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  • 1.
    Nordström, Marie
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Carlsson, Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Ericson, Dan
    Malmö universitet, Odontologiska fakulteten (OD).
    Lager, Anders
    Malmö universitet, Odontologiska fakulteten (OD).
    Jansson, Henrik
    Folktandvården Skåne Lund Sweden.
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Hänsel Petersson, Gunnel
    Malmö universitet, Odontologiska fakulteten (OD).
    Some young adults can maintain good oral health despite socioeconomic challenges2024Ingår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, artikel-id e12985Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

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  • 2.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS).
    Priebe, Gisela
    Karlstad Univ, Dept Social & Psychol Studies, Karlstad, Sweden..
    The self-perceived impact of sexual abuse on daily life and general health - an issue to consider in dental care2024Ingår i: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 40, nr S2, s. 43-52Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Aim: To analyse, from the perspective of adults with a history of sexual abuse, the impact of the experience on their general health and well-being.Material and Methods: The participants comprised 12 strategically selected informants (10 women), aged 19-56; all sexually abused during child- and/or adulthood. They were interviewed in-depth and encouraged to describe the impact of the sexual abuse on their daily lives. The consequences of sexual abuse on oral health have previously been reported. The interviews were recorded digitally, transcribed verbatim and analysed according to qualitative content analysis with an inductive approach.Results: The overall theme illustrating the latent content was Sexual abuse experience-limiting long-term consequences, always present in body and mind. The first category covering the manifest content was 'A lost foothold', with two subcategories: (i) emotional repercussions and (ii) physical health repercussions. The second category was 'The significance of distance to trauma', with two subcategories (i) keeping a distance and tending to escape and (ii) processing the trauma experience-a struggle towards balance.Conclusions: A history of sexual abuse cannot be understood in isolation: the long-term repercussions pervade daily life. However, after disclosure of the abuse and processing the trauma, it is possible to ameliorate some of the negative effects. In this context, the dental setting emerges as a potentially important venue for disclosure as almost every person, sooner or later, visits the dentist.

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  • 3.
    Olsson, Jenny
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Ljunggren, Anna
    Malmö universitet, Odontologiska fakulteten (OD).
    Pre-medical assessment of root canal-filled teeth with asymptomatic apical periodontitis: a multifaceted balancing act2023Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 56, nr 9, s. 1063-1076Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: Prior to certain medical therapies, dental assessment and treatment of oral foci of infection are recommended. The aim of the present study was to acquire a deeper understanding of the decision-making process regarding pre-medical management of root canal-filled teeth with asymptomatic apical periodontitis.

    METHODOLOGY: Hospital-affiliated dentists in Sweden were contacted for a semi-structured, in-depth interview. The absolute inclusion criterion was that the dentists had experienced and could recount at least two authentic cases involving root canal-filled teeth with asymptomatic apical periodontitis - one case having resulted in pre-medical treatment, and one having resulted in expectancy. Fourteen interviews, with fourteen informants, were conducted and included in the study. During the interviews, open-ended questions and comments encouraging the informants to elaborate and clarify their experiences were offered. The interviews were digitally recorded, transcribed verbatim and analyzed using Qualitative Content Analysis with an inductive approach.

    RESULTS: A theme describing the latent content was identified through interpretation of the collected data: A multifaceted balancing act characterized by a sometimes-difficult risk-benefit-estimation, where an increased uncertainty entails an increased reliance on external opinions. Three main categories, comprising four subcategories, describing the manifest content were recognized: The tipping scale, The team effort and The frame of reference.

    CONCLUSION: The current interview study found pre-medical decision-making regarding root canal-filled teeth with asymptomatic apical periodontitis to be a multifactorial and contextual process marked by uncertainty and collaborative measures. Further research, resulting in the development of evidence-based treatment guidelines, is suggested necessary.

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  • 4.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Leonard, Kerstin
    Malmö universitet, Odontologiska fakulteten (OD).
    Vidigsson, My
    Malmö universitet, Odontologiska fakulteten (OD).
    Tegelberg, Åke
    Malmö universitet, Odontologiska fakulteten (OD).
    Koch, Margaretha
    Malmö universitet, Odontologiska fakulteten (OD).
    Adoption of change in endodontic practice after an educational program: A qualitative study2022Ingår i: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, nr 3, s. 781-792Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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  • 5.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS).
    Månsson, Sarah
    Malmö universitet, Odontologiska fakulteten (OD).
    Wallin, Louise
    Malmö universitet, Odontologiska fakulteten (OD).
    Priebe, Gisela
    Lund University.
    Child Sexual Abuse-Challenging Conditions for Adult Oral Health: A Qualitative Study.2022Ingår i: JDR clinical and translational research, ISSN 2380-0852, Vol. 8, nr 1, artikel-id 23800844211053775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to analyze perceptions of oral health in adults who have been exposed to child sexual abuse. Eleven participants (10 women), 19 to 56 y of age, who had experienced sexual abuse as children were purposively selected and interviewed in-depth. The participants were encouraged to describe how they perceived the effect of the sexual abuse on their oral health as adults. The interviews were recorded digitally and transcribed verbatim. The collected material was analyzed according to qualitative content analysis. The theme "challenging conditions for maintaining oral health" was identified, comprising 2 categories: first, "the emotional significance," with the subcategories 1) emotional barriers and 2) powerful relief, and second, "the obstacles to oral health," with the subcategories 1) daily self-care with complications and 2) dental appointments with difficulties. The findings indicate that the experience of sexual abuse during childhood can have a negative impact on oral care in adulthood. The informants stated that oral health was of utmost importance but also associated with strong emotions. There were obstacles to maintenance of oral health that were difficult to surmount.Knowledge Transfer Statement:The study provides access to the attitudes of survivors of child sexual abuse regarding oral health and the needs and obstacles that they experience. This is important knowledge for dental professionals to optimize dental care.

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  • 6.
    Dawson, Victoria
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö universitet, Odontologiska fakulteten (OD). Department of Endodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Coronal restoration of the root filled tooth: a qualitative analysis of the dentists' decision-making process2021Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 54, nr 4, s. 490-500Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To describe the decision-making process of the general dental practitioner (GDP) underlying the choice of coronal restoration of a root filled tooth.

    METHODOLOGY: GDPs were strategically selected with respect to gender, age, undergraduate dental school, service affiliation and duration of professional experience. Semi-structured in-depth interviews were conducted, focusing on the informant's personal experience of the process which leads to a decision as to how to restore a root filled tooth. The informants were invited to describe in their own words the latest two cases involving decisions of direct or full crown restorations respectively. The interviews were digitally recorded and transcribed verbatim. Interviews from 14 informants, aged 27 - 64 (mean age 46 years), were included and analyzed according to Qualitative Content Analysis.

    RESULTS: A theme (latent content) was identified: Clinical factors were considered important but were overruled by context and patient opinions, if in conflict. Three main categories, including seven sub-categories (manifest content), were identified. The categories were clinical factors, contextual factors and patient´s views. Clinical factors underlying the GDPs´ decision included the current dental status and the estimated longevity of the intended restoration. In certain cases contextual factors were also of importance, either supporting the GDPs´ decision or modifying it. However, the patient´s views played a decisive role in the final choice of coronal restoration, leading to either mutual acceptance or a compromise, taking into account the patient´s economic status and opinions.

    CONCLUSIONS: With respect to coronal restoration of a root filled tooth, the GDPs' decision-making process was based not only on clinical factors, but also on decisive contextual factors and consideration of the patients' views.

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  • 7.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS).
    Grinneby, David
    Malmö universitet, Odontologiska fakulteten (OD).
    Nilsson, Petra
    Malmö universitet, Odontologiska fakulteten (OD).
    Priebe, Gisela
    Lund University.
    Dental care of patients exposed to sexual abuse: Need for alliance between staff and patients2021Ingår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 129, nr 3, artikel-id e12782Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to explore the experiences of sexually abused individuals as dental patients. Purposively selected were 13 informants (11 women) aged 19-56. All had experienced sexual abuse as children or adults and memories of this abuse had been triggered and expressed during a dental appointment. They were encouraged to relate in their own words their experiences of the dental appointment. The interviews were recorded digitally, transcribed verbatim, and analysed according to Qualitative Content Analysis. The overall theme illustrating the latent content was The dental appointment - a volatile base requiring predictability and a secure working alliance. The first category covering the manifest content was The dental care provider "assumes responsibility," with two subcategories: (i) contradictory disclosure, and (ii) alliance formation - a levelling of power. The second category was The patient is "in focus," with two subcategories: (i) alertness to signs of discomfort, and (ii) attention to obvious but subtle expressions of needs. On an understanding that the patient has been sexually abused, an individually tailored, patient-centered approach to treatment is suggested. Dental care providers may also need to be aware of and reflect on their position of power, in relation to the patient and its possible chairside implications.

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  • 8.
    Milosavljevic, Aleksandar
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Englander, Magnus
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Götrick, Bengt
    Malmö universitet, Odontologiska fakulteten (OD).
    The lived experience of performing a periodontal treatment in the context of general dentistry2021Ingår i: BDJ Open, E-ISSN 2056-807X, Vol. 7, artikel-id 7Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Aim: To describe what characterises the lived experience of performing a periodontal treatment in the context of general dentistry.

    Materials and methods: Three dental hygienists from general dentistry in Sweden, were purposively selected as participants and interviewed. The participants described a situation in which they had performed a periodontal treatment. The descriptions were analysed using the descriptive phenomenological psychological method.

    Results: The general meaning structure of the lived experience of performing a periodontal treatment comprised five constituents, (a) an established treatment routine, (b) importance of oral hygiene, (c) self-awareness and motivation of the patient, (d) support and doubt, and (e) mechanical infection control. The periodontal treatment is perceived as being set prior to its commencement and as following established routines, in which the patients’ oral hygiene is experienced as a crucial part. The patients’ self-awareness and a supportive clinician are seen as important factors in motivating the patient towards positive behavioural change, although there is a presence of doubt in patients’ ability to maintain this positive change. Mechanical infection control is perceived as successful but sometimes difficult to perform.

    Conclusions: Important, patient-related, factors are constituting the phenomenon of performing a periodontal treatment but an experience that the pre-existing standardised workflow influences patient management was also present.

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  • 9.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS).
    McCarthy, Erin
    University of St Lawrence, USA.
    Priebe, Gisela
    Lunds universitet.
    Dental care: an emotional and physical challenge for the sexually abused2020Ingår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, nr 128, s. 317-324Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to explicate persistent psychological and bodily memories of sexualabuse and how they are expressed during dental appointments. The participantscomprised 13 sexually abused individuals (11 women), who recalled and expressedthese experiences during a dental appointment. They were encouraged to describe,in detail, aspects of the appointment which triggered memories of the sexual abuse.The interviews were recorded, transcribed verbatim, and analyzed using QualitativeContent Analysis. The identified overall theme illustrating the latent content was‘An echo of sexual abuse transformed into (dys) functional reactions’. The first categorycovering the manifest content was ‘The inner invisible struggle’, with two subcategories:(i) mental inscriptions of the abuse experience; and (ii) consequences ofthe dental encounter. The second category was ‘The discoverable manifestations’,with two subcategories: (i) enigmatic communication; and (ii) expressions of bodilymemories. The dental appointment arouses similar psychological stressful reactionsas the episodes of abuse; both implicit and explicit expressions are recognizable.Dental staff can contribute to disclosure by improved understanding of the strain adental appointment can cause in patients who have been subjected to sexual abuseand familiarity with the associated bodily expressions.

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  • 10.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Dragicevic, Mille
    Malmö universitet, Odontologiska fakulteten (OD).
    Fuhrmann, Märta
    Malmö universitet, Odontologiska fakulteten (OD). Public Dental Health Service, Skåne County Council, Malmö, Sweden.
    Alleviation of acute dental pain from localised apical periodontitis: A prospective randomised study comparing two emergency treatment procedures2019Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 46, nr 2, s. 120-126Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare the outcomes of two emergency treatment procedures to alleviate pain from localised symptomatic apical periodontitis: complete chemo‐mechanical disinfection (CMD) of the root canal system, or removal of necrotic tissue from the pulp chamber (RNT), that is without instrumentation of the root canals. Methods: Fifty‐seven consecutive patients from the emergency clinic at Malmö University met the inclusion criteria: spontaneous pain and/or pain on percussion and palpation, non‐bleeding pulp in the canal orifice, pain ≥4 on a Numeric Rating Scale and ≥18 years of age. The diagnosis was symptomatic apical periodontitis, in the absence of swelling and/or fever. Pre‐operative pain levels and intake of analgesics were registered. The patients were randomised to one of the two treatment groups. Three to five days post‐operatively, the patients were contacted by telephone and asked to grade their current pain level and report any post‐operative intake of analgesics and antibiotics. Results: Of the patients treated with CMD of the root canal system, 26/30 (87%) reported satisfactory pain relief, compared with 22/27 (81%) of those treated by RNT. There was no mean difference in pain relief between the two groups (P = 0.879). Post‐operatively, 37% in each group reported using analgesics and one in each group reported using antibiotics. Conclusion: Three to five days after treatment, a majority (>80%) in both groups reported adequate pain relief, in some cases in combination with analgesics. Removal of necrotic and infected tissue from the pulp chamber might therefore be a cost‐effective emergency treatment alternative to complete chemo‐mechanical disinfection.

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  • 11.
    Dawson, Victoria
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö universitet, Odontologiska fakulteten (OD).
    Leonard, Kerstin
    Vidigsson, My
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Coronal Restoration of Root-filled Teeth: General Dental Practitioners' Decision-Making Process2019Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: A better outcome has been shown for teeth restored with laboratory-fabricated crowns. This may not necessarily imply that full crowns are better than direct restorations, as it may be a result of selection bias. The aim was to describe the decision process regarding the choice of coronal restoration on a root-filled tooth from the perspective of the dentist. Methods: A strategic selection of 15 general dental practitioners (GDPs) in Sweden was performed. An absolute inclusion criterion was that the dentist had a recent experience of root canal treatments followed by a decision concerning permanent coronal restoration. The included dentists provided a variation concerning gender, age, work experience, location of undergraduate education and dental service provider. Semi-structured in-depth interviews were conducted with focus on the personal experience of the informant when choosing how to permanently restore the root-filled tooth. The informants were invited to, in their own words, narrate on the two latest occasions when this situation occurred for direct and full crown restorations respectively. The interviews were verbatim transcribed and then analyzed according to Qualitative Content Analysis, to be classified into an overall theme covering the latent content together with categories and subcategories illustrating the manifest content. Results: Preliminary results indicate a pattern, not yet definitely classified, but revealing the GDPs' efforts to take their current theoretical knowledge and clinical experience into consideration in the decision-making process together with an assessment of the residual tooth substance and the patients' oral health conditions. This is done parallel to an evaluation of and with certain emphasis to the patients' economic situation and preferences. Conclusions: The general dental practitioners' decision-making process regarding the choice of coronal restoration on a root-filled tooth was based not only on clinical factors: decisive for the decision was contextual factors comprising a patient centered approach.

  • 12.
    Danesh, Noushin
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Ljunggren, Anna Camilla
    Malmö universitet, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö universitet, Odontologiska fakulteten (OD).
    Development of criteria for investigation of periapical tissue from root-filled teeth.2019Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, nr 4, s. 269-274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To develop and assess a set of criteria to grade inflammation including relative area of inflammation in periapical lesions in endodontically treated teeth. Material and methods: A set of criteria was developed, encompassing data on: Lymphocytes, denoting chronic inflammation, were graded 0 (occasional) to 4 (heavy/dense inflammation). Polymorphonuclear cells, denoting acute inflammation, were graded 0 (none) to 2 (many). The third parameter, area of inflammation, that is, the relative area of the specimen that was inflamed, was graded 0 (none) to 4 (76–100%). The criteria were tested on 199 consecutive biopsies from 180 patients (aged 31–75 years). Information about symptoms was retrieved from the referrals. Mann–Whitney’s U-test was used to calculate possible differences in average values for the histopathological variables in the two groups of patients: symptomatic or asymptomatic. Results: Using the criteria, varying grades of inflammation were seen in the biopsies. The majority showed few or no PMN cells. There was a correlation between symptoms and the extent of infiltration of lymphocytes and plasma cells (p = .001), PMN cells (p < .001) and the area of inflammation (p = .002): biopsies from the asymptomatic patients exhibited less pronounced and relatively smaller areas of inflammation. Conclusions: Using the criteria on a specific selection of root-filled teeth with persisting apical periodontitis, periapical inflammation was common, but varied in extent and severity. The inflammation was less pronounced and affected a relatively smaller area in asymptomatic teeth, although outliers in both directions were identified.

  • 13.
    Mota de Almeida, Fernando José
    et al.
    Tandvårdens Kompetenscentrum, Luleå, Sweden.
    Flygare, Lennart
    Department of Radiation Sciences, Umeå University, Umeå, Sweden.
    Knutsson, Kerstin
    Malmö universitet, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö universitet, Odontologiska fakulteten (OD).
    'Seeing is believing': a qualitative approach to studying the use of cone beam computed tomography in endodontics in Sweden.2019Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 52, nr 10, s. 1519-1528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To gain insight into the decision processes of dentists when requesting a cone beam computed tomography (CBCT) examination in endodontic settings. Methodology: Fourteen dentists (eight female) 33–58 years of age (mean = 44) practising in Sweden were interviewed. Ten of the dentists were specialists in Endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists comprised a strategically selected diverse sample in terms of gender, age, work experience, educational background, location of practice, service affiliation and accessibility to CBCT. Data were obtained through semistructured interviews exposing the context of their last three self‐reported referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer's open‐ended questions. The interviews were audio‐recorded and transcribed verbatim. The text was analysed by qualitative content analysis. Results: The manifest content was organized into three categories that were defined as visualization as a desire, facilitating tough decisions and allocating responsibility. Conclusion: An overall theme (covering the latent content) was identified: A balance between clinical common sense and a ‘better safe than sorry’ attitude guides the use of CBCT in endodontic settings. Informants had high clinical standards, knowledge concerning radiation risks and good sense, which could compensate for their lack of knowledge of guidelines. The national radiation regulatory system was perceived to work as a slightly porous gatekeeper for over‐usage.

  • 14.
    Wolf, Eva
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Centrum för sexologi och sexualitetsstudier (CSS).
    Priebe, Gisela
    Sexual Abuse Experiences and Dental Care Visits - Challenging!2019Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: Victims of sexual abuse are more likely to experience dental fear as well as to suffer from an impaired oral health. Objective. To explicate and describe the persistent psychological and bodily memories of sexual abuse and how it is expressed during the visit to the dentist. Methods: Thirteen participants (11 women) who experienced sexual abuse as children or adults and in whom the abuse experiences were remembered and expressed during a dental appointment, were interviewed. The informants were encouraged to tell in their own words and in as much detail as possible about situations at the dental appointment when they were reminded of the sexual abuse experiences. To provide for as much empirical variation of the participants, some strategic selection criteria were applied; sex, age and class. The interviews were recorded digitally and transcribed verbatim. The collected material was analyzed according to Qualitative Content Analysis. Results: A pattern in the subjects’ experiences was identified and classified into the following theme and categories. The overall theme illustrating the latent content was An echo of sexual abuse transformed into (dys) functional reactions. The first main category covering the manifest content was The inner invisible struggle with two subcategories: (i) the abuse experience mental inscriptions and (ii) the consequences of the dental encounter. The second category was The discernible manifestations with two subcategories: (i) the enigmatic communication and (ii) the bodily expressions. Conclusions: During dental care the same reactions and negative emotions may arise as during abuse occasions. In the context of the abuse these are adequate defense responses, but in the dental clinic they are in a strict sense not adequate. The dental care situation contains both implicit and explicit expressions that are recognizable for dental staff. With knowledge of the pattern and expressions, dental care can provide better treatment and care.

  • 15. Mota de Almeida, Fernando José
    et al.
    Flygare, Lennart
    Knutsson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Circumstances behind the use of Cone Beam Computed Tomography for endodontic reasons in Sweden from the perspective of the referring dentist2017Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 50, nr S1, artikel-id R007Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Aim: To study the circumstances preceding the CBCT examination referral for endodontic reasons in Sweden. Methodology: Fourteen dentists (8 female) 33–58 years of age (mean =44), practicing in Sweden were strategically selected. Ten of the dentists were specialists in endodontics. The absolute inclusion criterion was experience of referring patients for CBCT for endodontic reasons. The included dentists provided a variation concerning gender, age, work experience, education background, location of practice, service affiliation and accessibility to CBCT. Data was obtained through thematic, semi-structured interviews exposing the context of their last self-reported three referrals. Dentists were encouraged to describe their experiences of the circumstances in their own words, aided by the interviewer’s openended questions. The interviews were audio recorded and transcribed verbatim. Qualitative content analysis was used to analyze the text. Results: The preliminary results may indicate that high clinical diagnostic standards, clinical common sense and a willingness of helping the patient with minimal harm may restrict the use of CBCT to address complex diagnostic judgements or therapeutic decisions, which comply with existing European guidelines on the use of CBCT in endodontics. Knowledge of guidelines was however limited among the interviewed dentists. Conclusions: Common sense and high professional standards seem to lead dentists in Sweden to comply with current European guidelines for the use of CBCT in endodontics even when the den tists lack knowledge of the guidelines. Acknowledgements: This work is funded by the Norrbotten County Council.

  • 16.
    Granevik Lindström, Maria
    et al.
    Department of Endodontics, Specialist Clinic Kaniken, Public Dental Health Service, Uppsala, Sweden.
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö högskola, Odontologiska fakulteten (OD).
    The Antibacterial Effect of Nd:YAG Laser Treatment of Teeth with Apical Periodontitis: A Randomized Controlled Trial2017Ingår i: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 43, nr 6, s. 857-863Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: The aim of this blind, in vivo, randomized controlled trial was to evaluate the antibacterial effect of Nd:YAG laser irradiation in endodontic treatment of single-rooted teeth with apical periodontitis. The hypothesis was that mechanical enlargement of the root canal and Nd:YAG laser irradiation would yield more negative bacterial samples than conventional treatment. METHODS: Forty-one patients (45 teeth) were allocated to the laser (n = 22) or control (n = 23) group. The teeth in the laser group were instrumented, irrigated with saline, and irradiated with Nd:YAG laser according to a standard protocol. The teeth in the control group were similarly instrumented but irrigated with 1% unbuffered sodium hypochlorite and 15% EDTA solution. Bacterial samples were taken before and after treatment, blinded, and immediately sent for culturing and analysis. RESULTS: The initial bacterial samples were positive in 20 of 22 teeth in the laser group and 18 of 23 (P = .414) in the control group. After the initial treatment, negative bacterial samples were found in 11 teeth in the laser group and 13 (P = .768) in the control group. After 2 to 4 days with no antibacterial dressing in the root canals, 5 teeth in the laser group and 9 (P = .337) in the control group yielded negative bacterial samples. CONCLUSIONS: After intervention, neither the test group nor the control group yielded predictable negative bacterial samples. Thus, the results failed to verify the hypothesis that Nd:YAG laser irradiation would yield significantly more negative bacterial samples than conventional irrigation with 1% unbuffered sodium hypochlorite solution.

  • 17.
    Fransson, Helena
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Formation of a hard tissue barrier after experimental pulp capping or partial pulpotomy in humans: an updated systematic review2016Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 49, s. 533-542Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The aim was to update a systematic review of pulp capping and partial pulpotomy by Olsson et al. (2006), by evaluating new evidence on formation of a hard tissue barrier after pulp capping and partial pulpotomy of experimental exposures in humans. PubMed (01-01-2005 to 01-03-2014) and CENTRAL were searched using specific keywords. Hand searches were made and the level of evidence for each included article was evaluated by the authors. The evidence of the conclusions was graded as strong, moderately strong, limited or insufficient. The initial search in PubMed yielded 215 abstracts. Hand searches of reference lists yielded no additional original scientific articles. After a selection process and interpretation, 22 articles were included and rated for level of evidence: no article was rated as high and seven as moderate. Overall the methodological quality of studies has improved since the previous systematic review was published in 2006. The conclusions are that there is limited scientific evidence that application of calcium hydroxide or mineral trioxide aggregate to an exposed pulp frequently results in formation of a hard tissue barrier, whereas adhesives or enamel matrix derivatives do not. There is insufficient scientific evidence that mineral trioxide aggregate promotes hard tissue formation more frequently than calcium hydroxide.

  • 18.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Non-specific chronic orofacial pain patients' experiences of everyday life situations: a qualitative study2016Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, nr 2, s. 213-222Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Kronisk ansiktssmärta är ett komplext tillstånd med konsekvenser som påverkar hela livssituationen. Syftet med studien var att med ett kvalitativt angreppssätt analysera upplevelsen av vardagssituationer för patienter med svårförklarlig kronisk ansiktssmärta. Elva kvinnor och tre män (21 till 77 år) valdes strategiskt ut bland de patienter med kronisk ansiktssmärta som remitterats till Orofaciala smärtenheten vid Odontologiska fakulteten, Malmö högskola, Malmö, Sverige. Samtliga utvalda informanter accepterade att delta. Data samlades in genom två tematiska djupintervjuer med varje informant. Intervjuerna spelades in med en digital ljudupptagare och skrevs ut ordagrant. Den text som berörde vardagssituationer identifierades i samtliga intervjuer och analyserades med kvalitativ innehållsanalys. Analysen av informanternas berättelser om vardagssituationer avslöjade en rädsla för konflikter, för den egna svagheten och för det okända. Analysen avslöjade också att informanterna uttryckte självanklagelser och att de undvek situationer som kunde orsaka rädsla. Åtta av de 14 informanterna nämnde inte någon vardagssituation de kände sig tillfreds med. Informanternas upplevelser av vardagssituationer dominerades av negativa känslor. Sammanfattningsvis kan kronisk långvarig svårförklarad ansiktssmärta inte förstås som ett isolerat fenomen utan måste beaktas i relation till den individ som drabbats av tillståndet.

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  • 19.
    Dawson, Victoria
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Åkerman, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Periapical status of root-filled teeth restored with composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population2016Ingår i: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 42, nr 9, s. 1326-1333Artikel i tidskrift (Refereegranskat)
    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.

  • 20.
    Korduner, Eva-Karin
    et al.
    Malmö högskola, Odontologiska fakulteten (OD). Department of Prosthetic Dentistry, Public Dental Health Service, Malmö, Sweden.
    Collin Bagewitz, I.
    Department of Prosthetic Dentistry, Public Dental Health Service, Karlskrona, Sweden.
    Von Steyern, Per Vult
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Prosthodontic decision-making relating to dentitions with compromised molars: the perspective of Swedish General Dental Practitioners2016Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, nr 12, s. 967-976Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this investigation was to study the clinical prosthodontic decision-making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in-depth, semi-structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients' needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision-making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues' or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision-making more than the SDA concept. The conflicting results in the prosthetic decision-making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentists own clinical practice.

  • 21.
    Gyllensvärd, K.
    et al.
    Public Dental Health Service, Jönköping, Sweden.
    Qvarnström, M.
    Private Practice, Helsingborg, Sweden.
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    The dentist's care-taking perspective of dental fear patients: a continuous and changing challenge2016Ingår i: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 43, nr 8, s. 598-607Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to analyse the care taking of dental fear patients from the perspective of the dentist, using a qualitative methodology. In total, 11 dentists from both the private and public dental service were selected through a purposive sampling according to their experience of treating dental fear patients, their gender, age, service affiliation and location of undergraduate education. Data were obtained using one semi-structured interview with each informant. The interviews were taped and verbatim transcribed. The text was analysed using qualitative content analysis. The theme, 'The transforming autodidactic process of care taking', covering the interpretative level of data content was identified. The first main category covering the descriptive level of data was 'The continuous and changing challenge', with the subcategories 'The emotional demand' and 'The financial stress'. The second main category identified was 'The repeated collection of experience', with the subcategories 'The development of resources' and 'The emotional change'. The dentists' experience of treating dental fear patients was considered a challenging self-taught process under continuous transformation. The competence and routine platform expanded over time, parallel to a change of connected emotions from frustration towards safety, although challenges remained.

  • 22.
    Korduner, Eva-Karin
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Söderfeldt, Björn
    Malmö högskola, Odontologiska fakulteten (OD).
    Bagewitz, Ingrid Collin
    Publ Dent Hlth Serv, Dept Prosthet Dent, Karlskrona, Sweden.
    Von Steyern, Per Vult
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    The Shortened Dental Arch concept from the perspective of Swedish General Dental Practitioners: a qualitative study2016Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to study the cognizance of and attitudes towards the Shortened Dental Arch (SDA) concept among Swedish General Dental Practitioners (GDPs) and the application of the SDA concept in their treatment planning using Qualitative Content Analysis. Eleven Swedish GDPs were purposively selected and all agreed to participate. In-depth semi-structured interviews were conducted and covered treatment considerations concerning two patient cases and the participants' reflections regarding pre-formulated statements about the SDA concept. Qualitative content analysis was used to analyze this data. The emerging theme was "the SDA concept is irrelevant" in the sense of the GDPs disregarding treatments providing dentitions with loss of posterior teeth. There was a strong reluctance to extract teeth, without consideration of the SDA concept, and a firmly patient-focused attitude towards the needs, age and financial situation of the patients. Within the limitations of this study, Swedish GDPs show little or no cognizance of the SDA concept and it does not seem to be applied in their treatment planning. The results show that the qualitative methodology can be beneficial for further understanding of cognizance and attitudes towards the SDA concept

  • 23.
    Petersson, Kerstin
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Håkansson, Jan
    Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden.
    Twenty-year follow-up of root filled teeth in a Swedish population receiving high-cost dental care2016Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 49, nr 7, s. 636-645Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To study the 20-year survival rate and periapical status of root filled teeth in a Swedish population requiring high-cost dental care and to identify factors related to survival and normal periapical status at follow-up. METHODOLOGY: The study population comprised 104 patients selected from four local health insurance districts with treatment plans including radiographs submitted for approval for reimbursement from the Swedish National Dental Insurance in 1977. In 1998, a clinical and radiographic follow-up examination was conducted, to register the status of 449 teeth identified as root filled at baseline. Differences in tooth survival and periapical status at follow-up, with reference to periapical status and quality of root filling at baseline, were analysed by chi-square tests. Multiple regression analysis was used to describe tooth survival and normal periapical status at follow-up, with the explanatory baseline variables: tooth type, type of restoration, type of post, quality of root filling, periapical status, marginal bone loss and caries. Differences were considered significant at a 5% level. RESULTS: Two hundred and ninety (65%) of the root filled teeth survived at follow-up. Baseline variables associated with low odds for tooth survival were mandibular molar, maxillary premolar, prefabricated posts other than screw posts, severe marginal bone loss, caries and apical periodontitis (AP). Normal periapical status at follow-up was registered in 49% of the root filled teeth. Baseline variables associated with low odds for normal periapical status (high risk for AP) at follow-up were mandibular molar, maxillary premolar, AP, severe marginal bone loss and inadequate root filling quality. Of the root filled teeth with AP at baseline, 42% had been left untreated during the observation period, and at follow-up, the AP persisted in 57% of these teeth. CONCLUSIONS: After 20 years, 65% of the root filled teeth had survived and one-third remained with a sound periapical condition, without any further treatment. Almost half of the APs registered at baseline were left without treatment, and more than half of them persisted after 20 years.

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  • 24.
    Koch, Margaretha
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Tegelberg, Åke
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice2015Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 48, nr 7, s. 680-689Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim To compare the technical quality and long-term outcomes of root canal treatment by general practitioners of a Swedish Public Dental Service, before and after an endodontic education including Ni-Ti rotary technique (NiTiR). Methodology A random sample was compiled, comprising one root filled tooth from each of 830 patients, treated by 69 general practitioners participating in the education: 414 teeth root filled in 2002, pre-education, using primarily stainless steel instrumentation and filling by lateral compaction, and 416 teeth root filled post-education (2005), using mainly NiTiR and single-cone obturation. Follow-up radiographs taken in 2009 were evaluated alongside immediate post-filling radiographs from 2002 to 2005. The density and length of the root fillings were registered. Periapical status was assessed by the Periapical Index (PAI), using two definitions of disease: apical periodontitis (AP) (PAI 3 + 4 + 5) and definite AP (PAI 4 + 5). Tooth survival was registered. Root fillings pre- and post-education were compared using chi-square and Fisher's exact tests. Crude extraction rates per 100 years were calculated for comparison of tooth survival. Explanatory variables (type of tooth, root filling quality, periapical status, marginal bone loss, type and quality of coronal restoration) in relation to the dependent variable (AP at follow-up) were analysed by multivariable logistic regression. Results Follow-up data were available for 229 (55%) of teeth treated pre-and 288 (69%) treated post-education: both tooth survival (P < 0.001) and root filling quality were significantly higher (P < 0.001) in the latter. However, there was no corresponding improvement in periapical status. Both preand post-education, root fillings with definite AP on completion of treatment had significantly higher odds of AP or definite AP at follow-up. For teeth treated post-education, inadequate root filling quality was significantly associated with AP at follow-up. Conclusions Despite a higher tooth survival rate and a significant improvement in technical quality of root fillings after the education, there was no corresponding improvement in periapical status.

  • 25.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Pigg, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Fransson, Helena
    Malmö högskola, Odontologiska fakulteten (OD).
    Jonasson, Peter
    Antibiotikabehandling vid endodontiska infektioner2014Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 106, nr 4, s. 76-78Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Enligt aktuella nationella riktlinjer (Socialstyrelsen 2012) bör tandvården i första hand erbjuda antibiotikabehandling endast till personer med symtom på grund av apikal parodontit, där infeltionen kring rotspetsen visar på spridning och där personens allmäntillstånd är påverkat. Vid symtomatisk tand då infektionen inte tillfredsställande kan avlägsnas, till exempel då patienten inte kan gapa eller då rotkanalen inte är tillgänglig för infektionsbehandling kan sys- temisk antibiotika ordineras i avvaktan på att endodontisk behandling eller extraktion är möj- lig. Syftet med förskrivningen är då att begränsa spridning av befintlig infektion eller hindra progression av sjukdomen. När allmäntillståndet är påverkat är antibiotikabehandling indicerad eftersom detta är ett tecken på infektionsspridning. För exartikulerade och replanterade permanenta tänder har systemisk antibiotikabehandling tidigare rekommenderats, för att eventuellt underlätta den parodontala läkningen och minska risken för rotresorption. I en senare systematisk översikt har man inte kunnat påvisa några entydiga positiva effekter av detta. Utöver detta rekommenderas lokal antibiotikabehandling av roten före replantering av tand med oavslutad rotutveckling för att öka chanserna för revaskularisering.

  • 26.
    Dawson, Victoria
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Åkerman, Sigvard
    Malmö högskola, Odontologiska fakulteten (OD).
    Periapical status of non-root-filled teeth with resin composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population2014Ingår i: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 40, nr 9, s. 1303-1308Artikel i tidskrift (Refereegranskat)
    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.

  • 27.
    Koch, Margaretha
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Englander, Magnus
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för socialt arbete (SA).
    Tegelberg, Åke
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Successful clinical and organisational change in endodontic practice: a qualitative study2014Ingår i: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579, Vol. 18, nr 3, s. 121-127Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process.

  • 28.
    Fransson, Helena
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Larsson, Kerstin
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Efficacy of lasers as an adjunct to chemo-mechanical disinfection of infected root canals: a systematic review2013Ingår i: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 46, nr 4, s. 296-307Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to evaluate the efficacy of various types of lasers used as an adjunct to chemo-mechanical disinfection of infected root canals with the outcome measures 'normal periapical condition' or 'reduction of microbial load'. PubMed, CENTRAL and ISI Web of Knowledge literature searches with specific indexing terms and a subsequent hand search were made with stated limits and criteria. Relevant publications were retrieved, followed by interpretation. The quality of each included publication was assessed as high, moderate or low. The initial search process yielded 234 publications. All abstracts of these publications were read, and the reference lists of relevant publications were hand-searched. Ten articles were read in full text and interpreted according to a data extraction form. Five were included in the systematic review and were assessed. A meta-analysis was impossible to perform because the included studies were heterogeneous with regard to study design, treatment and outcome measures. Positive effects were reported; however, no concluding evidence grade could be made because each included study was judged to have low quality, primarily due to lack of a power analysis, blinding and reproducibility. The evidence grade for whether lasers can be recommended as an adjunct to chemo-mechanical disinfection of infected root canals was insufficient. This does not necessarily imply that laser should not be used as an adjunct to root canal treatment but instead underscores the need for future high-quality studies.

  • 29.
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Lyssnande möten i tandvården2012Ingår i: Hälsofrämjande möten: från barnhälsovård till palliativ vård / [ed] Anna Hertting, Margareta Kristenson, Studentlitteratur AB, 2012, s. 129-136Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 30.
    Bondemark, Lars
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    List, Thomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Ekberg, EwaCarin
    Malmö högskola, Odontologiska fakulteten (OD).
    Eriksson, Lars
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Arne
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Tegelberg, Åke
    Malmö högskola, Odontologiska fakulteten (OD).
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Funktionsstörningar och smärta2008Ingår i: Tandläkartidningen, ISSN 0039-6982, Vol. 100, nr 9-10, s. 64-68Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Orofaciala funktionsstörningar och smärta är en sammanfattning av kliniska problem och sjukdomar som involverar bett, käkar, tuggmuskulatur, käkleder och omgivande strukturer. Orsakerna är oftast multifaktoriella för de barn, ungdomar och vuxna som drabbas.

  • 31.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Birgerstam, Pirjo
    Institution of Psychology, Lund University, Lund, Sweden.
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Nonspecific chronic orofacial pain: Studying patient experiences and perspectives with a qualitative approach2008Ingår i: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 22, nr 4, s. 349-358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To analyze the nonspecific chronic orofacial pain patient’s experience of the pain condition and to gain knowledge on the complexity of the problem. Methods: Fourteen patients (11 female, 3 male) aged 21–77 years were selected among those referred to a specialist clinic. All selected patients agreed to participate. Data were obtained through thematic in-depth interviews that exposed the context of the orofacial pain condition. The 2 interviews with each patient were audiotaped and transcribed verbatim. The text material was analyzed using a qualitative research strategy based on phenomenology. Results: The essence of the chronic orofacial pain was expressed by the patients as something that eludes perception and comprehension. The pain was difficult to grasp and to communicate. The consequence of the pain was experienced by the patients as to be stricken by the pain and was expressed as living a life permeated by hopelessness, resignation, and a lack of faith. Conclusion: The patients in this study experienced their chronic orofacial pain to have no limits and to repressively permeate all aspects of their existence: social, practical, and emotional.

  • 32.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Birgerstam, P
    The non-specific chronic orofacial pain patients´attitude to every-day life. A phenomenological study2007Konferensbidrag (Refereegranskat)
  • 33.
    Wolf, Eva
    Malmö högskola, Odontologiska fakulteten (OD).
    Chronic orofacial pain. Understanding patients from two perspectives: the clinical view and the patient's experience2006Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Det övergripande syftet har varit att studera patienter med långvarig ansiktssmärta dels från ett kliniskt perspektiv och dels från patientens perspektiv. Samtliga patienter som ingått i studierna var remitterade till Tandvårdshögskolan i Malmö pga långvarig ansiktssmärta. Det kliniska perspektivet erhölls genom en retrospektiv studie av 109 patienter (85 kvinnor, 24 män) som blivit undersökta i en smärtgrupp. Därvid studerades parametrar som diagnos, smärtkarakteristika, medicinering och utbildning. Uppmärksamhet riktades mot skillnader och likheter mellan kvinnor och män avseende de parametrar som studerats. En uppföljning av patienternas smärttillstånd gjordes 4-9 år efter den ursprungliga undersökningen. För att få patienternas perspektiv intervjuades fjorton patienter (11 kvinnor, 3 män) om sina personliga upplevelser av att leva med långvarig ansiktssmärta. Varje patient intervjuades vid två tillfällen under ca 1-1.5 timme. Nedan listas fynden från de kliniska studierna och intervjustudierna. Upplevelserna som de intervjuade patienterna förmedlade innebar ett annat perspektiv på flera av fynden från de kliniska studierna. - Kvinnorna var i majoritet bland de patienter som ingick i studierna. När kvinnor och män jämfördes registrerades fler likheter än olikheter för de parametrar som studerades. -Patienterna hade en lägre utbildningsnivå än svenska invånare av samma ålder. -En majoritet av patienterna som studerades kliniskt rapporterade ett upprepat vårdsökande med anledning av smärtan. De intervjuade patienterna upplevde misstro och avfärdande vid sina vårdbesök. De upplevde också smärtan som svårgripbar och svår att kommunicera. -En majoritet av patienterna som studerades kliniskt hade kvarstående smärta vid uppföljningen. De intervjuade patienterna uttryckte ett behov av att bli omhändertagna och hade ofta en begränsad förmåga att hantera smärtan konstruktivt. -De patienter som studerades kliniskt och medicinerade med centralt verkande läkemedel (sömnmedel, antidepressiva, lugnande eller starka smärtstillande tabletter) hade en risk för kvarstående smärta vid uppföljningen. De intervjuade patienterna förmedlade känslor av hopplöshet och hade en pessimistisk syn på framtiden. Att studera patienter med långvarig ansiktssmärta både från ett kliniskt perspektiv och från patientens eget perspektiv innebar en ökad förståelse för att långvarig ansiktssmärta är ett komplext tillstånd som påverkar patientens hela livssituation. Patienterna söker ofta tandvård pga sin ansiktssmärta. Det är därför angeläget att inom tandvården utveckla konstruktiva strategier för omhändertagandet, särskilt när sjukdomstillstånd i munhålan och angränsande vävnader är adekvat diagnostiserade och behandlade men patienten fortfarande har ont.

  • 34.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Birgerstam, Pirjo
    Institution of Psychology, Lund University, Lund, Sweden.
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Patients' experiences of consultations for nonspecific chronic orofacial pain: A phenomenological study2006Ingår i: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 20, nr 3, s. 226-233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To use a qualitative research study to analyze the experiences of patients with nonspecific chronic orofacial pain with respect to consultations for their pain condition. Methods: Fourteen patients (11 women and 3 men; age range, 21 to 77 years) were strategically selected through a purposive sampling of the chronic orofacial pain patients referred to the Orofacial Pain Unit at the Faculty of Odontology, Malmö University, Malmö, Sweden. A qualitative research strategy, based on phenomenological philosophy was chosen. Thematic in-depth interviews were conducted twice with each patient in order to expose the context of the orofacial pain condition. The interviews were audiotaped and transcribed verbatim. The text material was analyzed to determine the attitude of the patients concerning their experience from the consultations. Results: All selected patients consented to participate. The patients expressed dissatisfaction with the consultations and related many examples of poor communication and understanding. The patients also felt a great need to be taken care of and expressed contradictory statements concerning pain improvement. Conclusion: The results suggest that the communication between the patients and the care providers was unsatisfactory and that the patients were limited in their ability to develop a personal coping strategy.

  • 35.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, Maria
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Arne
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, Kerstin
    Malmö högskola, Odontologiska fakulteten (OD).
    Long-term follow-up by means of a questionnaire of 109 patients with long-lasting orofacial pain.2002Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 26, nr 3, s. 125-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims were to follow-up, analyse and compare the pain status after 4-9 years with that at the baseline examination of 109 consecutive patients referred to the Pain Group at the Faculty of Odontology in Malmö, Sweden during the period 1988-1993 due to long-lasting orofacial pain. A further aim was to identify predictive factors of significance for pain alteration. 85 (78%) women with a median age of 51 years and 24 (22%) men with a median age of 60 years were included in the study. A survey of the pain status at the follow-up was conducted by means of a mailed questionnaire. The questionnaire covered the following aspects: pain alteration, pain intensity, pain location, medication and education. After one reminder, the non-responding patients were called for a telephone interview. A response level of 85% was obtained. Significant improvements were noted by the patients in the answers of the questionnaire in mainly three areas; the patients answered individually that pain relief had occurred, pain intensity rated on the VAS was lower at follow-up compared to the baseline examination and a decrease in drug use was reported. The responses indicated pain relief for 75% of the patients. However, only 27% of the patients experienced total disappearance of pain. Medication at baseline with opioids, muscle relaxants with central effect, antidepressants, neuroleptics, hypnotics or sedatives was found to be a predictive factor for persistent pain.

  • 36.
    Wolf, Eva
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, K
    Malmö högskola, Odontologiska fakulteten (OD).
    Petersson, A
    Malmö högskola, Odontologiska fakulteten (OD).
    Nilner, M
    Malmö högskola, Odontologiska fakulteten (OD).
    Long-lasting orofacial pain: a study of 109 consecutive patients referred to a pain group2001Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 25, nr 3, s. 129-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to register and evaluate the orofacial pain condition, with special focus on the equalities/inequalities between the sexes, in consecutive patients referred to the pain group at the Centre for Oral Health Sciences in Malmö, Sweden. The 109 patients, 85 (78%) women and 24 (22%) men, were referred to the pain group during the years 1988 to 1993 and were clinically examined using a standardised procedure. Pain duration of one year or more was experienced by 83% of the patients. The pain onset was related to dental care or toothache by 56% of the patients. Temporomandibular disorders were the most common diagnoses (52%) and were more common among women than among men (p < 0.05). Multiple pain locations were frequently reported, range 1-47 locations, and the women had significantly (p < 0.05) more pain locations than the men. Equalities between the sexes were more frequent than inequalities among patients referred for long-lasting orofacial pain. It can be discussed whether the sex difference in the prevalence of pain of musculoskeletal origin emerges from biological differences or can be explained by different psychosocial circumstances.

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