASURES: Intervention effectiveness was estimated in a randomised controlled trial as numbers of abstinent participants after 1 and 5-8 years of follow-up. The economic evaluation was performed from a societal perspective using a Markov model by estimating future disease-related costs (in Euro (euro) 2018) and health effects (in quality-adjusted life-years (QALYs)). Programmes were explicitly compared in an incremental analysis, and the results were presented as an incremental cost-effectiveness ratio. SETTING: The study was conducted in dental clinics in Sweden. PARTICIPANTS: 294 smokers aged 19-71 years were included in the study. INTERVENTIONS: Behaviour therapy, coaching and pharmacological advice (HIT) was compared with one counselling session introducing a conventional self-help programme (LIT). RESULTS: The more costly HIT led to higher number of 6-month continuous abstinent participants after 1 year and higher number of sustained abstinent participants after 5-8 years, which translates into larger societal costs avoided and health gains than LIT. The incremental cost/QALY of HIT compared with LIT amounted to euro918 and euro3786 using short-term and long-term effectiveness, respectively, which is considered very cost-effective in Sweden. CONCLUSION: CEA favours the more costly HIT if decision makers are willing to spend at least euro4000/QALY for tobacco cessation treatment.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6060 (URN)10.1136/bmjopen-2019-030934 (DOI)000502537200371 ()31420398 (PubMedID)2-s2.0-85070812368 (Scopus ID)30264 (Local ID)30264 (Archive number)30264 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
Isacsson, G., Schumann, M., Nohlert, E., Mejersjö, C. & Tegelberg, Å. (2019). Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia - A multicentre randomised controlled trial. (ed.). Journal of Oral Rehabilitation, 46(1), 5-13
Open this publication in new window or tab >>Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia - A multicentre randomised controlled trial.
Show others...
2019 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 46, no 1, p. 5-13Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. OBJECTIVE: The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain. METHODS: This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population. RESULTS: In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812). Treatment-related adverse events were doubled in the methylprednisolone group. CONCLUSION: Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
arthralgia, corticosteroids, injection, intra‐articular, pain management, temporomandibular joint
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7006 (URN)10.1111/joor.12718 (DOI)000453587800002 ()30240024 (PubMedID)2-s2.0-85054690627 (Scopus ID)26645 (Local ID)26645 (Archive number)26645 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-01-17Bibliographically approved
Tegelberg, Å., Nohlert, E., Bornefalk-Hermansson, A., Fransson, A. & Isacsson, G. (2019). Respiratory Outcome After One-year Treatment Of Obstructive Sleep Apnea With Bibloc Versus Monobloc Oral Appliances: a Multicenter, Randomized Equivalence Trial. Sleep Medicine, 64(Suppl. 1), S378-S378
Open this publication in new window or tab >>Respiratory Outcome After One-year Treatment Of Obstructive Sleep Apnea With Bibloc Versus Monobloc Oral Appliances: a Multicenter, Randomized Equivalence Trial
Show others...
2019 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 64, no Suppl. 1, p. S378-S378Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: The benefit of bibloc over monobloc appliances in one-year obstructive sleep apnea (OSA) has not been evaluated in randomized trials. We hypothesized that these types of appliances are equally effective.

Methods: In this multicenter, randomized equivalence trial patients with OSA were assigned to either bibloc or monobloc appliance treatment. At baseline a one-night home respiratory polygraphy was done without respiratory support, and at one-year follow-up examination iterated with the appliance in place. The outcome was the change in the apnea-hypopnea-index (AHI) and the equivalence limits were set at ±5.

Results: Out of 302 patients 146 were randomly assigned to bibloc and 156 to monobloc. In 88 and 104 patients, respectively, were analysed per-protocol with a significant reduction of AHI with a mean change -16.7 (95% CI -19.4 to -14.1) in the bibloc and -11.8 (-14.9 to -8.7) in the monobloc and not significantly equivalent. The proportion of responders defined as AHI < 10 at the follow-up was 68% and 65% for bibloc and monobloc, respectively. Treatment related adverse events were generally mild and transient and occurred similar in frequencies between groups.

Conclusions: Bibloc and monobloc appliance treatment gave a significant positive effect in treating OSA. The treatment modalities were not statistically equivalent, with a numerically greater reduction with bibloc, and, were associated with a similar degree of adverse events.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-18291 (URN)10.1016/j.sleep.2019.11.1053 (DOI)000558768401210 ()
Available from: 2020-09-22 Created: 2020-09-22 Last updated: 2024-06-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2812-5409

Search in DiVA

Show all publications