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  • 1.
    Bajramaj, Ermira
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Häggman-Henrikson, Birgitta
    Malmö universitet, Odontologiska fakulteten (OD). Department of Odontology, Clinical Oral Physiology, Umeå University, 901 87 Umeå, Sweden.
    Dawson, Andreas
    Centre for Oral Rehabilitation, Östergötland County Council, Linköping, 581 85 Norrköping, Sweden; Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden.
    Gerdle, Björn
    Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden.
    Ghafouri, Bijar
    Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden.
    The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls2019Ingår i: Diagnostics, ISSN 2075-4418, Vol. 9, nr 1, artikel-id 14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the metabolic milieu and thereby influence the results when comparing healthy subjects to those with TMD. This study aimed to investigate the levels of serotonin and glutamate during the acute tissue trauma period in healthy subjects and in patients with TMD. Microdialysis was carried out in 15 patients with TMD and 15 controls, and samples were collected every 20 min during a period of 140 min. No significant alterations of serotonin or glutamate were observed over the 2 h period for the healthy subjects. For the TMD group, a significant decrease in serotonin was observed over time (p < 0.001), followed by a significant increase between 120 and 140 min (p < 0.001). For glutamate, a significant reduction was observed at 40 min compared to baseline. The results showed that there was a spontaneous increase of serotonin 2 h after the insertion of the catheter in patients with TMD. In conclusion, the results showed that there are differences in the masseter muscle levels of serotonin and glutamate during acute nociception in patients with myofascial TMD compared to healthy subjects.

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  • 2.
    Dawson, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Experimental tooth clenching: a model for studying mechanisms of muscle pain2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    “I felt like I’d done three rounds with Mike Tyson…all becauseI was grinding my teeth in my sleep”, så beskrev en patient somintervjuades av Daily Mail i en artikel där det ökade problemet medöverbelastning i käkarna beskrevs, vilket kan leda till tandslitage,muskelsmärta, och frakturer på tandmaterial. Det personliga lidandet,och de ekonomiska kostnaderna för både individ och samhälle ärstort. Bruxism innebär en daglig och/eller nattlig tandpressningeller tandgnissling och anges med en förekomst av ca 10-20% ibefolkningen.Tidigare undersökningar har visat att tandpressning ochpsykologisk stress är vanligare bland patienter med kroniskmuskelsmärta i ansiktet jämfört med friska försökspersoner, ochanses kunna bidra till kronisk muskelsmärta i ansiktet, så kalladmyofasciell temporomandibulär dysfunktion (M-TMD). Dethar även föreslagits att bruxism, t ex tandpressning, kan leda tillträningsvärk i tuggmuskulaturen. M-TMD är ett smärttillstånd somkan drabba tuggmuskulaturen och är ungefär dubbelt så vanligt hoskvinnor som hos män. Vanligt förekommande symtom är smärtaoch ömhet i tuggmuskulaturen, men även en reducerad tuggfunktion.Flera studier har använt sig av experimentellatandpressningsmodeller för att öka förståelsen mellan tandpressningoch smärta i tuggmuskulaturen. I dessa studier har olika stor bitkraftanvänts vid tandpressningen, vilket resulterar i att det blir svårt attjämföra resultaten från dessa studier och dra slutsatser om vilkatandpressningsmodeller som är de mest optimala.12Vid tandpressning så kan det bli syrefattigt i tuggmuskulaturen,vilket kan resultera i en frisättning av smärtframkallande substanser,såsom serotonin och glutamat. I tuggmuskulaturen finns detsmärtreceptorer som kan aktiveras av dessa substanser. I tidigarestudier har man observerat att patienter med M-TMD har en högrehalt av dessa substanser i tuggmuskulaturen jämfört med friskaindivider.Finns det ett samband mellan tandpressning och träningsvärk?Hur kommer det sig att patienter med M-TMD har en högre haltav serotonin och glutamat i tuggmuskulaturen? Denna kunskapsaknas idag, således var det övergripande målet med denna avhandlingatt öka kunskapen om detta. På sikt kan denna kunskap bidra tillförbättrade diagnostiska metoder, och behandlingsmodeller.I studie I så utvecklades ett instrument som undersöker kvalitetenpå experimentella bruxismstudier, som senare kan användas i ensystematisk översikt, så att slutsatser kan dras avseende de mestoptimala experimentella bruxism modellerna som inducerar ensmärta på friska individer som efterliknar den kliniska smärtan sompatienter med M-TMD uppvisar.I studie II undersöktes sambandet mellan tandpressning vidolika bitkraftsnivåer och träningsvärk. Våra resultat antyder attträningsvärk i tuggmuskulaturen inte tycks uppstå efter experimentelltandpressning hos friska individer.I delstudier III och IV undersöktes frisättning av serotonin ochglutamat efter tandpressning hos friska individer och patienter medM-TMD med hjälp av mikrodialys. De huvudsakliga fynden var attvi kunde bekräfta tidigare fynd, att patienter med M-TMD har enhögre halt av serotonin i tuggmuskulaturen. Däremot utsöndradesdessa substanser inte i samband med tandpressning, varken hosfriska individer eller hos patienter.

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    Comprehensive summary
  • 3.
    Dawson, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Käkmuskelsmärta: mekanismer och effekt av behandling2010Ingår i: Tandläkartidningen, ISSN 0039-6982, nr 3, s. 58-59Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Kronisk käkmuskelsmärta, så kallad myofasciell temporomandibulär dysfunktion (m-tmd), kännetecknas av smärta vid tuggning, begränsad tuggfunktion och gapsvårigheter. Den leder ofta till nedsatt daglig funktion och minskad livskvalitet. Förekomsten i befolkningen är ungefär tio procent och man har funnit att det är vanligare bland kvinnor än män [1]. I dag saknas det kunskap om de underliggande mekanismerna till kronisk muskelsmärta, likaså varför det är vanligare bland kvinnor. Syftet med projektet är att få ökad kunskap om de mekanismer som bidrar till muskelsmärtan, samt att i en randomiserad studie utvärdera den smärtlindrande effekten av beteendeterapi. Hypotesen som ligger till grund för forskningsprojektet är att tandpressning orsakar en frisättning av serotonin i tuggmuskulaturen, som både bidrar till och underhåller m-tmd. Denna perifera frisättning påverkas av både östrogen och kortisol. Om hypotesen stämmer bör specifik terapi inriktad på att minska överbelastning i tuggsystemet leda till att halten av intramuskulärt serotonin reduceras och därigenom också smärtlindring.

  • 4.
    Dawson, Andreas
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Centre for Oral Rehabilitation Östergötland County Council, Linköping, Sweden.
    Bendixen, Karina
    Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health Aarhus University, Aarhus, Denmark.
    Tran, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    van Bui, Tuan
    Malmö universitet, Odontologiska fakulteten (OD).
    Svensson, Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö universitet, Odontologiska fakulteten (OD).
    Effects of Acute Experimental Stress on Pain Sensitivity and Cortisol Levels in Healthy Participants: A Randomized Crossover Pilot Study2020Ingår i: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 34, nr 3, s. 281-290Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To investigate pain sensitivity in the masseter muscle and index finger in response to acute psychologic stress in healthy participants. Methods: Fifteen healthy women (23.7 +/- 2.3 years) participated in two randomized sessions: in the experimental stress session, the Paced Auditory Serial Addition Task (PASAT) was used to induce acute stress, and in the control session, a control task was performed. Salivary cortisol, perceived stress levels, electrical and pressure pain thresholds (PTs), and pain tolerance levels (PTLs) were measured at baseline and after each task. Mixed-model analysis was used to test for significant interaction effects between time and session. Results: An interaction effect between time and session occurred for perceived stress levels (P < .001); perceived stress was significantly higher after the experimental task than after the control task (P < .01). No interaction effects occurred for salivary cortisol levels, electrical PTs, or pressure PTLs. Although significant interactions did occur for electrical PTL (P < .05) and pressure PT (P < .001), the simple effects test could not identify significant differences between sessions at any time point. Conclusion: The PASAT evoked significant levels of perceived stress; however, pain sensitivity to mechanical or electrical stimuli was not significantly altered in response to the stress task, and the salivary cortisol levels were not altered in response to the PASAT. These results must be interpreted with caution, and more studies with larger study samples are needed to increase the clinical relevant understanding of the pain mechanisms and psychologic stress.

  • 5.
    Dawson, Andreas
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Centre for Oral Rehabilitation, Östergötland County Council, Linköping, Sweden; Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
    Dawson, Jenny
    Centre for Oral Rehabilitation, Östergötland County Council, Linköping, Sweden.
    Ernberg, Malin
    Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden; Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden.
    The effect of botulinum toxin A on patients with persistent idiopathic dentoalveolar pain: A systematic review2020Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, nr 9, s. 1184-1191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It has been suggested that botulinum toxin A (BONT-A) is a safe and effective treatment in relieving pain in patients with persistent idiopathic dentoalveolar pain (PIDP).

    OBJECTIVES: This study aimed to systematically evaluate all the available studies investigating the pain-relieving effects of BONT-A in patients with PIDP.

    METHODS: A systematic search with specific search terms was made in PubMed, Web of Science and Scopus. Two authors screened titles and abstracts and selected eligible studies for inclusion in the systematic review. The quality of the studies was evaluated by the 12 items Quality Assessment Tool for Observational studies (Pre-Post) Studies with No Control Group, and the level of evidence was assessed according to GRADE.

    RESULTS: Three observational studies of 3695 identified were included (445 overlapping studies; 3247 excluded studies). All studies were uncontrolled observational studies investigating the pain-relieving effect of BONT-A in patients with PIDP. The included studies had a fair quality (moderate risk of bias) and insufficient level of evidence. The pain reducing effect by BONT-A injections was in average 50% or more in two studies, in one study 3 out of 4 patients became almost pain free.

    CONCLUSIONS: This systematic review shows that presently the level of scientific evidence is insufficient to evaluate the pain-relieving effect of BONT-A injections in patients with PIDP. There are indications that BONT-A injections could be a possible management option for patients with PIDP that seems to be safe and with few adverse events. There is a need for well-designed placebo-controlled, double-blind RCTs.

  • 6.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ghafouri, Bijar
    Gerdle, Björn
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, Malin
    Effects of experimental tooth clenching on pain and intramuscular release of 5-HT and glutamate in patients with myofascial TMD2014Ingår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, nr 8, s. 740-749Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:: It has been suggested that tooth clenching may be associated with local metabolic changes, and is a risk factor for myofascial temporomandibular disorders (M-TMD). This study investigated the effects of experimental tooth clenching on the levels of 5-HT, glutamate, pyruvate, and lactate, as well as on blood flow and pain intensity, in the masseter muscles of M-TMD patients. METHODS:: Fifteen patients with M-TMD and 15 healthy controls participated. Intramuscular microdialysis was done to collect 5-HT, glutamate, pyruvate, and lactate and to assess blood flow. Two hours after the insertion of a microdialysis catheter, participants performed a 20-min repetitive tooth clenching task (50% of maximal voluntary contraction). Pain intensity was measured throughout. RESULTS:: A significant effect of group (P<0.01), but not of time, was observed on 5-HT levels, and blood flow. No significant effects of time or group occurred on glutamate, pyruvate, or lactate levels. Time and group had significant main effects on pain intensity (P<0.05, and P<0.001). No significant correlations were identified between: (i) 5-HT, glutamate, and pain intensity or between (ii) pyruvate, lactate, and blood flow. DISCUSSION:: This experimental tooth clenching model increased jaw muscle pain levels in M-TMD patients and evoked low levels of jaw muscle pain in healthy controls. M-TMD patients had significantly higher levels of 5-HT than healthy controls and significantly lower blood flow. These two factors may facilitate the release of other algesic substances that may cause pain.

  • 7.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ghafouri, Bijar
    Gerdle, Björn
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, Malin
    Pain and intramuscular release of algesic substances in the masseter muscle after experimental tooth-clenching exercises in healthy subjects2013Ingår i: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 27, nr 4, s. 350-360Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To investigate whether experimental tooth clenching leads to a release of algesic substances in the masseter muscle. Methods: Thirty healthy subjects (16 females, 14 males) participated. During two sessions, separated by at least 1 week, intramuscular microdialysis was performed to collect masseter muscle 5-hydroxytryptamine (5-HT) and glutamate as well as the metabolic markers pyruvate and lactate. Two hours after the start of microdialysis, participants were randomized to a 20-min repetitive experimental tooth-clenching task (50% of maximal voluntary contraction) or a control session (no clenching). Pain and fatigue were measured throughout. The Friedman and Wilcoxon tests were used for statistical analyses. Results: No alterations were observed in the concentrations of 5-HT, glutamate, pyruvate, and lactate over time in the clenching or control session, or between sessions at various time points. Pain (P < .01) and fatigue (P < .01) increased significantly over time in the clenching session and were significantly higher after clenching than in the control session (P < .01). Conclusion: Low levels of pain and fatigue developed with this experimental tooth-clenching model, but they were not associated with an altered release of 5-HT, glutamate, lactate, or pyruvate. More research is required to elucidate the peripheral release of algesic substances in response to tooth clenching.

  • 8.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    A comparison in pain- and tolerance thresholds between Middle-Easterns and Swedes, man and women2008Konferensbidrag (Refereegranskat)
  • 9.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Comparison of pain thresholds and pain tolerance levels between Middle Easterners and Swedes and between genders2009Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 36, nr 4, s. 271-278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This study evaluates the presence of culture and gender differences in pain thresholds and pain tolerance levels between Middle Easterners and Swedes. METHODS: Sixty-four healthy individuals, 32 Middle Easterners (16 men and 16 women, mean age: 24.6 +/- 3.4 years) and 32 Swedes (16 men and 16 women, mean age: 24 +/- 3.5 years) participated in the study. Three experimental pain tests were conducted in each participant. Pain thresholds and pain tolerance levels were measured using an algometer (mechanical stimulus), the PainMatcher((R)) (electric stimulus) and cold pressor test (thermal stimulus). RESULTS: While no significant differences in pain thresholds were observed between Middle Easterners and Swedes in algometer and cold pressor tests, differences in pain tolerance levels were significant (P < 0.01 for both tests). All between-culture differences in pain perception, pain threshold and pain tolerance level were non-significant when measured with the PainMatcher. Significant between-gender differences were observed only in pain threshold with the PainMatcher (P < 0.05) and in pain tolerance level with the algometer (P < 0.01) and the PainMatcher (P <0.001). CONCLUSION: This study found significant differences in two out of three pain tolerance level tests - but not pain threshold tests - between the Middle Eastern and Swedish cultures and between genders. These differences were more pronounced between Middle Eastern and Swedish men than between Middle Eastern and Swedish women. Gender differences were more pronounced within the Swedish than the Middle Eastern culture. These findings indicate that culture and gender influence pain experience.

  • 10.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, M
    Svensson, P
    Assessment of Proprioceptive Allodynia After Tooth-Clenching Exercises2012Ingår i: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 26, nr 1, s. 39-48Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To (A) evaluate test-retest reliability of vibrotactile sensitivity in the masseter muscle and (B) test if (1) the vibration threshold is decreased after experimental tooth clenching, (2) intense vibrations exacerbate pain after tooth clenching, (3) pain and fatigue are increased after tooth clenching, and (4) pressure pain thresholds are decreased after tooth clenching. METHODS: In part A, 25 healthy female volunteers (mean age: 42 ± 12 years) participated, and 16 healthy females (mean age 32 ± 10 years) participated in three 60-minute sessions, each with 24- and 48-hour follow-ups in part B. Participants were randomly assigned tooth-clenching exercises with clenching levels of 10%, 20%, or 40% of maximal voluntary clenching. A Vibrameter applied to the right masseter muscle measured perceived intensity of vibration and perceived discomfort, which were assessed on 0-50-100 numeric rating scales. An electronic algometer measured pressure pain threshold (PPT). Two 0- to 100-mm visual analog scales measured pain intensity (VASpain) and fatigue (VASfatigue). Measurements were made on the right masseter muscle. Interclass correlation coefficient (ICC) was used to calculate test-retest reliability of VT measurements. Outcome variables were tested with two-way ANOVAs for repeated measures and Dunnett's post-hoc test. RESULTS: Moderate long-term (ICC 0.59) and good short-term (ICC 0.92) reliability was found for VT on the masseter muscle. Clenching level had no main effect on perceived intensity of vibration; time effects (P < .05) were only observed at 40 minutes (Dunnett's test: P < .01). Clenching level and time had no effect on perceived discomfort. Only time effects were significant for PPT (P < .01), with reductions at 50 and 60 minutes compared to baseline (Dunnett's test: P < .05). Clenching level and time had main effects for VASpain and VASfatigue (P < .001). Conclusion: Experimental tooth clenching appears to evoke moderate levels of pain and fatigue and short-lasting hyperalgesia to mechanical stimulation, but not proprioceptive allodynia. The absence of proprioceptive allodynia does not necessarily exclude delayed onset muscle soreness (DOMS) but warrants further studies on the clinical manifestations of DOMS in jaw muscles.

  • 11.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, Malin
    Svensson, P
    Assessment of prioceptive allodynia after tooth-clenching exercises: Preliminary results2009Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
  • 12.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, Malin
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    ASSESSMENT OF PROPRIOCEPTIVE ALLODYNIA AFTER TOOTH CLENCHING2010Ingår i: Abstracts of the 13th World Congress of Pain, IASP (International Association for the Study of Pain and Omnipress) , 2010, artikel-id PW107Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Eccentric muscle exercise can induce delayed onset muscle soreness (DOMS). It is known that vibratory stimulus is an effective method to stimulate mechanoreceptors and that 80-Hz vibratory stimulus increases pain in an eccentric exercised muscle (Weerakkody et al. 2001). Lund (1994) suggested that bruxism is related to DOMS. This study evaluates the effects of experimental tooth clenching on vibrotactile and pressure sensitivity in healthy females. Methods: Sixteen healthy females (mean age 32 ± 10) participated in this study, which comprised three sessions. In each session participants were randomly assigned to a tooth clenching exercise, with a clenching level of 10%, 20%, or 40% of maximal voluntary clenching (MVC). The first day of each session, patients did six bouts of tooth clenching exercises, each bout lasting 5 minutes during 1 hour. Registrations were made at baseline, after each bout of tooth clenching (short perspective), and after 24 and 48 hours. A Vibrameter®was used to measure the vibration threshold (VT). A fixed vibratory stimulus (100 Hz, 399.99-μm amplitude) was applied for 15 s and the perceived intensity of vibration (PIV) and perceived discomfort (PD) were rated on 0-50-100 scales (0 = no sensation; 50 = pain threshold/discomfort; 100 = worst imaginable pain/worst imaginable discomfort). An electronic algometer was used to measure pressure pain thresholds (PPT). A 0-10 visual analogue scale (VAS) measured pain intensity (VP) and fatigue (VF). All registrations were made on the central and most prominent part of the right masseter muscle. Results: No main effects of contraction level was observed for VT (P=0.184) or PIV (P=0.628), but there were significant time effects (P<0.001; P<0.05) with significant increases in VT at 30, 40, 50 and 60 min (Dunnett: P<0.05) and significant increase in PIV at 40 min compared to baseline (Dunnett: P<0.05). There were no main effects of contraction level (P=0.524) or time (P=0.705) for PD. For PPT there was no effect of contraction (P=0.819) but a significant time effect (P<0.01) with decreases at 50 and 60 min compared to baseline (Dunnett: P<0.05). Main effects of contraction level and time were observed for VP and VF (both P<0.001). VP and VF were significantly increased at 40% MVC, and at 10-60 min and at 24 h follow-up. Conclusions: This study demonstrated that tooth clenching alters VT only in the short term perspective. Tooth clenching at different levels is associated with moderate levels of pain and fatigue and changes in PPT. The effect on PIV and PD was small, thus suggesting that tooth clenching is not directly related to DOMS.

  • 13.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Ernberg, Malin
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    Assessment of proprioceptive allodynia after tooth clenching exercises2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Bruxism is suggested to be a risk factor of temporomandibular disorders and a contributing factor to delayed onset muscle soreness (DOMS). Assessments of proprioceptive allodynia—a phenomenon that occurs in muscles with DOMS—could indicate whether bruxism leads to DOMS. This study evaluated whether experimental tooth clenching leads to DOMS. Sixteen healthy females (mean age 32 ± 10 years) participated in three 60-min sessions with 15-min follow-ups at 24 and 48 h. Participants were randomly assigned tooth clenching exercises with clenching levels of 10%, 20%, or 40% of maximal voluntary clenching (MVC). A Vibrameter® measured perceived intensity of vibration (PIV) and perceived discomfort (PD), which were assessed on 0–50–100 numeric rating scales. An electronic algometer measured pressure pain thresholds (PPT). A 0–100-mm visual analogue scale measured pain intensity (VASpain) and fatigue (VASfatigue). Measurements were made on the right masseter muscle. Clenching level had no main effect on PIV and time effects (p < 0.05) were only observed at 40 min (Dunnet: p < 0.01). Clenching level and time had no effect on PD. Only time effects were significant for PPT (p < 0.01) with reductions at 50 and 60 min compared to baseline (Dunnett: p’s < 0.05). Clenching level and time had main effects for VASpain and VASfatigue (p < 0.001). We conclude that experimental tooth clenching at various levels is not related to DOMS—since no signs of proprioceptive allodynia were observed—but to a development of moderate levels of pain and fatigue and reduced PPT.

  • 14.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ljunggren, Lennart
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för biomedicinsk vetenskap (BMV).
    Ernberg, M.
    Svensson, P.
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Effect of experimental tooth clenching on the release of beta-endorphin2014Ingår i: Journal of Headache and Pain, ISSN 1129-2369, E-ISSN 1129-2377, Vol. 15Artikel i tidskrift (Övrigt vetenskapligt)
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  • 15.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Ljunggren, Lennart
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för biomedicinsk vetenskap (BMV).
    Ernberg, Malin
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Effect of experimental tooth clenching on the release of β-endorphin2014Ingår i: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 28, nr 2, s. 159-164Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To investigate the association between experimental tooth clenching and the release of β-endorphin in patients with myofascial temporomandibular disorders (M-TMD) and healthy subjects. METHODS: Fifteen M-TMD patients and 15 healthy subjects were included and assigned an experimental tooth-clenching task. Venous blood was collected and pain intensity was noted on a visual analog scale. The masseter pressure pain threshold (PPT) was assessed 2 hours before the clenching task and immediately after. A mixed-model analysis of variance was used for statistical analyses. RESULTS: Significant main effects for time and group were observed for pain intensity and PPT, with significantly lower mean values of pain intensity (P < .001) and PPT (P < .01) after the clenching task compared with baseline. M-TMD patients had significantly higher pain intensity (P < .001) and significantly lower PPT (P < .05) than healthy subjects. No significant time or group effects were observed for the level of β-endorphin. Neither pain intensity nor PPT correlated significantly with β-endorphin levels. CONCLUSION: This experimental tooth-clenching task was not associated with significant alterations in β-endorphin levels over time, but with mechanical hyperalgesia and low to moderate levels of pain in healthy subjects and M-TMD patients, respectively. More research is required to understand the role of the β-endorphinergic system in the etiology of M-TMD

  • 16.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Raphael, Karen G
    Glaros, Alan
    Axelsson, Susanna
    Arima, Taro
    Ernberg, Malin
    Farella, Mauro
    Lobbezoo, Frank
    Manfredini, Daniele
    Michelotti, Ambra
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Development of a quality-assessment tool for experimental bruxism studies: reliability and validity2013Ingår i: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 27, nr 2, s. 111-122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To combine empirical evidence and expert opinion in a formal consensus method in order to develop a quality-assessment tool for experimental bruxism studies in systematic reviews. METHODS: Tool development comprised five steps: (1) preliminary decisions, (2) item generation, (3) face-validity assessment, (4) reliability and discriminitive validity assessment, and (5) instrument refinement. The kappa value and phi-coefficient were calculated to assess inter-observer reliability and discriminative ability, respectively. RESULTS: Following preliminary decisions and a literature review, a list of 52 items to be considered for inclusion in the tool was compiled. Eleven experts were invited to join a Delphi panel and 10 accepted. Four Delphi rounds reduced the preliminary tool-Quality-Assessment Tool for Experimental Bruxism Studies (Qu-ATEBS)- to 8 items: study aim, study sample, control condition or group, study design, experimental bruxism task, statistics, interpretation of results, and conflict of interest statement. Consensus among the Delphi panelists yielded good face validity. Inter-observer reliability was acceptable (k = 0.77). Discriminative validity was excellent (phi coefficient 1.0; P < .01). During refinement, 1 item (no. 8) was removed. CONCLUSION: Qu-ATEBS, the seven-item evidence-based quality assessment tool developed here for use in systematic reviews of experimental bruxism studies, exhibits face validity, excellent discriminative validity, and acceptable inter-observer reliability. Development of quality assessment tools for many other topics in the orofacial pain literature is needed and may follow the described procedure.

  • 17.
    Dawson, Andreas
    et al.
    Malmö högskola, Odontologiska fakulteten (OD). Center for Oral Rehabilitation, Östergötland County Council, Linköping, Sweden; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Dentistry, Aarhus University, Aarhus, Denmark.
    Stensson, Niclas
    Rehabilitation Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University and Pain and Rehabilitation Centre, Östergötland County Council, Linköping, Sweden.
    Ghafouri, Bijar
    Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University and Centre of Occupational and Environmental Medicine, Östergötland County Council, Linköping, Sweden; Rehabilitation Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University and Pain and Rehabilitation Centre, Östergötland County Council, Linköping, Sweden.
    Gerdle, Björn
    Rehabilitation Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University and Pain and Rehabilitation Centre, Östergötland County Council, Linköping, Sweden.
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Dentistry, Aarhus University, Aarhus, Denmark; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
    Svensson, Peter
    Malmö högskola, Odontologiska fakulteten (OD). Center for Functionally Integrative Neuroscience (CFIN), MindLab, Aarhus University Hospital, Aarhus, Denmark; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Dentistry, Aarhus University, Aarhus, Denmark; Section of Clinical Oral Physiology, Department of Dentistry, Aarhus University, Aarhus, Denmark; Section of Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Ernberg, Malin
    Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Dentistry, Aarhus University, Aarhus, Denmark; Section of Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Dopamine in plasma: a biomarker for myofascial TMD pain?2016Ingår i: Journal of Headache and Pain, ISSN 1129-2369, E-ISSN 1129-2377, Vol. 17, nr 1, artikel-id 65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Dopaminergic pathways could be involved in the pathophysiology of myofascial temporomandibular disorders (M-TMD). This study investigated plasma levels of dopamine and serotonin (5-HT) in patients with M-TMD and in healthy subjects. METHODS: Fifteen patients with M-TMD and 15 age- and sex-matched healthy subjects participated. The patients had received an M-TMD diagnosis according to the Research Diagnostic Criteria for TMD. Perceived mental stress, pain intensity (0-100-mm visual analogue scale), and pressure pain thresholds (PPT, kPa) over the masseter muscles were assessed; a venous blood sample was taken. RESULTS: Dopamine in plasma differed significantly between patients with M-TMD (4.98 ± 2.55 nM) and healthy controls (2.73 ± 1.24 nM; P < 0.01). No significant difference in plasma 5-HT was observed between the groups (P = 0.75). Patients reported significantly higher pain intensities (P < 0.001) and had lower PPTs (P < 0.01) compared with the healthy controls. Importantly, dopamine in plasma correlated significantly with present pain intensity (r = 0.53, n = 14, P < 0.05) and perceived mental stress (r = 0.34, n = 28, P < 0.05). CONCLUSIONS: The results suggest that peripheral dopamine might be involved in modulating peripheral pain. This finding, in addition to reports in other studies, suggests that dopaminergic pathways could be implicated in the pathophysiology of M-TMD but also in other chronic pain conditions. More research is warranted to elucidate the role of peripheral dopamine in the pathophysiology of chronic pain.

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  • 18.
    Ikoma, Tomoko
    et al.
    Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
    Bendixen, Karina Haugaard
    Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
    Arima, Taro
    Section of International Affairs, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
    Dawson, Andreas
    Malmö universitet, Odontologiska fakulteten (OD). Scandinavian Center for Orofacial Neurosciences (SCON), Denmark , Sweden; Centre for Oral Rehabilitation, Östergötland County Council, Linköping, Norrköping, Sweden.
    Yamaguchi, Taihiko
    Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
    List, Thomas
    Malmö universitet, Odontologiska fakulteten (OD). Scandinavian Center for Orofacial Neurosciences (SCON), Denmark.
    Svensson, Peter
    Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Effects of Low-Intensity Contractions of Different Craniofacial Muscles in Healthy Participants: An Experimental Cross-Over Study2018Ingår i: Headache, ISSN 0017-8748, E-ISSN 1526-4610, Vol. 58, nr 4, s. 559-569Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective.-Repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, ie, bruxism, is traditionally linked to pain and unpleasantness in the active muscles. The aim of this study was to investigate the effects of standardized craniofacial muscle contractions on self-reported symptoms. Methods.-Sixteen healthy volunteers performed six 5-minute bouts of 20% maximal voluntary contraction task of the jaw-closing (Jaw), the orbicularis-oris (O-oris), and the orbicularis-oculi (O-oculi) muscles. Participants rated their perceived pain, unpleasantness, fatigue, and mental stress levels before, during, and after the contraction tasks on 0-10 Numeric Rating Scales (NRS). Each muscle contraction task (= 1 session) was separated by at least 1 week and the order of the sessions was randomized in each subject. Results.-All muscle contraction tasks evoked significant increases in NRS scores of pain (mean +/- SD: Jaw; 3.8 +/- 2.7, O-oris; 1.9 +/- 2.2, O-oculi; 1.4 +/- 1.3, P < .014), unpleasantness (Jaw; 4.1 +/- 2.5, O-oris; 2.1 +/- 1.9, O-oculi; 2.9 +/- 1.8, P<.001), fatigue (Jaw; 5.8 +/- 2.0, O-oris; 3.2 +/- 2.3, O-oculi; 3.6 +/- 1.9, P<.001), and mental stress (Jaw; 4.1 +/- 2.1, O-oris; 2.2 +/- 2.7, O-oculi; 2.9 +/- 2.2, P<.001). The Jaw contractions were associated with higher NRS scores compared with the O-oris and the O-oculi contractions (P<.005) without differences between the O-oris and the O-oculi (P>.063). All symptoms disappeared within 1 day (P>.469). Conclusions.-The results showed that submaximal static contractions of different craniofacial muscle groups could evoke transient, mild to moderate levels of muscle pain and fatigue and increased stress scores. The fatigue resistance may differ between different muscle groups. Further studies are warranted to better understand the contribution of specific craniofacial muscle groups for the characteristic presentation of musculoskeletal pain conditions in the head.

  • 19.
    Nordin, Sara
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Dawson, Andreas
    Malmö högskola, Odontologiska fakulteten (OD). Centre for Oral Rehabilitation, Östergötland County Council, Linköping, Sweden.
    Ekberg, EwaCarin
    Malmö högskola, Odontologiska fakulteten (OD).
    Achieved Competencies and Satisfaction in Temporomandibular Disorders and Orofacial Pain Education2016Ingår i: Journal of Oral & Facial Pain and Headache, ISSN 2333-0376, Vol. 30, nr 2, s. 156-164Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To assess dental students' achieved competencies and perceived satisfaction with their temporomandibular disorders (TMD) and orofacial pain education and to compare these with the results of their final examination in TMD and orofacial pain. METHODS: Dental students from two consecutive classes (2011/2012 and 2012/2013) at the Department of Orofacial Pain and Jaw Function at the dental school in Malmö, Sweden completed two self-evaluations, one at the beginning of semester seven and one at the end of semester eight. The questionnaire that they were given concerned achieved competencies and satisfaction with education in TMD and orofacial pain. Items focused on anatomy, physiology, and clinical training. Students estimated their competence and satisfaction on a numeric rating scale and described their idea of treating TMD and orofacial pain patients on a verbal rating scale. Outcome variables were tested with paired samples t test for differences over time and independent samples t test for between-class comparisons; both were adjusted for multiple testing with Bonferroni correction. RESULTS: Significant improvement in all items was observed for achieved competencies and satisfaction in both classes between semester seven and semester eight (P < .05). No differences in competencies or satisfaction occurred between classes at the end of the clinical course in semester eight (P > .05). CONCLUSION: This study has shown that expansion in undergraduate TMD and orofacial pain education at the dental school in Malmö has allowed all students to develop the same level of competence, independent of prior experience. The study also pointed out that continuous evaluation and enhancement of TMD and orofacial pain education in undergraduate dental education is beneficial

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