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  • 1.
    Abtahi, Jahan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Henefalk, G.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Aspenberg, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Randomised trial of bisphosphonate-coated dental implants: Radiographic follow-up after five years of loading2016In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 45, no 12, p. 1564-1569Article in journal (Refereed)
    Abstract [en]

    The results of a randomised trial with bisphosphonate-coated dental implants have been reported previously. Each patient received one coated and one uncoated implant in a double-blind split-mouth design study. After 6 months of osseointegration, resonance frequency analysis indicated better fixation of the coated implants. Reduced marginal bone resorption was also shown. However, it was not known whether the advantage of the bisphosphonate coating would persist over time. The radiographic results at 5 years after implant installation are reported herein. A blinded investigator measured marginal resorption on fresh radiographs obtained for 14 of the 16 patients (two had died) and compared these with the post-implantation images. Non-parametric statistics were used. All implants functioned well. The median marginal bone loss for control implants was found to be 0.70 mm, which is less than usually reported in the literature. The bisphosphonate-coated implants showed even less resorption (median 0.20 mm). The median difference within each pair of implants after 5 years of use was 0.34 mm (95% confidence interval 0.00-0.75 mm; P = 0.04). The present data suggest that bisphosphonate-coated implants enable prolonged preservation of the marginal bone.

  • 2.
    Alstad, V.
    et al.
    Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Surgical removal of keratocystic odontogenic tumours via a Le Fort I osteotomy approach: a retrospective study of the recurrence rate2017In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 46, no 4, p. 6p. 434-439Article in journal (Refereed)
    Abstract [en]

    The keratocystic odontogenic tumour (KCOT) is one of the most aggressive odontogenic cysts and has a high recurrence rate. The treatment of these tumours is the subject of debate. A KCOT in the posterior maxilla with sinus involvement is rare. Few reports have been published in the literature. The purpose of this study was to evaluate the recurrence rate after surgical removal of maxillary KCOTs via a Le Fort I osteotomy. A search was performed to identify patients with a follow-up time of at least 5 years. Nine patients were included in the study. The following clinical variables were analyzed: age at surgery, sex, symptoms, site and size of the tumour, surgical approach, and recurrence rate. The surgical approaches were curettage (n=6) and enucleation (n=3). Recurrence was seen in three patients (33%); all had multilocular tumours. No recurrence was seen in patients with unilocular tumours. The Le Fort I osteotomy approach allows direct visualization and ensures wide excision, minimizing the risk of recurrence. In this series, cases with a multilocular KCOT showed a higher risk of recurrence due to the difficulty of removing the tumour in total. All recurrences took place within 2 years of the intervention; a 5-year follow-up is recommended.

  • 3.
    Bannister, Patricia
    et al.
    Dental School, University of Manchester, Manchester, UK.
    Lindberg, Nina
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Jeppesen, Karin
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Copenhagen, Denmark.
    Elfving-Little, Ulla
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland.
    Semmingsen, Ann-Margritt
    Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
    Paganini, Anna
    Department of Plastic Surgery, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Gustavsson, Annica
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Slevin, Emma
    Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK.
    Jacobsen, Gry
    Center for Cleft Lip and Palate, Haukeland University Hospital, Bergen, Norway.
    Eyres, Phil
    Dental School, University of Manchester, Manchester, UK.
    Semb, Gunvor
    Dental School, University of Manchester, Manchester, UK;Department of Plastic and Reconstructive Surgery, Oslo University of Hospital Rikshospitalet and Statped, Sørøst, Hospital Oslo, Norway.
    Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 3. Descriptive study of postoperative nursing care following first stage cleft closure.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 6p. 21-26Article in journal (Refereed)
    Abstract [en]

    Background:Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. Materials and methods:A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials. This included the age and weight at admission, the postoperative recovery setting, pain management, postoperative feeding, post-operative complications, and length of hospital stay. Results:Four hundred and three nursing forms from the first surgical procedure were returned for analysis. Differences in important aspects of care such as postoperative analgesia and postoperative feeding were evident. Postoperative care was influenced by local custom and practice, as little firm clinical evidence exists to guide optimal management. Conclusion:Postoperative recovery may play a significant role in the future selection of surgical protocols, and future trials need to consider cross-study site training to familiarise nurses, prior to any changes in surgical methods. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]

  • 4.
    Berglund, Caroline
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Ekströmer, Karin
    Department of Radiology, Mälarsjukhuset Eskilstuna Hospital, Sweden.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Primary Chronic Osteomyelitis of the Jaws in Children: An Update on Pathophysiology, Radiological Findings, Treatment Strategies, and Prospective Analysis of Two Cases2015In: Case Reports in Dentistry, ISSN 2090-6447, E-ISSN 2090-6455, Vol. 2015, no 152717Article in journal (Refereed)
    Abstract [en]

    Objective. Primary chronic osteomyelitis (PCO) of the jaws in children is associated with pain, trismus, and swelling. In children, temporomandibular joint involvement is rare and few studies have been published due to the relatively low incidence. This paper presents two cases of mandibular PCO in children with the involvement of the collum mandibulae. In addition, a review of the literature regarding demographic data, histological, radiological, and laboratory findings, and treatment strategies of PCO was also performed. Material and Methods. Prospective analyses of two PCO cases. A PubMed search was used and the articles were sorted according to their corresponding key area of focus. Results. Review of the literature revealed twenty-four cases of PCO with two cases of mandibular condyle involvement. The mean age was 18 years; the male to female ratio was 1 : 3. Most of the patients were treated with anti-inflammatory drugs in combination with decortication. Clinical recurrence was seen in 7 cases. Conclusion. A combination of anti-inflammatory drugs and surgical intervention appears to be the first choice of treatment. However, surgical removal of necrotic tissue adjacent to collum mandibulae has its limitations in children. Further investigations are of utmost importance in order to increase our knowledge and understanding of this disease.

  • 5.
    Caban, Janusz
    et al.
    Vastervik Hospital, Sweden.
    Fermergard, Robert
    Vastervik Hospital, Sweden.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Long-term evaluation of osteotome sinus floor elevation and simultaneous placement of implants without bone grafts: 10-Year radiographic and clinical follow-up2017In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 19, no 6, p. 1023-1033Article in journal (Refereed)
    Abstract [en]

    BackgroundInsertion of an implant in the edentulous posterior maxilla is a challenging procedure because of poor bone quality and increased pneumatization of the maxillary sinus after tooth extraction. To increase the amount of bone, several surgical bone grafting techniques have been used?with considerable morbidity for patients. Osteotome sinus floor elevation (OSFE) is a less invasive technique. The clinical and radiographic outcome of 53 implants placed with this technique without bone graft has been reported previously. PurposeHere we report the clinical and radiographic findings after 10 years of implant load bearing. Material and methodsIn a retrospective study, 34 Astra implants in 25 patients were subjected to 10-year follow-up radiologically and clinically. Each patient received 1 or 2 conical Astra implants. The level of the marginal bone and the height of the residual peri-implant alveolar bone (RPAB) for each implant were measured from digital intra-oral radiographs. ResultsTwo implants in edentulous patients were lost at the 1-year follow-up, and 1 more at the 3-year examination. There was no loss between 3-year and 10-year follow-up. At 10-year follow-up 36 implants were included. Implants used in single-tooth replacements and in partially edentulous cases had a 100% survival rate. The mean marginal bone loss was 0.60.8 mm. The bone height at the time of implant insertion ranged from 1.8 to 6.9 mm, with a mean value of 4.3 +/- 1.0 mm. At 10-year follow-up the mean gain in bone at the implant sites for all implants was 2.6 +/- 1.2 mm. ConclusionsThe OSFE technique is a reliable method for rehabilitation of patients with atrophied posterior maxilla. However, the success of this method is associated with the amount of the residual bone. In the present study, this surgical approach without bone graft showed reliable long-term results with Astra implants.

  • 6.
    Cardemil, Carina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Bisfosfonatinducerad käkbensnekros (ONJ)2016Other (Other academic)
  • 7.
    Feragen, Kristin, Billaud
    et al.
    Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway.
    Rumsey, Nichola
    Centre for Appearance Research, University of the West of England, Bristol, UK.
    Heliövaara, Arja
    Department of Plastic Surgery, Cleft Palate and Craniofacial Centre, Helsinki University Central Hospital, Helsinki, Finland.
    Boysen, Betty, Marie
    Copenhagen Cleft Palate Centre, University Hospital of Copenhagen, Denmark.
    Johannessen, Emma Christine
    Department of Speech and Language Disorders, Statped Sørøst, Oslo, Norway.
    Havstam, Christina
    Division of Speech and Language Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Nyberg, Jill
    Division of Speech and Language Pathology, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden.
    Pedersen, Nina-Helen
    Department of Speech and Language Disorders, Statped Vest, Bergen, Norway.
    Bogh-Nielsen, Joan
    Cleft Palate Centre, Aarhus, Denmark.
    Eyres, Philip
    Dental School, University of Manchester, Manchester, UK.
    Bradbury, Eileen
    Private Practice, Manchester, UK.
    Semb, Gunvor
    Dental School, University of Manchester, Manchester, UK; Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway.
    Scandcleft randomised trials of primary surgery for unilateral cleft lip and Palate: 9. Parental report of social and emotional experiences related to their 5-year-old child's cleft diagnosis2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 8p. 73-80Article in journal (Refereed)
    Abstract [en]

    Background and aim:Parents of children with a cleft lip and palate may be emotionally affected by the child’s diagnosis. Their experiences and perceptions are important when evaluating the complexity of satisfactory treatment outcomes. The objective was to examine parents’ social and emotional experiences related to their child’s cleft diagnosis, and their perceptions of the child’s adjustment to living with a visible difference. Design:International multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods:A cohort of 448 children born with a non-syndromic UCLP were included. A total of 356 parents completed the Scandcleft Parent Questionnaire. Results:The majority of parents experienced practical and emotional support from family, friends, and health professionals. Nevertheless, parents had to cope with other people’s reactions to the cleft, experiences that were described as ranging from hurtful to neutral and/or positive. According to parents, 39% of the children had experienced cleft-related comments and/or teasing. More than half of the parents reported specific worries related to their child’s future. Conclusion:While the majority of the parents experienced positive support and coped well with the child’s diagnosis, some parents were at risk for psychological and emotional challenges that should be identified by the cleft team. To optimise outcomes and the child’s adjustment, these parents should be offered psychological support when necessary. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]

  • 8.
    Gudmundsson, Jens Kristjan
    et al.
    Eskilstuna Hospital, Sweden.
    Ajan, Aida
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients2016In: Journal of Applied Oral Science, ISSN 1678-7757, E-ISSN 1678-7765, Vol. 24, no 6, p. 561-567Article in journal (Refereed)
    Abstract [en]

    Objective: Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses. Material and Methods: Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results: Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthins tumor (17.5%). The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion: FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.

  • 9.
    Heliövaara, Arja
    et al.
    Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland.
    Küseler, Annelise
    Cleft Palate Center, Aarhus, Denmark.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Shaw, William
    Dental School, University of Manchester, Manchester, UK.
    Mølsted, Kirsten
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark.
    Karsten, Agneta
    Division of Orthodontics, Department of Dental Medicine, Stockholm Craniofacial Team, Karolinska Institutet, Stockholm, Sweden.
    Brinck, Eli
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Rizell,, Sara
    Orthodontic clinic, University Clinics of Odontology Gothenburg, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Sæle, Paul
    Oral Health Center of Excellence/Western Norway, Bergen, Norway.
    Hurmerinta, Kirsti
    Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland;.
    Rønning, Elisabeth
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Najar Chalien, Midia
    Orthodontic clinic, University Clinics of Odontology Gothenburg, Sweden.
    Bellardie,, Haydn
    Greater Manchester Cleft Unit, Royal Manchester Children’s Hospital, Manchester, UK.
    Mooney,, Jeanette
    Greater Manchester Cleft Unit, Royal Manchester Children’s Hospital, Manchester, UK.
    Eyres, Phil
    Dental School, University of Manchester, Manchester, UK.
    Semb, Gunvor
    Dental School, University of Manchester, Manchester, UK;Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Rikshospitalet and Statped Sørøst, Oslo, Norway.
    Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 6. Dental arch relationships in 5 year-olds.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 6p. 52-57Article in journal (Refereed)
    Abstract [en]

    Background and aim:Good dentofacial growth is a major goal in the treatment of unilateral cleft lip and palate (UCLP). The aim was to evaluate dental arch relationships at age 5 years after four different protocols of primary surgery for UCLP. Design:Three parallel randomised clinical trials were undertaken as an international multi-centre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods:Three different surgical procedures for primary palatal repair (Arms B, C, D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Study models of 418 patients (273 boys) at the mean age of 5.1 years (range = 4.8–7.0) were available. Dental arch relationships were assessed using the 5-year index by a blinded panel of 16 orthodontists. Kappa statistics were calculated to assess reliability. The trials were tested statistically witht-and Chi-square tests. Results:Good-to-very good levels of intra- and interrater reliability were obtained (0.71–0.94 and 0.70–0.87). Comparisons within each trial showed no statistically significant differences in the mean 5-year index scores or their distributions between the common method and the local team protocol. The mean index scores varied from 2.52 (Trial 2, Arm C) to 2.94 (Trial 3, Arm D). Conclusion:The results of the three trials do not provide statistical evidence that one technique is better than the others. Further analysis of the possible influence of individual surgical skill and learning curve are being pursued in this dataset. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]

  • 10.
    Herlofson, B.B.
    et al.
    Department of Oral Surgery and Oral Medicine, Faculty of Dentistry- University of Oslo, Oslo, Norway.
    Wexell, C.L.
    Department of Oral and Maxillofacial Surgery, Southern Alvsborg Hospital, Borås; Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden .
    Nørholt, S.E.
    Aarhus University, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.
    Igland, E.
    Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
    Cardemil, Carina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Ehrenstein, V.
    Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
    Schiødt, V.
    Department of Oral and Maxillofacial Surgery, Rigshospitalet, Copenhagen, Denmark.
    THE SCANDINAVIAN OSTEONECROSIS COHORT STUDY - REPORT ON THE FIRST 4 YEARS OF RESEARCH COLLABORATION2016Conference paper (Other academic)
  • 11.
    Karsten, Agneta
    et al.
    Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Hurmerinta, Kirsti
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland.
    Heliövaara, Arja
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland.
    Küseler,, Annelise
    Cleft Palate Center, Aarhus, Denmark.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway.
    Bellardie, Haydn
    Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens’ Hospital, Manchester, UK.
    Rønning, Elisabeth
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway.
    Shaw, William
    Dental School, University of Manchester, Manchester, UK.
    Mølsted, Kirsten
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Copenhagen, Denmark.
    Sæle, Paul
    Oral Health Center of Expertise/Western Norway, Bergen, Norway.
    Brinck, Eli
    Oral Health Center of Expertise/Western Norway, Bergen, Norway.
    Rizell, Sara
    Department of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Najal Chalier, Midia
    Department of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Eyres, Philip
    Dental School, University of Manchester, Manchester, UK.
    Semb, Gunvor
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway; Dental School, University of Manchester, Manchester, UK.
    Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 6p. 58-63Article in journal (Refereed)
    Abstract [en]

    Background and aim:Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. Design:Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods:Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7–6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion. Results:The inter- and intra-examiner reliability was good-to-excellent (0.61–0.94; 0.66–1.0, respectively). The mean total scores (+2 to −18) varied from −5.56 (Trial 2C) to −7.21 (Trial 3D). The mean anterior scores (+2 to −6) varied from −1.66 (Trial 2C) to −2.56 (Trial 3A). The mean posterior cleft-side scores (0 to −6) varied from −3.24 (Trial 3A) to −3.82 (Trial 3D) and the mean non-cleft-side scores (0 to −6) varied from −0.60 (Trial 2C) to −1.30 (Trial 3A); however, no significant differences were found within the trials. Conclusion:There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]

  • 12.
    Larsson Wexell, Cecilia
    et al.
    Södra Älvsborgs Sjukhus; Sahlgrenska akademin, Göteborgs universitet, Göteborg.
    Brokstad Herlofson, Bente
    Inst for klinisk odontologi, Universitet i Oslo; Radiumhospitalet, Oslo Universitetssykehus, Norge.
    Norholt, Sven Erik
    Aarhus universitetshospital; Inst för Odentologi, Health, Aarhus Universitet, Danmark.
    Cardemil, Carina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Avd för biomaterialvetenskap, Inst för kliniska vetenskaper, Sahlgrenska akademin, Göteborgs universitet, Göteborg.
    Schlodt, Morten
    Rigshospitalet, Köpenhamn, Danmark.
    Läkemedelsrelaterad osteonekros i käkarna, del 1: Översikt och riktlinjer2015In: Tandläkartidningen, ISSN 0039-6982, Vol. 12Article, review/survey (Other academic)
  • 13.
    Lena Sundell, Anna
    et al.
    Institute Postgrad Dent Educ, Sweden.
    Ullbro, Christer
    UiT Arctic University of Norway, Norway.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Twetman, Svante
    University of Copenhagen, Denmark.
    Comparing caries risk profiles between 5-and 10-year-old children with cleft lip and/or palate and non-cleft controls2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, no 85Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model. Methods: The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the childs oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as "high" or "low". Results: Children with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p less than 0.05) and displayed less good oral hygiene (p less than 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67 % but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95 % CI = 1.25-2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk. Conclusion: Children with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.

  • 14.
    Mølsted, Kirsten
    et al.
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Copenhagen, Denmark.
    Humerinta, Kirsti
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland.
    Küseler,, Annelise
    Cleft Palate Center, Aarhus, Denmark.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway.
    Bellardie, Haydn
    Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens Hospital, Manchester, UK.
    Shaw, William
    Dental School, University of Manchester, Manchester, UK.
    Karsten, Agneta
    Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kåre Sæle, Paul
    Oral Health Center of Expertise/Western Norway, Bergen, Norway.
    Rizell, Sara
    Department of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Eyres, Philip
    Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens Hospital, Manchester, UK.
    Semb, Gunvor
    Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway;(4);Dental School, University of Manchester, Manchester, UK;(6);Statped Sørøst, Oslo, Norway.
    Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 9p. 64-72Article in journal (Refereed)
    Abstract [en]

    Background and aim:Facial appearance is one of the most relevant measures of success in cleft lip and palate treatment. The aim was to assess nasolabial appearance at 5 years of age in all children in the project. In this part of the project the local protocol for lip closure continued to be used because the primary lip and nose operations were not part of the randomisation. The great majority of the surgeons used Millard’s technique together with McComb’s technique for the nose. One center used Tennison-Randalls technique and in one center the centers own technique as well as nose plugs were used. Methods:Three hundred and fifty-nine children participated in this part of the project. Standardised photos according to a specific protocol developed for the Scandcleft project were taken. Only the nasolabial area was shown, the surrounding facial features were masked. Three components were scored using a 5-point ordinal scale. A new developed Scandcleft Yardstick was used. Results:The reliability of the method was tested using the weighted kappa statistics. Both the interrater and intrarater reliability scores were good to very good. There were statistically significant differences between the three trials. Conclusion:The Millard procedure combined with McComb technique had been used in the majority of the cases in all three trials. There were statistically significant differences between the three trials concerning upper lip, nasal form, and cleft side profile. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]

  • 15.
    Norderyd, Johanna
    et al.
    Institute Postgrad Dent Educ, Sweden; Jonköping University, Sweden.
    Graf, Jonas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Marcusson, Agneta
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.
    Nilsson, Karolina
    Ryhov County Hospital, Sweden.
    Sjöstrand, Eva
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Habilitation.
    Steinwall, Gunilla
    Habilitation Centre, Ryhov County Hospital, Jönköping.
    Ärleskog, Elinor
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Sublingual administration of atropine eyedrops in children with excessive drooling - a pilot study2017In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 27, no 1, p. 22-29Article in journal (Refereed)
    Abstract [en]

    BackgroundDrooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable. AimTo analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities. DesignThe study had a prospective, single-system research design. The participants served as their own controls. The study period was 3 weeks without treatment, 4 weeks with atropine eyedrop solution 10 mg/mL one drop a day followed by 4 weeks of one drop twice a day. Parents rating of their childs drooling was assessed on a 100-mm VAS, and unstimulated salivary secretion rate measurement was performed together with notations about side effects and practicality. ResultsParents VAS assessment of drooling decreased from a median (range) of 74 (40-98) at baseline to 48 (18-88) (P = 0.05) and 32 (12-85) (P = 0.004) after 4 weeks of atropine once a day and another 4 weeks of atropine twice a day, respectively (n = 11). Unstimulated salivary secretion rates decreased from baseline to end of study (P = 0.032). Several parents complained about difficult administration. No irreversible side effects were noted. ConclusionsSublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.

  • 16.
    Semb, Gunvor
    et al.
    Division of Dentistry, University of Manchester , Manchester , UK; Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway; Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway..
    Enemark, Hans
    Cleft Palate Center , Aarhus , Denmark.
    Friede, Hans
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paulin, Gunnar
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Lilja, Jan
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Rautio, Jorma
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Andersen, Mikael
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Åbyholm, Frank
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lohmander, Anette
    Division of Speech and Language Pathology , Karolinska Institute, and Karolinska University Hospital , Stockholm , Sweden.
    Shaw, William
    Division of Dentistry, University of Manchester , Manchester , UK.
    Mølsted, Kirsten
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Heliövaara, Arja
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Bolund, Stig
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Hukki, Jyri
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Vindenes, Hallvard
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Davenport, Peter
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Arctander, Kjartan
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Larson, Ola
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Berggren, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Whitby, David
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Leonard, Alan
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Neovius, Erik
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Elander, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Willadsen, Elisabeth
    Department of Nordic Studies and Linguistics , University of Copenhagen , Denmark.
    Bannister, R. Patricia
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bradbury, Eileen
    Private Practitioner , Manchester , UK.
    Henningsson, Gunilla
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Persson, Christina
    Institute of Neuroscience and Physiology, Speech and Language; Division for Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden Pathology Unit , Sahlgrenska Academy, University of Gothenburg , Sweden; .
    Eyres, Philip
    Division of Dentistry, University of Manchester , Manchester , UK.
    Emborg, Berit
    Cleft Palate Center , Aarhus , Denmark.
    Kisling-Møller, Mia
    Division of Dentistry, University of Manchester , Manchester , UK.
    Küseler, Annelise
    Division of Dentistry, University of Manchester , Manchester , UK.
    Granhof Black, Birthe
    Division of Dentistry, University of Manchester , Manchester , UK.
    Schöps, Antje
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Bau, Anja
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Boers, Maria
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Søgaard Andersen, Helene
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Jeppesen, Karin
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Marxen, Dorte
    Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Denmark.
    Paaso, Marjukka
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Hölttä, Elina
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Alaluusua, Suvi
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Turunen, Leena
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Humerinta, Kirsti
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Elfving-Little, Ulla
    Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland.
    Tørdal, Inger Beate
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Kjøll, Lillian
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Aukner, Ragnhild
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Hide, Øydis
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Feragen, Kristin Billaud
    Department of Speech and Language Disorders , Statped sørøst , Oslo , Norway.
    Rønning, Elisabeth
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Skaare, Pål
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Brinck, Eli
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Semmingsen, Ann-Magritt
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Lindberg, Nina
    Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway.
    Bowden, Melanie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Davies, Julie
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Mooney, Jeanette
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Bellardie, Haydn
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Schofield, Nina
    Greater Manchester Cleft Lip and Palate Unit , Royal Manchester Childrens' Hospital , Manchester , UK.
    Nyberg, Jill
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Lundberg, Maria
    Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
    Linder-Aronson Karsten, Agneta
    Stockholm Craniofacial Team, Department of Dental Medicine , Karolinska Institute , Stockholm , Sweden.
    Larson, Margareta
    Eastman Institute, Stockholms Läns Landsting , Stockholm , Sweden.
    Holmefjord, Anders
    Statped vest , Bergen , Norway.
    Reisæter, Sigvor
    Statped vest , Bergen , Norway.
    Pedersen, Nina-Helen
    Statped vest , Bergen , Norway.
    Rasmussen, Therese
    Statped vest , Bergen , Norway.
    Tindlund, Rolf
    Dental School, University of Bergen , Bergen , Norway.
    Sæle, Paul
    Oral Health Center of Expertise/Western Norway , Bergen , Norway.
    Blomhoff, Reidunn
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Jacobsen, Gry
    Centre for Cleft Lip and Palate, Bergen University Hospital Haukeland , Bergen , Norway.
    Havstam, Christina
    Division for Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden.
    Rizell, Sara
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Enocson, Lars
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Hagberg, Catharina
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Najar Chalien, Midia
    Department of Orthodontics , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Paganini, Anna
    Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
    Lundeborg, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Mjönes, Anna-Britta
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Gustavsson, Annica
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Hayden, Christine
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    McAleer, Eilish
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Slevan, Emma
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Gregg, Terry
    The Royal Hospital for Sick Children , Belfast , N. Ireland.
    Worthington, Helen
    Division of Dentistry, University of Manchester , Manchester , UK.
    A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.2017In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 51, no 1, p. 2-13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.

    METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.

    RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.

    CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.

    TRIAL REGISTRATION: ISRCTN29932826.

  • 17.
    Shah, Furqan A.
    et al.
    Univ Gothenburg, Sweden; BIOMATCELL VINN Excellence Ctr Biomat and Cell Ther, Sweden.
    Stoica, Adrian
    Masaryk Univ, Czech Republic.
    Cardemil, Carina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Univ Gothenburg, Sweden; BIOMATCELL VINN Excellence Ctr Biomat and Cell Ther, Sweden.
    Palmquist, Anders
    Univ Gothenburg, Sweden; BIOMATCELL VINN Excellence Ctr Biomat and Cell Ther, Sweden.
    Multiscale characterization of cortical bone composition, microstructure, and nanomechanical properties in experimentally induced osteoporosis2018In: Journal of Biomedical Materials Research. Part A, ISSN 1549-3296, E-ISSN 1552-4965, Vol. 106, no 4, p. 997-1007Article in journal (Refereed)
    Abstract [en]

    Cortical bone plays a vital role in determining overall bone strength. We investigate the structural, compositional, and nanomechanical properties of cortical bone following ovariectomy (OVX) of 12-week-old Sprague Dawley rats, since this animal model is frequently employed to evaluate the performance of implantable biomaterials in compromised bone healing conditions. Morphological parameters and material properties of bone in the geometrical center of the femoral cortex were investigated four and eight weeks post-OVX and in unoperated controls (Ctrl), using X-ray micro-computed tomography, backscattered electron scanning electron microscopy, Raman spectroscopy, and nanoindentation. The OVX animals showed increase in body weight, diminished bone mineral density, increased intracortical porosity, but increased bone mass through periosteal apposition (e.g., increases in periosteal perimeter, cortical cross-sectional thickness, and cross-sectional area). However, osteocyte densities, osteocyte lacunar dimensions, and the nanomechanical behavior on the single mineralized collagen fibril level remained unaffected. Our correlative multiscale investigation provides structural, chemical, and nanomechanical evidence substantiating earlier reports suggesting that rats ovariectomized at 12 weeks undergo simultaneous bone loss and growth, resulting in the effects of OVX being less obvious. Periosteal apposition contradicts the conventional view of bone loss in osteoporosis but appears advantageous for the greater functional demand imposed on the skeleton by increased body weight and fragility induced by increased intracortical porosity. Through a variety of morphological changes, it is likely that 12-week-old rats are able to adapt to OVX-related microstructural and compositional alterations. (c) 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 997-1007, 2018.

  • 18.
    Sundell, Anna Lena
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. The Institute for Postgraduate Dental Education, Department of Paediatric Dentistry, Jönköping, Sweden.
    Children with orofacial clefts: dental caries and health-related quality of life2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background. The current understanding on caries and enamel developmental defects prevalence and frequency, caries risk, health-related quality life (HRQoL) and stress response in young children with cleft lip and/or palate (CL/P) are sparse. In this thesis these aspects were investigated in 5- and 10- year-old children with CL/P in comparison to non-cleft children in the same ages.

    Design. The studies in this thesis have a cross-sectional case-control design. Participants. The study group consisted of 139 children with CL/P (80 children aged 5 years and 59 aged 10 years) and 313 non-cleft controls (144 children aged 5 years and 169 aged 10 years).

    Method. Caries was scored according to International Caries Detection and Assessment System (ICDAS II) and developmental enamel defects were measured as presence and frequency of hypoplasia and hypomineralization. Oral hygiene was assessed using Quigley-Hein plaque index. Stimulated saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rates. Information regarding children’s oral hygiene routines, dietary habits and fluoride exposure were collected with questionnaires. Caries risk was evaluated with algorithm-based software, Cariogram while HRQoL was perceived with KIDSCREEN-52. Stress response was analyzed with cortisol concentration in saliva at three different time points using a commercial competitive radioimmunoassay.

    Results. Caries prevalence (36% versus 18%) and caries frequency (1.2 dmfs versus 0.9 dmfs) was significantly higher in 5-year-old children with CL/P in comparison to non-cleft controls. In 10-yearolds no significant difference was found between children with CL/P and non-cleft controls in caries prevalence (47% versus 38%) or in caries frequency (0.7 DMFS versus 0.5 DMFS). Children with CL/P had significantly higher prevalence of enamel defects, higher counts of salivary lactobacilli and less good oral hygiene. The odds of being categorized with high caries risk were elevated in children with CL/P. Children with CL/P had similar HRQoL and salivary cortisol concentrations as non-cleft controls. However, 10-year-old boys with CL/P had significantly higher cortisol concentrations in the evening than non-cleft boys.

    Conclusions. Preschool children with CL/P seem to have more caries in the primary dentition than non-cleft controls. Children with CL/P had increased odds of being categorized as high caries risk individuals compared to controls. Some of the contributing factors seem to be higher prevalence of enamel defects, impaired oral hygiene and elevated salivary lactobacilli. Furthermore, as measured with the help of cortisol concentrations in saliva, children with CL/P were not more stressed than noncleft controls and their HRQoL was comparable to a European norm population. It appears that regular comprehensive preventive oral care in children with CL/P is effective in preventing caries development in permanent teeth. However, children with CL/P are at risk of caries development and preventive oral care should be implemented and started earlier than today.

    List of papers
    1. Caries prevalence and enamel defects in 5-and 10-year-old children with cleft lip and/or palate: A case-control study
    Open this publication in new window or tab >>Caries prevalence and enamel defects in 5-and 10-year-old children with cleft lip and/or palate: A case-control study
    Show others...
    2016 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, p. 90-95Article in journal (Refereed) Published
    Abstract [en]

    Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.

    Place, publisher, year, edition, pages
    TAYLOR & FRANCIS LTD, 2016
    Keywords
    Cleft palate; cleft lip and palate; dental caries; hypomineralization; hypoplasia
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-124077 (URN)10.3109/00016357.2015.1044562 (DOI)000366811600002 ()25972142 (PubMedID)
    Note

    Funding Agencies|FORSS Medical Research Council of Southeast Sweden; Futurum Academy of Health and Care Jonkoping County Council; Swedish Dental Association; Swedish Society of Paediatric Dentistry

    Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2017-05-03
    2. Comparing caries risk profiles between 5-and 10-year-old children with cleft lip and/or palate and non-cleft controls
    Open this publication in new window or tab >>Comparing caries risk profiles between 5-and 10-year-old children with cleft lip and/or palate and non-cleft controls
    2015 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, no 85Article in journal (Refereed) Published
    Abstract [en]

    Background: Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model. Methods: The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the childs oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as "high" or "low". Results: Children with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p less than 0.05) and displayed less good oral hygiene (p less than 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67 % but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95 % CI = 1.25-2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk. Conclusion: Children with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.

    Place, publisher, year, edition, pages
    BioMed Central, 2015
    Keywords
    Cleft lip; Cleft palate; Cleft lip and/or palate; Caries risk; Cariogram; Children
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-120739 (URN)10.1186/s12903-015-0067-x (DOI)000358428000002 ()26208495 (PubMedID)
    Note

    Funding Agencies|FORSS - Medical Research Council of Southeast Sweden, Futurum, - Academy of Health and Care Jonkoping County Council; Swedish Dental Association; Swedish Society of Paediatric Dentistry

    Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2017-12-04
    3. A comparison of health-related quality of life in 5- and 10-year-old Swedish children with and without cleft lip and/or palate
    Open this publication in new window or tab >>A comparison of health-related quality of life in 5- and 10-year-old Swedish children with and without cleft lip and/or palate
    2017 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 27, no 4, p. 238-246Article in journal (Refereed) Published
    Abstract [en]

    Background The current understanding on health-related quality of life (HRQoL) in young Swedish children with cleft lip and/or palate (CL/P) is sparse, and therefore, research on impact of CL/P on HRQoL in children is needed.

    Aims To investigate HRQoL in 5- and 10-year-old Swedish children with CL/P in comparison with non-cleft controls. Also to analyse whether there were any differences in HRQoL between children with cleft lip (with or without cleft palate, CL ± P) and cleft palate only (CP) and/or gender differences. Design A total of 137 children with CL/P and 305 non-cleft controls participated. HRQoL was measured with KIDSCREEN-52.

    Results All children in the study exhibited HRQoL within or above the age-matched reference interval of the method with similar results in both groups; however, in the dimension ‘social support and peers’, the 10-year-old children with CL/P perceived lower HRQoL than the non-cleft controls, but it did not reach statistical significance. Type of cleft or gender did not influence HRQoL.

    Conclusions Both 5- and 10-year-old Swedish children with CL/P had HRQoL in the normal reference interval. Their general life situations were well adjusted to their clefts, but the older children with CL/P felt more excluded and less supported by peers.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    National Category
    Surgery Dentistry
    Identifiers
    urn:nbn:se:liu:diva-132622 (URN)10.1111/ipd.12253 (DOI)000403011100002 ()27464906 (PubMedID)
    Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2018-05-07Bibliographically approved
  • 19.
    Sundell, Anna Lena
    et al.
    Inst Postgrad Dent Educ, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Toernhage, Carl-Johan
    Skaraborg Hosp, Sweden; Univ Gothenburg, Sweden.
    Salivary Cortisol Rhythms in Children With Cleft Lip and/or Palate: A Case-Control Study2018In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 55, no 8, p. 1072-1080Article in journal (Refereed)
    Abstract [en]

    Objective: Knowledge about the stress response in children with cleft lip and/or palate (CUP) is sparse and the association between the stress response and health-related quality of life (HRQoL) is unknown. Consequently, investigations on the influence of CUP on the stress response alone and its association with HRQoL are of importance. The purpose was to determine whether salivary cortisol concentration in children with CL/P differs from that in children without clefts (controls) and whether there are any differences in salivary cortisol concentrations between ages, gender, and type of cleft. Furthermore, the final aim was to determine the correlation between salivary cortisol concentration and HRQoL. Design: The study used a cross-sectional case-control design. Participants: Ninety-one 5- and 10-year-old children with CUP and 180 age-matched controls. Main Outcome Measures: Salivary samples were collected on 2 mornings and 1 evening for each child. Samples were analyzed using a commercial competitive radioimmunoassay and HRQoL was assessed using the KIDSCREEN-52. Results: Salivary cortisol concentrations were similar in children with CL/P and controls. There was no difference in salivary cortisol concentrations between children with different types of cleft. There was no correlation between cortisol concentration and HRQoL. Conclusion: Five- and 10-year-old children with corrected CUP seemed not to be more stressed than controls, and there were no correlation to HRQoL. The HRQoL levels - were comparable to that of a European norm population.

  • 20.
    Sundell, Anna Lena
    et al.
    Institute Postgrad Dent Educ, Sweden.
    Nilsson, Anna-Karin
    Institute Postgrad Dent Educ, Sweden.
    Ullbro, Christer
    UiT Arctic University of Norway, Norway.
    Twetman, Svante
    University of Copenhagen, Denmark.
    Marcusson, Agneta
    Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science.
    Caries prevalence and enamel defects in 5-and 10-year-old children with cleft lip and/or palate: A case-control study2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, p. 90-95Article in journal (Refereed)
    Abstract [en]

    Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.

  • 21.
    Sundell, Anna Lena
    et al.
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Törnhage, Carl-Johan
    Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden / Sahlgrenska Academy, Gothenburg's University, Gothenburg, Sweden.
    Marcusson, Agneta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    A comparison of health-related quality of life in 5- and 10-year-old Swedish children with and without cleft lip and/or palate2017In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 27, no 4, p. 238-246Article in journal (Refereed)
    Abstract [en]

    Background The current understanding on health-related quality of life (HRQoL) in young Swedish children with cleft lip and/or palate (CL/P) is sparse, and therefore, research on impact of CL/P on HRQoL in children is needed.

    Aims To investigate HRQoL in 5- and 10-year-old Swedish children with CL/P in comparison with non-cleft controls. Also to analyse whether there were any differences in HRQoL between children with cleft lip (with or without cleft palate, CL ± P) and cleft palate only (CP) and/or gender differences. Design A total of 137 children with CL/P and 305 non-cleft controls participated. HRQoL was measured with KIDSCREEN-52.

    Results All children in the study exhibited HRQoL within or above the age-matched reference interval of the method with similar results in both groups; however, in the dimension ‘social support and peers’, the 10-year-old children with CL/P perceived lower HRQoL than the non-cleft controls, but it did not reach statistical significance. Type of cleft or gender did not influence HRQoL.

    Conclusions Both 5- and 10-year-old Swedish children with CL/P had HRQoL in the normal reference interval. Their general life situations were well adjusted to their clefts, but the older children with CL/P felt more excluded and less supported by peers.

  • 22.
    Tardast, Arezo
    et al.
    Department Oral and Maxillofacial Surg, Norway.
    Sjoman, Reine
    Region Östergötland.
    Loes, Sigbjorn
    Department Oral and Maxillofacial Surg, Norway.
    Abtahi, Jahan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Bisphosphonate associated osteomyelitis of the jaw in patients with bony exposure: prevention, a new way of thinking2015In: Journal of Applied Oral Science, ISSN 1678-7757, E-ISSN 1678-7765, Vol. 23, no 3, p. 310-314Article in journal (Refereed)
    Abstract [en]

    Objective: There is strong evidence of a link between the use of systemic bisphosphonates (BPs) and osteonecrosis of the jaw, especially in cancer patients. Among risk factors for BRONJ, tooth extraction and immune suppressive drugs seem to have significant role on bone healing. Therefore, the importance of these parameters in development of BRONJ was reviewed in this retrospective study in two maxillofacial surgery units. Material and Methods: From 2007 to 2012, 46 patients on bisphosphonate who had developed oral bony lesions participated in this study. The pharmacological exposure, comorbidities, maxillofacial findings, types of treatment and outcome data were collected from clinical and radiological records. Results: The most frequently used BP was alendronate (67%). Tooth extraction was reported in 61% of patients with BRONJ. Systemic corticosteroids were prescribed in 35 cases (76%) as an adjuvant for BP. Patients on corticosteroids had a lower probability of bony lesion healing (pless than0.05) than patients without corticosteroids. Of the 46 patients who underwent conservative treatments, only ten were completely healed (21%). Conclusions: Beside tooth extraction, corticosteroids were shown to be an implant risk factor for low rate of bone healing and hence the development of BRONJ. The outcome of conservative treatment was uncertain and this emphasizes the importance of prevention.

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