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  • 1.
    Björnfot Holmström, Sofia
    et al.
    Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lira-Junior, Ronaldo
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
    Zwicker, Stephanie
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Majster, Mirjam
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Gustafsson, Anders
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Svensson, Mattias
    Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Boström, Elisabeth A
    Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    MMP-12 and S100s in saliva reflect different aspects of periodontal inflammation2019In: Cytokine, ISSN 1043-4666, E-ISSN 1096-0023, Vol. 113, p. 155-161Article in journal (Refereed)
    Abstract [en]

    Matrix metalloproteinase (MMP)-12, S100A8/A9, and S100A12 are involved in innate immune responses. We addressed whether different aspects of oral health and non-disease-related covariates influence their levels in saliva. 436 participants were clinically examined, completed a health questionnaire, and provided stimulated saliva. Salivary levels of MMP-12, S100A8/A9, and S100A12 were determined by enzyme-linked immunosorbent assays. Lower MMP-12 levels were observed in individuals 40-64years old (yo) compared to < 40yo, and higher S100A8/A9 levels were found in individuals > 64yo compared to 40-64yo. Smokers exhibited lower MMP-12 and S100A12 levels compared to non-smokers. All three proteins were elevated in individuals with bleeding on probing (BOP)>20% compared to those with BOP</=20%, and the S100A8/A9 levels were higher in individuals having >/= 10% gingival pocket depths (PPD)>/=4mm compared to the ones with shallow pockets < 4mm. The extent of alveolar bone loss or presence of manifest caries did not alter any of the markers. MMP-12, S100A8/A9, and S100A12 levels were higher in participants with high periodontal inflammatory burden. All three proteins correlated positively to BOP, PPD, and to several inflammatory mediators. The explanatory variables for MMP-12 in saliva were age, smoking, presence of any tumor, and percentage of PPD>/=4mm. The determinant of salivary S100A8/A9 was percentage of BOP, while S100A12 levels were associated with percentage of BOP and presence of any tumor. Taken together, MMP-12 and the S100/calgranulin levels in saliva reflect different aspects of periodontal inflammation. Smoking and age should be taken into account in further investigation of these proteins as biomarker candidates of periodontal disease.

  • 2.
    Dawson, Victoria
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Wolf, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Periapical status of non-root-filled teeth with resin composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population2014In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 40, no 9, p. 1303-1308Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Experimental studies show that dental pulp cells respond unfavorably to contact with resin composite restorative material. Hypothetically, in a random population, the frequency of apical periodontitis should be higher for teeth restored with resin composite than with amalgam. Therefore, the aim was to compare the periapical status of non-root-filled teeth restored with resin composite, amalgam, or laboratory-fabricated crowns in an adult Swedish population. METHODS: The subjects comprised 440 individuals from a randomly selected sample of 1,000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all non-root-filled teeth by clinical examination and intraoral clinical photographs. Periapical status was evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed using the chi-square test and logistic regression analysis. RESULTS: There was no significant difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite or amalgam (1.3% and 1.1%, respectively). The frequency of AP for teeth restored with laboratory-fabricated crowns was significantly higher (6.3%). Regression analysis showed no association between AP and resin composite restorations but a significant association with laboratory-fabricated crowns. CONCLUSIONS: The results indicate that the risk of damage to the pulp-dentin complex from exposure to resin composite material and dentin bonding agents shown in experimental studies is not reflected in the clinical setting. However, in the study sample, AP was diagnosed in a significantly higher proportion of teeth restored with laboratory-fabricated crowns.

  • 3.
    Dawson, Victoria
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Kerstin
    Malmö högskola, Faculty of Odontology (OD).
    Wolf, Eva
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Periapical status of root-filled teeth restored with composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population2016In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 42, no 9, p. 1326-1333Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim was to compare the periapical status of root-filled teeth restored with resin composite, laboratory-fabricated crowns, or amalgam in a Swedish adult population. METHODS: The subjects consisted of 440 individuals from a randomly selected sample of 1000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all root-filled teeth by using clinical examination and intraoral clinical photographs. Periapical status, root-filling quality, and marginal bone loss were evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed by using the χ2 test and logistic regression. RESULTS: No difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite, laboratory-fabricated crowns, or amalgam (29.7%, 26.2%, and 43.1%, respectively) of adequate quality was found. No association between AP and resin composite restorations was disclosed; however, there was an association between AP and inadequate root-filling quality and marginal bone loss >1/3 of the root length. CONCLUSIONS: The results did not indicate any association between AP and resin composite restorations. Neither the type nor the material of the restoration was of significance for periapical status as long as the quality was adequate.

  • 4.
    Franzon, Bengt
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Dental politics and subsidy systems for adults in Sweden from 1974 until 20162017In: BDJ Open, E-ISSN 2056-807X, Vol. 3, no 17007Article in journal (Refereed)
    Abstract [en]

    Aims: The dental health sector, as part of the Swedish welfare system, originated in 1974. Since then, the dental insurance has undergone three major changes. The aim of this archive study was to study where in the legislative process the dental politics concerning national dental insurance and subsidies were formed. Materials and Methods: The material, such as Commission of inquiry proposals and Government Bills from four major dental reforms, was collected from the library at the Sveriges Riksdag (Swedish Parliament) and was analysed and structured using a modified version of the Health Field Model. Results: The views on the fundamental ideas, such as the connection between general and dental health, preventive dentistry, rehabilitation of the mouth and promotion of dental health, were the same over the years. The views on dentistry as a market, when it comes to freedom of prices, have undergone a major change since 1974, but the view on the welfare state remains the same. Conclusions: The Swedish dental subsidy systems and how dentistry has been treated politically are the results of a chain of events ranging from care for the population's dental health, political doctrines, ‘zeitgeist‚, dental policy, to state finances.

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  • 5.
    Franzon, Bengt
    et al.
    Malmö University, Faculty of Odontology (OD).
    Moutakis, Mikael
    Department of Economics, Gothenburg University, Gothenburg, Sweden; The Swedish Dental- and Pharmaceutical Benefits Agency, Stockholm, Sweden.
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    The relationship between practice ownership and follow-up of comprehensive dental care. A Swedish register study.2024In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 83, p. 151-159Article in journal (Refereed)
    Abstract [en]

    AIMS: The aims of this register study were:

    1. To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership.
    2. To study the extent of follow-up of patients who have undergone two types of treatments. 

    MATERIAL & METHODS: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed.  Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently.

    CONCLUSION: Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

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  • 6.
    Gillborg, Susanna
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    TMD-pain among adults in the county of Scania2009Conference paper (Other academic)
    Abstract [en]

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

  • 7.
    Gillborg, Susanna
    et al.
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Ekberg, EwaCarin
    Malmö University, Faculty of Odontology (OD).
    Tooth wear in Swedish adults: A cross-sectional study2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 2, p. 235-245Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 8.
    Gillborg, Susanna
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Ekberg, Ewa Carin
    Malmö högskola, Faculty of Odontology (OD).
    Temporomandibular Disorder Pain and Related Factors in an Adult Population: A Cross-Sectional Study in Southern Sweden2017In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 31, no 1, p. 37-45Article in journal (Refereed)
    Abstract [en]

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

  • 9.
    Grant, Melissa
    et al.
    School of Dentistry, Institute of Clinical Sciences, University of Birmingham and Birmingham Community Healthcare Foundation Trust, Birmingham, United Kingdom.
    Kilsgård, Ola
    Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD). Swedish Dental Service of Skåne, Lund, Sweden.
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden.
    Demmer, Ryan T
    Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
    Malmström, Johan
    Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
    Jönsson, Daniel
    Malmö University, Faculty of Odontology (OD). Swedish Dental Service of Skåne, Lund, Sweden.
    The Human Salivary Antimicrobial Peptide Profile according to the Oral Microbiota in Health, Periodontitis and Smoking.2019In: Journal of Innate Immunity, ISSN 1662-811X, E-ISSN 1662-8128, Vol. 11, no 5, p. 432-443Article in journal (Refereed)
    Abstract [en]

    Antimicrobial peptides (AMPs) are a diverse family of peptides that defend the mucosal surfaces of the oral cavity and other locations. Many AMPs have multiple functions and properties that influence aspects of innate defense and colonization by microorganisms. The human oral cavity is home to the second-most diverse microbiome, and the health of the mouth is influenced by the presence of these bacteria as well as by extrinsic factors such as periodontitis and smoking. This study hypothesized that the AMP profile is different in the presence of extrinsic factors and that this would also be reflected in the bacteria present. The AMP profile was analyzed by quantitative selected-reaction-monitoring mass spectrometry analysis and 40 bacterial species were quantified by DNA-DNA hybridization in saliva donated by 41 individuals. Periodontal status was assessed through dental examination and smoking status through medical charting. Periodontal health (in nonsmokers) was associated with a higher abundance of ribonuclease 7, protachykinin 1, β-defensin 128, lipocalin 1, bactericidal permeability-increasing protein fold-containing family B member 3, and bone-marrow proteoglycan. Nonsmoking periodontal disease was associated with an abundance of neutrophil defensin 1 and cathelicidin. However, 7 AMPs were overabundant in periodontal disease in smokers: adrenomedullin, eosinophil peroxidase, 3 different histones, myeloperoxidase, and neutrophil defensin 1. There were no differentially abundant AMPs in smokers versus nonsmokers with periodontal health. Correlation network inference of healthy nonsmokers, healthy smokers, nonsmoking periodontitis, or smoking periodontitis donors demonstrated very different networks growing in complexity with increasing numbers of stressors. The study highlights the importance of the interaction between the oral cavity and its resident microbiota and how this may be influenced by periodontal disease and smoking.

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  • 10.
    Götrick, Bengt
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Ericson, Dan
    Malmö högskola, Faculty of Odontology (OD).
    Torstenson, R
    Tobin, Gunnar
    Oral pilocarpine for treatment of opioid-induced oral dryness in healthy adults2004In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 83, no 5, p. 393-397Article in journal (Refereed)
    Abstract [en]

    Pilocarpine induces a profuse flow of saliva when administered orally, but effects on drug-induced oral dryness have not been examined. The aim of this trial was to investigate if pilocarpine increases production of saliva in individuals suffering from dry mouth due to treatment with opioids. Sixtyfive individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol (50 mg t.d.s.) to induce oral dryness, and were thereafter assigned to one of three groups. Secretion rate of saliva was measured before and after tramadol, and after the oral administration of pilocarpine (5 mg), placebo, or no treatment. Baseline characteristics did not differ among the groups (mean ± SEM: 0.37 ± 0.06 mL/min), and tramadol lowered the secretion at the same level in all groups (0.15 ± 0.02 mL/min). Pilocarpine increased the flow above that observed with placebo (0.66 ± 0.19 vs. 0.15 ± 0.02 mL/min). Thus, pilocarpine re-establishes the flow of saliva in the state of tramadol-induced oral dryness.

  • 11.
    Hedenbjörk-Lager, Anders
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Bjørndal, Lars
    Gustafsson, Anders
    Sorsa, Timo
    Tjäderhane, Leo
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Ericson, Dan
    Malmö högskola, Faculty of Odontology (OD).
    Caries correlates strongly with salivary levels of Matrix Metalloproteinase-82015In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 49, no 1, p. 1-8, article id 49Article in journal (Refereed)
    Abstract [en]

    The caries process in dentin involves the degradation of both mineral and organic matrix. The demineralization has been demonstrated to be caused by bacterial acids. How-ever, the collagen degradation is considered to be initiated by endogenous proteolytic enzymes, mainly collagenolytic matrix metalloproteinases (MMPs). This paper aims to relate salivary MMP-8 (or salivary collagenase-2) and tissue inhibi-tor of MMP (TIMP-1) levels to manifest caries in a large num-ber of subjects. A random sample of 451 adults (aged 18-87 years) living in the south of Sweden was included in this study. Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentra-tions of MMP-8, TIMP-1 and total protein, using an immuno-fluorometric assay, an enzyme-linked immunosorbent assay and the Bradford assay, respectively. Salivary numbers of mutans streptococci and lactobacilli were determined using a chair-side kit. Subjects with manifest caries lesions present-ed with elevated levels of MMP-8 (p < 0.001) as well as total protein, MMP-8/TIMP-1 ratio, bleeding on probing and plaque index (p = 0.05) compared with subjects without manifest caries. Multiple linear regression analysis with car-ies as the dependent variable revealed MMP-8 as the only significant explanatory variable (p < 0.001). TIMP-1 was not significant in any case. Using MMP-8 as the dependent vari-able revealed total protein concentration, caries lesions (p ≤ 0.001) and salivary secretion rate (p = 0.05) as explanatory variables. In conclusion, our data reveal that subjects with manifest caries lesions have elevated levels of salivary MMP-8 relative to subjects with no caries lesions.

  • 12.
    Hänsel Petersson, Gunnel
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Isberg, Per-Erik
    Ericson, Dan
    Malmö högskola, Faculty of Odontology (OD).
    Comparison of risk assessment based on clinical judgement and Cariogram in addition to patient perceived treatment need2016In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 17, no 1, article id 13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Predicting future risk for oral diseases, treatment need and prognosis are tasks performed daily in clinical practice. A large variety of methods have been reported, ranging from clinical judgement or "gut feeling" or even patient interviewing, to complex assessments of combinations of known risk factors. In clinical practice, there is an ongoing continuous search for less complicated and more valid tools for risk assessment. There is also a lack of knowledge how different common methods relates to one another. The aim of this study was to investigate if caries risk assessment (CRA) based on clinical judgement and the Cariogram model give similar results. In addition, to assess which factors from clinical status and history agree best with the CRA based on clinical judgement and how the patient's own perception of future oral treatment need correspond with the sum of examiners risk score. METHODS: Clinical examinations were performed on randomly selected individuals 20-89 years old living in Skåne, Sweden. In total, 451 individuals were examined, 51 % women. The clinical examination included caries detection, saliva samples and radiographic examination together with history and a questionnaire. The examiners made a risk classification and the authors made a second risk calculation according to the Cariogram. RESULTS: For those assessed as low risk using the Cariogram 69 % also were assessed as low risk based on clinical judgement. For the other risk groups the agreement was lower. Clinical variables that significantly related to CRA based on clinical judgement were DS (decayed surfaces) and combining DS and incipient lesions, DMFT (decayed, missed, filled teeth), plaque amount, history and soft drink intake. Patients' perception of future oral treatment need correlated to some extent with the sum of examiners risk score. CONCLUSIONS: The main finding was that CRA based on clinical judgement and the Cariogram model gave similar results for the groups that were predicted at low level of future disease, but not so well for the other groups. CRA based on clinical judgement agreed best with the number of DS plus incipient lesions.

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  • 13.
    Jansson, Henrik
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Wahlin, Åsa
    Malmö högskola, Faculty of Odontology (OD).
    Johansson, Veronica
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Isberg, Per-Erik
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Impact of Periodontal Disease Experience on Oral Health-related Quality of Life2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 3, p. 438-445Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Periodontal research has traditionally focused on the site level, regarding etiology, pathogenesis, and treatment outcome. Recently, some studies have indicated that the presence of periodontal disease is associated with reduced quality of life. The aim of this study is to investigate the impact of periodontal disease experience on the quality of life. METHODS: This cross-sectional study includes 443 individuals. Clinical and radiographic examinations were performed; in conjunction, the oral health-related quality of life of all participants was assessed using the Swedish short-form version of the Oral Health Impact Profile (OHIP-14). Based on marginal bone loss, measured on radiographs, three different groups were identified: participants with loss of supporting bone tissue of less than one third of the root length (BL-), loss of supporting bone tissue of one third or more of the root length in <30% of teeth (BL), or loss of supporting bone tissue of one third or more of the root length in ≥ 30% of teeth (BL+). RESULTS: The effect of periodontal disease experience on quality of life was considerable. For the BL- group, the mean OHIP-14 score was 3.91 (SD: 5.39). The corresponding mean values were 3.81 (SD: 5.29) for the BL group and 8.47 (SD: 10.38) for the BL+ group. The difference among all groups was statistically significant (P ≤ 0.001). A comparison among the mean OHIP-14 scores in the different groups (BL-, BL, and BL+) revealed significant differences in six of seven conceptual domains. CONCLUSIONS: The BL+ individuals experienced reduced quality of life, expressed as the OHIP-14 score, compared with the BL and BL- participants.

  • 14. Lira-Junior, Ronaldo
    et al.
    Holmström, Sofia Björnfot
    Clark, Reuben
    Zwicker, Stephanie
    Majster, Mirjam
    Johannsen, Gunnar
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Svensson, Mattias
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Boström, Elisabeth A.
    S100A12 Expression Is Modulated During Monocyte Differentiation and Reflects Periodontitis Severity2020In: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 11, article id 86Article in journal (Refereed)
    Abstract [en]

    S100A12 is a calcium-binding protein of the S100 subfamily of myeloid-related proteins that acts as an alarmin to induce a pro-inflammatory innate immune response. It has been linked to several chronic inflammatory diseases, however its role in the common oral immunopathology periodontitis is largely unknown. Previous in vitro monoculture experiments indicate that S100A12 production decreases during monocyte differentiation stages, while the regulation within tissue is poorly defined. This study evaluated S100A12 expression in monocyte subsets, during monocyte-to-macrophage differentiation and following polarization, both in monoculture and in a tissue context, utilizing a three-dimensional co-culture oral tissue model. Further, we explored the involvement of S100A12 in periodontitis by analyzing its expression in peripheral circulation and gingival tissue, as well as in saliva. We found that S100A12 expression was higher in classical than in non-classical monocytes. S100A12 expression and protein secretion declined significantly during monocyte-to-macrophage differentiation, while polarization of monocyte-derived macrophages had no effect on either. Peripheral monocytes from periodontitis patients had higher S100A12 expression than monocytes from controls, a difference particularly observed in the intermediate and non-classical monocyte subsets. Further, monocytes from periodontitis patients displayed an increased secretion of S100A12 compared with monocytes from controls. In oral tissue cultures, monocyte differentiation resulted in increased S100A12 secretion over time, which further increased after inflammatory stimuli. Likewise, S100A12 expression was higher in gingival tissue from periodontitis patients where monocyte-derived cells exhibited higher expression of S100A12 in comparison to non-periodontitis tissue. In line with our findings, patients with severe periodontitis had significantly higher levels of S100A12 in saliva compared to non-periodontitis patients, and the levels correlated to clinical periodontal parameters. Taken together, S100A12 is predominantly secreted by monocytes rather than by monocyte-derived cells. Moreover, S100A12 is increased in inflamed tissue cultures, potentially as a result of enhanced production by monocyte-derived cells. This study implicates the involvement of S100A12 in periodontitis pathogenesis, as evidenced by increased S100A12 expression in inflamed gingival tissue, which may be due to altered circulatory monocytes in periodontitis.

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  • 15. Lira-Junior, Ronaldo
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Gustafsson, Anders
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Boström, Elisabeth A.
    Colony stimulating factor-1 in saliva in relation to age, smoking, and oral and systemic diseases2017In: Scientific Reports, E-ISSN 2045-2322, Vol. 7Article in journal (Refereed)
    Abstract [en]

    Colony stimulating factor (CSF)-1 is a growth factor that stimulates the survival, proliferation and differentiation of mononuclear phagocytes, which has been implicated in several inflammatory diseases. This study evaluated the possible influence of age, sex, smoking, periodontitis, caries, and several systemic conditions on salivary levels of CSF-1. Four-hundred and forty-one individuals were enrolled in this study. All participants answered a health questionnaire and underwent a comprehensive oral examination. Stimulated saliva was collected and CSF-1 levels were analysed by enzyme-linked immunosorbent assay. Salivary levels of CSF-1 were significantly increased in participants over 64 years old and in non-smoking individuals, whereas no difference was observed between men and women. Individuals having periodontitis and manifest caries had significantly higher levels of CSF-1. Participants with muscle and joint disease exhibited increased CSF-1 levels as compared to those without. Age, smoking, percentage of pockets >= 4 mm, number of manifest caries lesions, and presence of tumor were associated with CSF-1 levels. Salivary levels of CSF-1 are associated with age, smoking, periodontitis, manifest caries, and the presence of muscle and joint diseases and tumors. CSF-1 might be a promising biomarker candidate in saliva of both local and systemic conditions that needs further investigation.

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  • 16. Lira-Junior, Ronaldo
    et al.
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Boström, Elisabeth A.
    Karolinska Institutet, Department of Dental Medicine, Division of Oral Diseases, Stockholm, Sweden.
    Gustafsson, Anders
    Salivary microbial profiles in relation to age, periodontal, and systemic diseases2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 3Article in journal (Refereed)
    Abstract [en]

    Background Analysis of saliva is emerging as a promising tool to diagnose and monitor diseases which makes determination of the salivary microbial profile in different scenarios essential. Objective To evaluate the effects of age, periodontal disease, sex, smoking, and medical conditions on the salivary microbial profile. Design A randomly selected sample of 441 individuals was enrolled (51% women; mean age 48.5 +/- 16.8). Participants answered a health questionnaire and underwent an oral examination. Stimulated saliva was collected and the counts of 41 bacteria were determined by checkerboard DNA-DNA hybridization. Results Elderly participants (>64 years old) presented a significant increase in 24 out of 41 bacterial species compared to adults (<= 64 years old). Eubacterium nodatum, Porphyromonas gingivalis, and Tannerella forsythia were significantly higher in participants with generalized bone loss compared to without. Males and non-smokers had higher bacteria counts in saliva. Individuals having mental disorders or muscle and joint diseases showed significantly altered microbial profiles whereas small or no differences were found for subjects with high blood pressure, heart disease, previous heart surgery, bowel disease, tumors, or diabetes. Conclusion Age, periodontal status, sex, smoking, and certain medical conditions namely, mental disorders and muscle and joint diseases, might affect the microbial profile in saliva.

  • 17. Looström, Henning
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Ericson, Dan
    Malmö högskola, Faculty of Odontology (OD).
    Tobin, Gunnar
    Götrick, Bengt
    Malmö högskola, Faculty of Odontology (OD).
    Tramadol-induced oral dryness and pilocarpine treatment: Effects on total protein and IgA2011In: Archives of Oral Biology, ISSN 0003-9969, E-ISSN 1879-1506, Vol. 56, no 4, p. 395-400Article in journal (Refereed)
    Abstract [en]

    Pilocarpine induces a profuse flow of saliva, and it may re-establish saliva production in cases of drug-induced oral dryness. The aim of the study (a sub-study to the previous trial investigating the pilocarpine fluid effects in individuals suffering from drug-induced dry mouth) was to search for saliva quality changes induced by the treatments. Sixty-five individuals were enrolled in a randomized, double-blind, placebo-controlled trial. The subjects received tramadol to induce oral dryness. Secretion rate was measured before and after tramadol, and then after pilocarpine, placebo, or no treatment. All saliva was analyzed for its protein and IgA content in the pilocarpine (n=15) and placebo groups (n=12). At baseline, the flow of saliva was 0.47±0.05ml/min, the protein output 0.17±0.2mg/min and the IgA output 0.022±0.002mg/min. After tramadol treatment (50mg 3×/day over two days), the flow was reduced by 64%, protein output by 52% and the IgA output by 38%. While placebo treatment did not affect any of the variables, the flow was 120%, the protein output 193% and the IgA output 83% of the baseline characteristics after pilocarpine treatment (5mg). Thus, the pilocarpine-induced increase in the flow rate in the state of tramadol-induced oral dryness results in saliva with a well preserved protein concentration but with a decrease in IgA concentration. However, compared to baseline, there was neither a decrease in output nor in concentration of IgA.

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  • 18.
    Lundegren, Nina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Håkansson, Jan
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Dental Treatment Need Among 20 to 25-year-old Swedes: Discrepancy Between subjective and Objective Need2004In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, no 2, p. 91-96Article in journal (Other academic)
    Abstract [en]

    Our aim was to analyze variables from a questionnaire sent to 20 to 25-year-old Swedes to determine how they perceive their oral treatment need, and to determine which variables affect this perception. The questionnaire was sent to 650 individuals randomly selected from the database of the National Social Insurance Board of Sweden. The response rate was 78%. Another questionnaire was sent to the dentists of these young adults in order to collect clinical information. The response rate was 66%. The respondent's answer to the question 'How do you rate your dental treatment need today?' was dichotomized and used as a dependent variable in a multivariate logistic regression model. Each increase in number of decayed- filled teeth led to a 13% increased treatment need, bad oral hygiene a 2.24-fold increase, and no periodontal disease an 80% reduction in treatment need. A higher education beyond comprehensive school increased the perceived treatment need 7.16 times; a poorer dental health than one's contemporaries led to a 14.47-fold increase. When dentist and patient assessments were combined, variables related to the patients' self-assessments were the only significant contributors to the statistical model. A lack of concordance between patients' and dentists' assessments of treatment need was found which highlighted the differences between patients' and dentists' views on treatment need. This study shows the importance of communication between dentist and patient.

  • 19.
    Lundegren, Nina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Isberg, Per-Erik
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Analysis of the perceived oral treatment need using Andersen's behavioural model2013In: Community Dental Health, ISSN 0265-539X, Vol. 30, p. 102-107Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate the influence of specific components of Andersen’s behavioural model on adult individuals’ perceived oral treatment need. Methods: A questionnaire was sent to a randomly selected sample of 9,690 individuals, 20 to 89 years old, living in Skåne, Sweden. The 58 questions, some with follow-up questions, were answered by 6,123 individuals; a 63% response rate. Selected for inclusion in the multivariate logistic regression analysis were those questions relating to Andersen’s behavioural model, phase five. Responses to “How do you rate your oral treatment need today?” were used as a dependent variable. The 62 questions chosen as independent variables represented the components: individual characteristics, health behaviour and outcomes in the model. Results: Of the independent variables, 24 were significant at the p≤0.05 level. Low educational level, previously unmet perceived oral treatment need, frequent visiting pattern, perception of worse oral health than one’s peers, an external locus of control, and to have received information from one’s dental caregiver about a need for oral treatment were all highly significant (p<0.001) variables correlating with high self-perceived oral treatment need. Conclusion: The Andersen behavioural model can be a useful theoretical tool for the study of perceived oral treatment need.

  • 20.
    Lundegren, Nina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Oral health in the adult population of Skane, Sweden: a clinical study2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 6, p. 511-519Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this study was to describe the oral health in the adult population of Skåne by clinical factors with special reference to age, gender, ethnicity and education. Materials and methods. Clinical examinations were performed on 451 randomly selected individuals, 20–89 years old, living in Skåne, Sweden. The clinical examination included a radiographic examination and a questionnaire. Clinical variables were put into cross-tabulations along with age, gender, educational level and ethnicity. Results. For all of the described clinical variables, except caries, the frequency increased with age. There were no differences in the clinical variables due to gender. The frequencies of missing teeth, caries, periodontal conditions and DMFT were higher among those with a lower educational level. More missing teeth, worse periodontal conditions, more apical destructions and less dental fillings were found in individuals who were not born in Sweden. Conclusions. The oral health in the adult population of Skåne was overall good, with low frequencies of oral disease and a large number of remaining teeth up to a high age. The patients' oral health status, as determined by a dentist's clinical examination, differed due to age, educational level and ethnicity, but not due to gender.

  • 21.
    Lundegren, Nina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Sohrabi, Melvin M.
    Thoren, Margareta Molin
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Prosthetic dental restorations in Swedish samples: prevalence and agreement between self-report, clinical findings, and influence on quality of life2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 4, p. 296-302Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations. Material and methods: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi(2) test. Results: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20-39 years compared to 4.9 for the age group 65-89 years. Conclusion: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations.

  • 22. Lundmark, Anna
    et al.
    Johannsen, Gunnar
    Eriksson, Kaja
    Kats, Anna
    Jansson, Leif
    Tervahartiala, Taina
    Rathnayake, Nilminie
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Sorsa, Timo
    Yucel-Lindberg, Tulay
    Mucin 4 and matrix metalloproteinase 7 as novel salivary biomarkers for periodontitis2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Aim: Periodontitis is a chronic inflammatory disease, characterized by irreversible destruction of tooth-supporting tissue including alveolar bone. We recently reported mucin 4 ( MUC4) and matrix metalloproteinase 7 (MMP7) as highly associated with periodontitis in gingival tissue biopsies. The aim of this study was to further investigate the levels of MUC4 and MMP7 in saliva and gingival crevicular fluid (GCF) samples of patients with periodontitis. Materials and Methods: Saliva and GCF samples were collected from periodontitis patients and healthy controls. The levels of MUC4, MMP7, and total protein concentrations were analysed using ELISA or Bradford assay. Results: MUC4 levels were significantly lower in saliva and GCF from periodontitis patients relative to healthy controls. MMP7 levels were significantly higher in saliva and GCF from periodontitis patients. Multivariate analysis revealed that MUC4 was significantly associated with periodontitis after adjusting for age and smoking habits and, moreover, that the combination of MUC4 and MMP7 accurately discriminated periodontitis from healthy controls. Conclusions: MUC4 and MMP7 may be utilized as possible novel biomarkers for periodontitis.

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  • 23. Rathnayake, Nilminie
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Tryselius, Ylva
    Sorsa, Timo
    Gustafsson, Anders
    Salivary Biomarkers for Detection of Systemic Diseases2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 4, article id e61356Article in journal (Refereed)
    Abstract [en]

    Background and Objective Analysis of inflammatory biomarkers in saliva could offer an attractive opportunity for the diagnosis of different systemic conditions specifically in epidemiological surveys. The aim of this study was to investigate if certain salivary biomarkers could be used for detection of common systemic diseases. Materials and Methods A randomly selected sample of 1000 adults living in Skåne, a county in the southern part of Sweden, was invited to participate in a clinical study of oral health. 451 individuals were enrolled in this investigation, 51% women. All participants were asked to fill out a questionnaire, history was taken, a clinical examination was made and stimulated saliva samples were collected. Salivary concentrations of IL-1β, -6, -8, TNF-α, lysozyme, MMP-8 and TIMP-1 were determined using ELISA, IFMA or Luminex assays. Results Salivary IL-8 concentration was found to be twice as high in subjects who had experience of tumour diseases. In addition, IL-8 levels were also elevated in patients with bowel disease. MMP-8 levels were elevated in saliva from patients after cardiac surgery or suffering from diabetes, and muscle and joint diseases. The levels of IL-1β, IL-8 and MMP-8, as well as the MMP-8/TIMP-1 ratio were higher in subjects with muscle and joint diseases. Conclusion Biomarkers in saliva have the potential to be used for screening purposes in epidemiological studies. The relatively unspecific inflammatory markers used in this study can not be used for diagnosis of specific diseases but can be seen as markers for increased systemic inflammation.

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  • 24. Rathnayake, Nilminie
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Tryselius, Ylva
    Sorsa, Timo
    Gustafsson, Anders
    Salivary biomarkers of oral health: a cross-sectional study2013In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 40, no 2, p. 140-147Article in journal (Refereed)
    Abstract [en]

    Aim Saliva is a useful diagnostic fluid for oral-related diseases. Monitoring salivary biomarkers for oral and systemic diseases could become an important complement to clinical examinations in epidemiological surveys. Recent findings indicate that it is possible to detect biomarkers for oral diseases within saliva samples. The aim of this study was to investigate if known salivary biomarkers could be used for epidemiological studies for detection of periodontitis. Materials and Methods A randomly selected sample of adults (20–89 years) living in Southern Sweden were invited to participate. Four hundred and fifty-one individuals were examined clinically using standard examination procedures. Stimulated saliva samples were collected and analysed for concentrations of IL-1β, -6, -8, lysozyme, matrix metalloproteinases (MMP)-8 and tissue inhibitor of metalloproteinase (TIMP)-1 using ELISA, immunofluorometric assay or Luminex assays. Results Patients with severe periodontitis presented with elevated salivary concentrations of IL-1β (p < 0.001) and MMP-8 (p < 0.001). In addition, the MMP-8/TIMP-1 ratio was significantly higher in the severe periodontitis group (p < 0.001). Smokers compared with non-smokers showed slightly lower concentrations of IL–8 (p < 0.05) and MMP-8 (p = 0.052). Conclusion This investigation shows that IL-1β, MMP-8 and the ratio of MMP-8/TIMP-1 could be used as markers of periodontal disease in larger patient populations.

  • 25.
    Sharma, Sonia
    et al.
    Malmö University, Faculty of Odontology (OD). University of Buffalo, USA.
    Lövgren, Anna
    Umeå University.
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Nilsson, Peter M.
    Lund University.
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    List, Thomas
    Malmö University, Faculty of Odontology (OD). Skåne University Hospital.
    Häggman-Henrikson, Birgitta
    Malmö University, Faculty of Odontology (OD). Umeå University.
    Prevalence of Facial Pain and Headache in Sweden2021In: The Journal of Oral & Facial Pain and Headache, ISSN 2333-0384 , E-ISSN 2333-0376 , Vol. 35, no 2, p. 139-+Article in journal (Refereed)
    Abstract [en]

    Aims: To compare the prevalence of facial pain and headache across various regions in Sweden. Methods: This study involved a comparison of cross-sectional questionnaire studies over a period of 10 years including 128,193 individuals and assessed facial pain, pain on function, and headache. Participants included (1) all Public Dental Service patients aged 16 to 90 years in Vasterbotten (n = 57,283) and Gavleborg (n = 60,900); and (2) random samples of residents in Kalmar (n = 3,560) and Skane (n = 6,450). Facial pain and pain on function were assessed for all participants, and headache was also assessed for participants in Kalmar and Skane. Descriptive statistics were used to estimate unadjusted prevalence estimates and demographic characteristics. Prevalence estimates were adjusted for age and sex using weighted distributions from the 2015 data in the Swedish population registry before comparisons across the regions. Results: Overall, the prevalence of facial pain and headache were significantly higher in female than in male participants (P<.01). The standardized prevalence of facial pain was 4.9% in Vasterbotten, 1.4% in Gavleborg, 4.6% in Kalmar, and 7.6% in Skane. For headache, the standardized prevalence was 18.9% in Kalmar and 21.3% in Skane. In Skane, individuals with facial pain had a 15-fold higher odds of headache than those without. Conclusion: In the present Swedish epidemiologic study, the prevalence of facial pain ranged from 1.4% in Gavleborg to 7.6% in Skane. Besides different sampling frames and other population characteristics, the presence of a high number of immigrants in Skane may account for some differences in pain prevalence across the Swedish regions.

  • 26.
    Shmarina, Elena
    et al.
    Malmö University, Faculty of Odontology (OD). Reg Kalmar Cty, Publ Dent Serv, Oskarshamn, Sweden..
    Ericson, Dan
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Exploring salutogenic factors supporting oral health in the elderly2022In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 80, no 4, p. 241-251Article in journal (Refereed)
    Abstract [en]

    Aim To explore associations between salutogenic factors and selected clinical outcome variables of oral health in the elderly, combining Antonovsky's salutogenic theory and the Lalonde Health Field concept. Methods The subjects comprised 146 individuals, aged 60 years and older, who had participated in a population-based epidemiological study in Sweden, 2011-2012, using questionnaire and oral examination data. A cross-sectional analysis used the selected outcome variables, such as number of remaining teeth, DMFT-index and risk assessment, and salutogenic factors from the questionnaire, clustered into domains and health fields, as artifactual-material, cognitive-emotional and valuative-attitudinal. This selection was based on findings from our previous analysis using a framework cross-tabulating two health models. The purpose was to facilitate analysis of associations not previously addressed in the literature on oral health. Bivariate and Multiple Linear Regression analyses were used. Results Numerous salutogenic factors were identified. Significant associations between outcome variables and salutogenic factors previously unreported could be added. Regression analysis identified three contributing independent factors for 'low DMFT'. Conclusions This study supports the usefulness of a salutogenic approach for analysing oral health outcomes, identifying university education, the importance of dental health organization recall system and close social network, as important salutogenic factors. The large number of salutogenic factors found supporting oral health among the elderly indicates the complexity of salutogenesis and the need for robust analysing tools. Combining two current health models was considered useful for exploring these covariations. These findings have implications for future investigations, identifying important research questions to be explored in qualitative analyses.

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  • 27.
    Shmarina, Elena
    et al.
    Malmö University, Faculty of Odontology (OD). Public Dental Service, Kalmar County Council, Oskarshamn, Sweden.
    Ericson, Dan
    Malmö University, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Salutogenic factors for oral health among older people: an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde2021In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, no 3, p. 218-231Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde. Material and methods This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated. Results The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m(2)' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors. Conclusions The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.

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  • 28.
    Silbereisen, Angelika
    et al.
    Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lira-Junior, Ronaldo
    Section of Oral Diagnostics and Surgery, Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden..
    Åkerman, Sigvard
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Boström, Elisabeth A
    Section of Oral Diagnostics and Surgery, Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden..
    Bostanci, Nagihan
    Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Association of salivary TREM-1 and PGLYRP1 inflammatory markers with non-communicable diseases.2023In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 50, no 11, p. 1467-1475Article in journal (Refereed)
    Abstract [en]

    AIM: Triggering receptor expressed on myeloid cells 1 (TREM-1) and peptidoglycan recognition protein 1 (PGLYRP1) are elevated in biofluids in the presence of various inflammatory conditions. This cross-sectional study aimed to evaluate the effect of age, sex, smoking and different oral and systemic non-communicable diseases on the levels of TREM-1 and PGLYRP1 in saliva.

    MATERIALS AND METHODS: In total, 445 individuals (mean age 48.7 ± 16.9 years, female:male 51%:49%) were included. All provided self-reported information on smoking and systemic diseases and whole stimulated saliva. Periodontal and cariological parameters were recorded. Salivary levels of TREM-1, PGLYRP1 and total protein were measured using commercially available assays.

    RESULTS: Salivary TREM-1 levels were significantly higher in stages III-IV periodontitis compared to other periodontal diagnoses (p < .05). Smoking, bleeding on probing (BOP), percentage of pockets ≥4 mm and the number of manifest caries were associated with TREM-1 (p < .05), while sex, BOP, number of manifest caries and muscle and joint diseases were associated with PGLYRP1 (p < .05).

    CONCLUSIONS: Salivary TREM-1 is associated with periodontitis and caries, while PGLYRP1 is associated with gingival inflammation and caries. Additionally, TREM-1 levels are modified by smoking, while PGLYRP1 is modified by sex and muscle and joint diseases. TREM-1 and PGLYRP1 in saliva could serve as potential biomarkers for detecting and monitoring non-communicable diseases.

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  • 29.
    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.

  • 30.
    Wahlin, Åsa
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Norderyd, Ola
    Malmö högskola, Faculty of Odontology (OD).
    Marginal bone loss in the adult population in the county of Skane, Sweden2013In: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, no 1, p. 39-47Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the prevalence and extent of periodontal disease registered as marginal bone loss and subject characteristics in the adult population in the county of Skåne in Sweden. One thousand individuals, 20-89 years old, were randomly selected and 451 subjects agreed to participate in the study. They answered a questionnaire and in conjunction with the clinical and radiological examination the subjects answered questions about their medical history. The examiners were co-ordinated regarding the diagnostic criteria through comprehensive written instructions, practice and discussions of clinical cases. One observer estimated marginal bone loss around the teeth on digital panoramic radiographs and bitewings. The individuals were classified regarding periodontal disease experience according to the following criteria: PD- = loss of supporting bone tissue < 1/3 of the root length, PD = loss of supporting bone tissue > or = 1/3 of the root length in < 30% of the teeth and PD+ = loss of supporting bone tissue > or = 1/3 the root length in > or = 30% of the teeth. Subjects with no or minor bone loss, i.e. PD- constituted 69% of the population. Twenty percent of the study population had marginal bone loss corresponding to localised periodontal disease (PD) and 11% exhibited generalised periodontal bone loss (PD+). The periodontal treatment need, defined as probing pocket depth > or = 6 mm and bleeding on probing > or = 20%, was 53% in the PD+ group. An interesting result was that there were no differences in periodontal disease experience between the genders. Conclusions: The prevalence and extent of periodontal disease in this study correlates well with recent other studies. Eleven percent of the population has experienced generalised periodontal disease, and 53% of them have a periodontal treatment need defined as 1 or more site with PPD > or = 6 mm and BoP > or = 20%.

  • 31.
    Åkerman, Sigvard
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Isaksson, Sten
    Klinge, Anna
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Munhålan2012In: Kliniska färdigheter: informationsutbyte mellan patient och läkare / [ed] Stefan Lindgren, Knut Aspegren, Studentlitteratur AB, 2012, p. 131-145Chapter in book (Other academic)
  • 32.
    Åkerman, Sigvard
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Lundkvist, Ingrid
    Zimmerman, Mikael
    Digitala journaler2008In: Digitala kliniken, Stockholm, Gothia Förlag , 2008, p. 11-28Chapter in book (Other academic)
  • 33.
    Åkerman, Sigvard
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Zimmerman, Mikael
    Lagar - det juridiska2008In: Digitala kliniken, Stockholm, Gothia Förlag , 2008, p. 87-93Chapter in book (Other academic)
  • 34. Özhayat, Esben Boeskov
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Öwall, Bengt
    Patients' experience of partial tooth loss and expectations to treatment: a qualitative study in Danish and Swedish patients2016In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, no 3, p. 180-189Article in journal (Refereed)
    Abstract [en]

    Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients' with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmark, and Malmo, Sweden, respectively, 20 patients with partial edentulism seeking rehabilitation were interviewed in a semistructured qualitative manner. The interviews were transcribed and analysed yielding overall domains. Six themes appeared as overall domains: (i) experienced impairments, (ii) experienced social awareness, (iii) expectation to treatment, (iv) expectation to durability/survival, (v) coping strategies dealing with the tooth loss including explanations of the tooth loss and (vi) modifications to experienced impairment. The impairments were mostly experienced as problems in social settings. Most participants expressed a simple wish to function normally; a fixed solution was preferred. Many Danish participants accepted a removable solution whereas only few Swedish participants did so. The domains coping strategies' and modifications' were not part of the chosen topics of interest, indicating a high wish of the participants to explain their tooth loss and how they coped with it. In conclusion, a large degree of social impairment was found in the patient group along with several coping strategies. The impairments were modified by a number of factors indicating that highly individualised care and treatment is needed. A state of normality was described as the primary treatment wish with a higher acceptance of removable solutions in Denmark than in Sweden. For final decision-making, surrounding factors seemed to influence the patients' choices.

1 - 34 of 34
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