| 1. |
- Petersson, Kerstin, et al.
(författare)
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20-year follow-up of patients receiving high-cost dental care within the Swedish Dental Insurance System : 1977–1978 to1998–2000
- 2006
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 30:2, s. 77-86
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to perform a long-term follow-up study of patients that had received high cost dental care within the Swedish National Dental Insurance System in 1977-1978 with special focus on remaining teeth, periodontal disease progression, change in the prevalence of root-filled teeth and teeth with apical periodontitis as well as the survival of fixed prosthetic reconstructions. All 262 patients who had had their treatment plans sent for approval for high-cost dental care in 4 local health insurance districts and who were sampled for base-line studies in 1977-1978, were offered a free clinical examination including radiographs in 1998. 177 patients (68% of the original sample) could be reached for telephone interview and 104 of them (40% of the original sample) were examined clinically and radiographically. Comparisons were made with records and radiographs from 1977-1978. The analyses were performed with the individual patient as the studied unit. The low progression of severe periodontal disease during the 20-23 year follow-up period and the decrease in number of teeth with apical periodontitis among a majority of the patients examined, indicated that the dental care received resulted in a limitation of dental disease on the individual level. Furthermore 63% of the patients had the fixed prosthetic reconstructions, received after approval 1977-1978, in full extention after 20-23 years. However, more tooth losses were observed among the patients in this study than in similar studies in Swedish general populations over the same decades. Furthermore multiple tooth extractions were significantly more frequent in patients with severe periodontitis at baseline and in patients with less apical periodontitis at follow-up in this study. Thus it seems that tooth extraction not seldom was a treatment choice for teeth with severe periodontitis and apical periodontitis among the patients examined clinically in this study.
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| 2. |
- Pigg, Maria, et al.
(författare)
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A comparative analysis of MRI, CBCT and conventional radiography in patients with atypical odontalgia and symptomatic apical periodontitis : preliminary results
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30:4, s. 173-174
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: Atypical odontalgia(AO) is a chronic pain condition located in the teeth and jaws. It has been suggested, that AO is best regarded as a neuropathic pain condition, but knowledge regarding the etiology, diagnostics, and management of AO is not yet satisfactory. This pilot study evaluates the clinical usefulness of more recently developed imaging methods for intraoral pain conditions. The aim is to compare the diagnostic findings using magnetic resonance imaging(MRI) and cone beam computed tomography(CBCT) with the findings from conventional radiography in patients with atypical odontalgia(AO) and symptomatic apical periodontitis(SAP). Material and methods: 12 patients (9 F, 3 M) mean age 50,25 years, range 36 - 63 years participated in the study. The patients were referred to the Orofacial Pain Unit or the Department of Endodontics, Faculty of Odontology, Malmö University. Inclusion criteria for AO were chronic pain (>6 months) located in a region where a tooth had been endodontically or surgically treated, pain with no pathological cause detectable in clinical or radiological examinations. For SAP, the inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in a clinical and radiographic examination. Ten of the patients in the study were diagnosed with AO and two with SAP. The patients were clinically assessed with a qualitative somatosensory examination, a dental examination, an examination of the masticatory system(RDC/TMD), and panoramic and intraoral radiographs. A questionnaire was used to gather information about pain characteristics, psychosocial status(SCL-90), and quality of life. Besides these measures, each patient underwent a CBCT(3D-Accuitomo, J Morita Co) examination and a MRI(Siemens Sonata Vision 1.5 T) examination with and without contrast enhancement. Contrast was enhanced by injections of Magnevist (469 mg/ml, Schering Nordiska). Bone destruction, sclerosis, and signs of inflammation were the main parameters studied. Results: In the preliminary results, average pain intensity was 6.3 on a numerical rating scale(NRS) and average pain duration was 3,6 years. 83% exhibited somatosensory abnormalities. Bone destruction not visible in the intraoral and panoramic radiographs was detected with CBCT in 40% (4/10) of the patients diagnosed with AO, and signs of inflammation were detected in the MRIs of 20% (2/10) of the patients diagnosed with AO. Conclusion: Preliminary findings indicate that CBCT and MRI can provide additional information to conventional radiography in the diagnosis of intraoral orofacial pain. Further studies with larger sample sizes of AO and SAP patients are necessary to determine the clinical relevance of these findings.
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| 3. |
- Rawski, A. A., et al.
(författare)
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The major factors that influence endodontic retreatment decisions
- 2003
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 27:1, s. 23-29
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Tidskriftsartikel (refereegranskat)abstract
- The presence of a new or persistent periapical radiolucency adjacent to a rootfilled tooth is often used as a criterion of endodontic treatment "failure". However, clinicians' suggested management of such cases is subject to substantial interindividual variation. Several components that might influence endodontic retreatment decision making have been explored, but data on which factors dentists actually think they consider, are missing. The aim was to interview 20 general dental practitioners (GDPs) and 20 endodontists about factors they thought would influence the prescription of endodontic retreatment. Six simulated cases were presented as cartoons accompanied with a clinical history. In two of the cases the teeth were planned to serve as an abutment tooth in a fixed prosthodontic construction. The status of the periapical bone tissue and the quality of rootfilling seal were varied. Between 1 and 6 factors per case were reported to influence decision making. In cases not planned to serve as abutment teeth most dentists considered that the periapical condition was the most important factor, whilst they considered the fixed prosthodontic construction to be the most important factor in cases planned as abutment teeth. Generally, endodontists seem to be more inclined to retreat and act on the mere presence of a periapical lesion regardless of size than GDPs. In a real clinical setting in direct contact with patients, additional factors like economy and patients' preferences might be expected to exert a major influence. The majority of the dentists stated that they thought that their colleagues would make similar decisions as they did themselves.
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| 4. |
- Wolf, Eva, et al.
(författare)
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Long-term follow-up by means of a questionnaire of 109 patients with long-lasting orofacial pain.
- 2002
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 26:3, s. 125-34
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to follow-up, analyse and compare the pain status after 4-9 years with that at the baseline examination of 109 consecutive patients referred to the Pain Group at the Faculty of Odontology in Malmö, Sweden during the period 1988-1993 due to long-lasting orofacial pain. A further aim was to identify predictive factors of significance for pain alteration. 85 (78%) women with a median age of 51 years and 24 (22%) men with a median age of 60 years were included in the study. A survey of the pain status at the follow-up was conducted by means of a mailed questionnaire. The questionnaire covered the following aspects: pain alteration, pain intensity, pain location, medication and education. After one reminder, the non-responding patients were called for a telephone interview. A response level of 85% was obtained. Significant improvements were noted by the patients in the answers of the questionnaire in mainly three areas; the patients answered individually that pain relief had occurred, pain intensity rated on the VAS was lower at follow-up compared to the baseline examination and a decrease in drug use was reported. The responses indicated pain relief for 75% of the patients. However, only 27% of the patients experienced total disappearance of pain. Medication at baseline with opioids, muscle relaxants with central effect, antidepressants, neuroleptics, hypnotics or sedatives was found to be a predictive factor for persistent pain.
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| 5. |
- Wolf, Eva, et al.
(författare)
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Non-specific chronic orofacial pain patients' experiences of everyday life situations : a qualitative study
- 2016
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 213-222
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Tidskriftsartikel (refereegranskat)abstract
- Kronisk ansiktssmärta är ett komplext tillstånd med konsekvenser som påverkar hela livssituationen. Syftet med studien var att med ett kvalitativt angreppssätt analysera upplevelsen av vardagssituationer för patienter med svårförklarlig kronisk ansiktssmärta. Elva kvinnor och tre män (21 till 77 år) valdes strategiskt ut bland de patienter med kronisk ansiktssmärta som remitterats till Orofaciala smärtenheten vid Odontologiska fakulteten, Malmö högskola, Malmö, Sverige. Samtliga utvalda informanter accepterade att delta. Data samlades in genom två tematiska djupintervjuer med varje informant. Intervjuerna spelades in med en digital ljudupptagare och skrevs ut ordagrant. Den text som berörde vardagssituationer identifierades i samtliga intervjuer och analyserades med kvalitativ innehållsanalys. Analysen av informanternas berättelser om vardagssituationer avslöjade en rädsla för konflikter, för den egna svagheten och för det okända. Analysen avslöjade också att informanterna uttryckte självanklagelser och att de undvek situationer som kunde orsaka rädsla. Åtta av de 14 informanterna nämnde inte någon vardagssituation de kände sig tillfreds med. Informanternas upplevelser av vardagssituationer dominerades av negativa känslor. Sammanfattningsvis kan kronisk långvarig svårförklarad ansiktssmärta inte förstås som ett isolerat fenomen utan måste beaktas i relation till den individ som drabbats av tillståndet.
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