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  • 1.
    Hongxing, L.
    et al.
    Department of Clinical Dentistry - Prosthodontics, University of Bergen, Bergen, Norway.
    Astrøm, A. N.
    Department of Clinical Dentistry - Community Dentistry, University of Bergen, Bergen, Norway.
    List, T.
    Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Nilsson, Ing-Marie
    Region Östergötland, Public Dental Health Care.
    Johansson, A.
    Department of Clinical Dentistry - Prosthodontics, University of Bergen, Bergen, Norway.
    Prevalence of temporomandibular disorder pain in Chinese adolescents compared to an age-matched Swedish population.2016In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, no 4, p. 241-8Article in journal (Refereed)
    Abstract [en]

    This study aimed to (i) assess the prevalence and perceived need for treatment of TMD pain, and its association with socio-economic factors and gender, in adolescents in Xi᾽an, Shaanxi Province, China, and (ii) compare the prevalence and association with gender of TMD pain in Xi᾽an to an age-matched Swedish population. We surveyed Chinese adolescents aged 15 to 19 years in Xi'an, China (n = 5524), using a questionnaire with two-stage stratified sampling and the school as the sampling unit. The study included second-year students at selected high schools. It also included an age-matched Swedish population (n = 17,015) surveyed using the same diagnostic criteria for TMD pain as that used in the Chinese sample. The survey found TMD pain in 14·8% (n = 817) of the Chinese sample and 5·1% (n = 871) of the Swedish sample (P < 0·0001). Girls had significantly more TMD pain than boys in both the Chinese (P < 0·05) and Swedish (P < 0·001) samples. TMD pain increased with age in the Chinese population. Of the Chinese adolescents with TMD pain, 47% reported that they felt a need for treatment. Rural schools, low paternal education levels, poverty, living outside the home, poor general and oral health, and dissatisfaction with teeth all showed significant positive correlations with TMD pain. Prevalence of TMD pain in Chinese adolescents was significantly higher than in the Swedish sample.

  • 2.
    Häggman-Henrikson, B.
    et al.
    Malmö University, Sweden; Umeå University, Sweden; Malmö University, Sweden.
    Alstergren, P.
    Malmö University, Sweden; SCON, Sweden; Skåne University Hospital, Sweden.
    Davidson, Thomas
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Malmö University, Sweden.
    Hogestatt, E. D.
    Lund University, Sweden.
    Ostlund, P.
    Umeå University, Sweden; Swedish Agency Health Technology Assessment and Assessment, Sweden.
    Tranaeus, S.
    Umeå University, Sweden; Swedish Agency Health Technology Assessment and Assessment, Sweden.
    Vitols, S.
    Swedish Agency Health Technology Assessment and Assessment, Sweden; Karolinska Institute, Sweden.
    List, T.
    Malmö University, Sweden; SCON, Sweden; Skåne University Hospital, Sweden.
    Pharmacological treatment of oro-facial pain - health technology assessment including a systematic review with network meta-analysis2017In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, no 10, p. 800-826Article, review/survey (Refereed)
    Abstract [en]

    This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients amp;gt;= 18 years with chronic (amp;gt;= 3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [ temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

  • 3.
    John, M. T.
    et al.
    University of Minnesota, USA.
    Feuerstahler, L.
    University of Minnesota, USA.
    Waller, N.
    University of Minnesota, MN 55455 USA.
    Baba, K.
    Showa University, Japan.
    Larsson, Pernilla
    Centre of Oral Rehabilitation, Prosthetic Dentistry,Norrköping .
    Celebic, A.
    University of Zagreb, Croatia.
    Kende, D.
    University of Pecs, Hungary.
    Rener-Sitar, K.
    University of Ljubljana, Slovenia.
    Reissmann, D. R.
    University of Medical Centre Hamburg Eppendorf, Germany.
    Confirmatory factor analysis of the Oral Health Impact Profile2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 9, p. 644-652Article in journal (Refereed)
    Abstract [en]

    Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the projects Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model and a bifactor model that included one general factor and four group factors. Using model-fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0.05, CFI = 0.99) and interpretability. These results corroborate our previous findings that four highly correlated factors - which we have named Oral Function, Orofacial Pain, Oro-facial Appearance and Psychosocial Impact - can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score.

  • 4.
    John, M. T.
    et al.
    University of Minnesota, USA.
    Reissmann, D. R.
    University of Medical Centre Hamburg Eppendorf, Germany.
    Feuerstahler, L.
    University of Minnesota, USA.
    Waller, N.
    University of Minnesota, USA.
    Baba, K.
    Showa University, Japan.
    Larsson, Pernilla
    Centre of Oral Rehabilitation, Prosthetic Dentistry,Norrköping.
    Celebic, A.
    University of Zagreb, Croatia.
    Szabo, G.
    University of Pecs, Hungary.
    Rener-Sitar, K.
    University of Ljubljana, Slovenia.
    Exploratory factor analysis of the Oral Health Impact Profile2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 9, p. 635-643Article in journal (Refereed)
    Abstract [en]

    Although oral health-related quality of life (OHRQoL) as measured by the Oral Health Impact Profile (OHIP) is thought to be multidimensional, the nature of these dimensions is not known. The aim of this report was to explore the dimensionality of the OHIP using the Dimensions of OHRQoL (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the projects Learning Sample (n = 5173), we conducted an exploratory factor analysis on the 46 OHIP items not specifically referring to dentures for 5146 subjects with sufficiently complete data. The first eigenvalue (27.0) of the polychoric correlation matrix was more than ten times larger than the second eigenvalue (2.6), suggesting the presence of a dominant, higher-order general factor. Follow-up analyses with Horns parallel analysis revealed a viable second-order, four-factor solution. An oblique rotation of this solution revealed four highly correlated factors that we named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact. These four dimensions and the strong general factor are two viable hypotheses for the factor structure of the OHIP.

  • 5.
    John, M. T.
    et al.
    Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA.
    Rener-Sitar, K.
    Department of Prosthodontics, University of Ljubljana, Ljubljana, Slovenia.
    Baba, K.
    Department of Prosthodontics, Showa University, Tokyo, Japan.
    Čelebić, A.
    Department of Prosthodontics, University of Zagreb, Zagreb, Croatia.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care.
    Szabo, G.
    Department of Prosthodontics, University of Pécs, Pécs, Hungary.
    Norton, W. E.
    epartment of Health Behavior, University of Alabama, Birmingham, AL, USA.
    Reissmann, D. R.
    Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Patterns of impaired oral health-related quality of life dimensions.2016In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, no 7, p. 519-27Article in journal (Refereed)
    Abstract [en]

    How dental patients are affected by oral conditions can be described with the concept of oral health-related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional, and Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions influence the individual. By determining which patterns of impact on OHRQoL dimensions exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions' functional, painful, aesthetical and psychosocial impact occurs. Data came from the Dimensions of OHRQoL Project with Oral Health Impact Profile (OHIP)-49 data from 6349 general population subjects and 2999 prosthodontic patients in the Learning Sample (N = 5173) and the Validation Sample (N = 5022). We hypothesised that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. In a four-dimensional OHRQoL model consisting Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact, oral conditions' impact can occur in any combination of the OHRQoL dimensions.

  • 6.
    Larsson, Pernilla
    et al.
    Department for Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    John, M. T.
    Division of Epidemiology and Community Health, Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Hakeberg, M.
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg,.
    Nilner, K.
    Department of Oral Prosthetics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    List, T.
    Department for Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    General population norms of the Swedish short forms of Oral Health Impact Profile2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 4, p. 275-281Article in journal (Refereed)
    Abstract [en]

    We reported the development and psychometric evaluation of a Swedish 14-item and a five-item short form of the Oral Health Impact Profile. The 14-item version was derived from the English-language short form developed by Slade in1997. The five-item version was derived from the German-language short form developed by John etal. in 2006. Validity, reliability and normative values for the two short form summary scores were determined in a random sample of the adult Swedish population (response rate: 46%, N=1366 subjects). Subjects with sufficient OHRQoL information to calculate a summary score (N=1309) were on average 50 center dot 1 +/- 17 center dot 4years old, and 54% were women. Short form summary scores correlated highly with the 49-item OHIP-S (r greater than= 0 center dot 97 for OHIP-S14, r greater than= 0 center dot 92 for OHIP-S5) and with self-report of oral health (r greater than= 0 center dot 41). Reliability, measured with Cronbachs alpha (0 center dot 91 for OHIP-S14, 0 center dot 77 for OHIP-S5), was sufficient. In the general population, 50% of the subjects had greater than= 2 OHIP-S14 score points and 10% had greater than= 11 points, respectively. Among subjects with their own teeth only and/or fixed dental prostheses and with partial removable dental prostheses, 50% of the population had greater than= 2 OHIP-S14 score points, and 10% had greater than= 11 points. For subjects with complete dentures, the corresponding figures were 3 and 24 points. OHIP-S5 medians for subjects in the three population groups were 1, 1 and 2 points. Swedish 14-item and 5-item short forms of the OHIP have sufficient psychometric properties and provide a detailed overview about impaired OHRQoL in Sweden. The norms will serve as reference values for future studies.

  • 7.
    Larsson, Pernilla
    et al.
    Department of Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    John, M. T.
    Division of Epidemiology and Community Health and Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Nilner, K.
    Department of Prosthetic Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
    List, T.
    Division of Epidemiology and Community Health and Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Normative values for the oro-facial Esthetic Scale in Sweden2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 2, p. 148-154Article in journal (Refereed)
    Abstract [en]

    This study reports the findings and challenges of the assessment of oro-facial aesthetics in the Swedish general population and the development of normative values for the self-reporting Orofacial Esthetic Scale (OES). In a Swedish national sample of 1406 adult subjects (response rate: 47%), OES decile norms were established. The influence of sociodemographics (gender, age, and education), oral health status and general health status on OES scores was analysed. Mean +/- standard deviation of OES scores was 503 +/- 156 units (0, worst score; 70, best score); less than1% of the subjects had the minimum score of 0, and 11% had the maximum score of 70 OES units. Orofacial Esthetic Scale score differences were (i) substantial (greater than5 OES units) for subjects with excellent/very good versus good to poor oral or general health status; ii) small (2 units), but statistically significant for gender (P=0.01) and two age groups (P=0.02), and (iii) absent for subjects with college versus no college education (P=0.31) or with and without dentures (P=0.90). To estimate normative values for a self-reporting health status, instrument is considered an important step in standardisation, and the developed norms provide a frame of reference in the general population to interpret the Orofacial Esthetic Scale scores.

  • 8.
    Limchaichana, N
    et al.
    Chulalongkorn University.
    Nilsson, H
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Ekberg, E.C.
    Malmö University.
    Nilner, M
    Malmö University.
    Petersson, A
    Malmö University.
    Clinical diagnoses and MRI findings in patients with TMD pain2007In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 34, no 4, p. 237-245Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the findings on magnetic resonance imaging (MRI) in temporomandibular disorders (TMD) pain patients with clinical diagnoses of myofascial pain or arthralgia/osteoarthritis in combination with myofascial pain according to the Research Diagnostic Criteria for TMD. The temporomandibular joints of 60 consecutive patients, 19 with myofascial pain and 41 patients with arthralgia/osteoarthritis in combination with myofascial pain were examined clinically and with MRI. Overall the most common MRI findings were different kinds of disc displacements and structural bone changes, which were found in both pain groups. However, disc displacements were found significantly (P = 0.002) more often in the group arthralgia/osteoarthritis in combination with myofascial pain. One hundred and four joints were found to have no clinical diagnosis of disc displacements, but 64 of these joints had findings of disc displacements on MRI. Joint fluid was found in both pain groups Patients having a combination of disc displacement and joint fluid were significantly (P = 0.047) more common in the pain group arthralgia/osteoarthritis in combination with myofascial pain. In conclusion, the MRI findings of different kinds of disc displacement and structural bone changes were common in TMD patients. The clinical diagnoses for subdivision into myogenous only or combined arthrogenous and myogenous pain groups were not confirmed by MRI

  • 9.
    Nilsson, Ing-Marie
    et al.
    Region Östergötland, Public Dental Health Care, Center for Oral Rehabilitation Norrköping. Malmo Univ, Sweden.
    Brogardh-Roth, Susanne
    Malmo Univ, Sweden.
    Månsson, Johanna
    Lund Univ, Sweden.
    Ekberg, EwaCarin
    Malmo Univ, Sweden.
    Temporomandibular pain in adolescents with a history of preterm birth2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, no 7, p. 589-596Article in journal (Refereed)
    Abstract [en]

    Aim

    To evaluate the frequency of temporomandibular disorder (TMD) pain among adolescents with a history of preterm birth compared to a matched control group.

    Methods

    A group of 192 preterm‐born adolescents was followed up at the age of 17‐19 years and compared to matched controls. Self‐report questionnaires included screening questions about TMD pain, chronic diseases, general health, depression, anxiety, anger, antisocial behaviour and self‐concept. TMD pain was defined as answering “yes” to one or both of the following questions: “Do you have pain in the temple, face, temporomandibular joint or jaws once a week or more?” and “Do you have pain when you open your mouth wide or chew once a week or more often?” Data analysis was performed using chi‐square test and logistic regression model with likelihood ratio test.

    Results

    A TMD pain frequency of 23% of preterm‐born adolescents and 26% among the controls was found, with no significant differences between the groups. Neither were there differences regarding anxiety, depression, anger or self‐confidence. Within the preterm group, adolescents with TMD pain registered tension and pain in the body, trouble sleeping, stomach pain and feelings of hopelessness about the future. The controls with TMD pain, more reported having a bad life, feeling like a failure and having bodily pain. Among tested background variables, only TMJ locking or intermittent locking once a week or more was found to explain TMD pain in adolescents.

    Conclusion

    A high frequency of TMD pain was found in both groups, one possible explanation could be TMJ dysfunction.

  • 10.
    Unell, L.
    et al.
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Johansson, A.
    University of Bergen, Norway.
    Ekback, G.
    University of Örebro, Sweden; Örebro County Council, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden.
    Carlsson, G. E.
    University of Gothenburg, Sweden.
    Dental status and self-assessed chewing ability in 70-and 80-year-old subjects in Sweden2015In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 42, no 9, p. 693-700Article in journal (Refereed)
    Abstract [en]

    The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80-than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability.

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