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1.
  • Abdulraheem, Salem, et al. (författare)
  • Hawthorne effect reporting in orthodontic randomized controlled trials : truth or myth? Blessing or curse?
  • 2018
  • Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:5, s. 475-479
  • Forskningsöversikt (refereegranskat)abstract
    • Objective To investigate in 10 orthodontic journals how many randomized controlled trials (RCTs) considered the Hawthorne effect, and if considered, to determine whether it was related to the patients or the therapists involved in the trial and, finally, to discuss the Hawthorne effect in an educational way. Materials and methods A search was performed on the Medline database, via PubMed, for publication type ‘randomized controlled trial’ published for each journal between 1 August 2007 and 31 July 2017. The American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, Australian Orthodontic Journal, Dental Press Journal of Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, Journal of Orofacial Orthopedics, Korean Journal of Orthodontics, Orthodontics and Craniofacial Research and Progress in Orthodontics were assessed. Two independent reviewers extracted the data and identified whether the Hawthorne effect was considered or discussed in the articles and whether the Hawthorne effect was related to the behaviour of the patients, the therapists, or both. Results The initial search generated 502 possible trials. After applying the inclusion and exclusion criteria, 290 RCTs were included and assessed. The Hawthorne effect was considered or discussed in 10 of 290 RCTs (3.4%), and all were related to the patients’ and none to the therapists’ behaviour. Conclusions The Hawthorne effect reported in orthodontic RCTs was suboptimal. The researchers’ lack of knowledge about this phenomenon is evident, despite evidence that the Hawthorne effect may cause over-optimistic results or false-positive bias.
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2.
  • Abdulraheem, Salem, et al. (författare)
  • The reporting of blinding in orthodontic randomized controlled trials : where do we stand?
  • 2019
  • Ingår i: European Journal of Orthodontics. - : Oxford Academic. - 0141-5387 .- 1460-2210. ; 41:1, s. 54-58
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To analyse in 10 orthodontic journals how many randomized controlled trials (RCTs) performed 'single-', 'double-', 'triple-', or 'outcome assessors blinding' and to evaluate, from the number of RCTs that did not conduct blinding, how many could actually have achieved it. Material and methods: Randomized controlled trials published in 10 orthodontic journals between 1 September 2012 and 28 February 2018 were included. A search was performed in PubMed and conducted for publication type 'randomized controlled trial' for each journal. Two reviewers independently analysed each RCT and registered that blinding was performed and included which specific type. It was also evaluated whether misclassifications of blinding items occurred and whether it was possible to achieve blinding among the RCTs that did not perform blinding. Results: After applying the inclusion criteria, 203 RCTs were assessed, and 61.6 per cent of them had used blinding, with the main type being 'outcome assessors blinding' (40.4%) followed by 'single-blinding' (15.3%), 'double-blinding' (2.5%), and 'triple-blinding' (3.4%). In 38.4 per cent of the trials, no blinding was performed; however, 79.4 per cent of them could have achieved blinding. Fifteen RCTs (7.3%) misclassified the blinding in relation to single-, double-, or triple-blinding. Journals followed the CONSORT (AJODO, EJO, JO, OCR) published together significantly more RCTs that performed blinding than journals not following the CONSORT. Conclusions: Blinding of outcome assessors was the most frequent type, as orthodontic trials are often of intervention design and thereby difficult to mask for patients and trial staff. The misclassifications of blinding items may indicate suboptimal knowledge among researchers and peer-reviewers regarding the definitions for diverse blinding types.
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4.
  • Abrahamsson, Cecilia, et al. (författare)
  • Alterations of temporomandibular disorders before and after orthognathic surgery
  • 2007
  • Ingår i: Angle orthodontist. - : Angle Orthodontist. - 0003-3219 .- 1945-7103. ; 77:4, s. 729-734
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVE: To answer the question whether orthognathic surgery does affect the prevalence of signs and symptoms of temporomandibular disorders (TMDs). MATERIALS AND METHODS: A literature survey in the PubMed and Cochrane Library electronic databases was performed and covered the period from January 1966 to April 2006. The inclusion criteria were controlled, prospective or retrospective studies comparing TMDs before and after orthognathic surgery in patients with malocclusion. There were no language restrictions, and three reviewers selected and extracted the data independently. The quality of the retrieved articles was evaluated by four reviewers. RESULTS: The search strategy resulted in 467 articles, of which 3 met the inclusion criteria. Because of few studies with unambiguous results and heterogeneity in study design, the scientific evidence was insufficient to evaluate the effects that orthognathic surgery had on TMD. Moreover, the studies had problems with inadequate selection description, confounding factors, and lack of method error analysis. CONCLUSION: To obtain reliable scientific evidence, additional well-controlled and well-designed studies are needed to determine how and if orthognathic surgery alters signs and symptoms of TMD.
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5.
  • Abrahamsson, Cecilia, et al. (författare)
  • Masticatory function in patients with dentofacial deformities before and after orthognathic treatment : a prospective, longitudinal, and controlled study
  • 2015
  • Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:1, s. 67-72
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of this study was to investigate the self-estimated masticatory ability and masticatory performance in patients with dentofacial deformities before and after orthognathic treatment; in comparison to an age- and gender-matched control group. SUBJECTS AND METHODS: The masticatory ability and masticatory performance were evaluated in 121 consecutive patients (treatment group), referred for orthognathic treatment. Eighteen months after treatment, 98 patients (81%) completed a follow-up examination. Masticatory ability was assessed on a visual analog scale, while the masticatory performance was evaluated by a masticatory test using round silicon tablets. Signs and symptoms of temporomandibular disorders (TMD) were registered by a clinical examination and a questionnaire. The control group comprised 56 age- and gender-matched subjects who were examined at baseline. RESULTS: At the baseline examination, the treatment group had a significantly lower masticatory ability and performance compared with the control group. After treatment, the masticatory ability significantly improved in the treatment group and reached the same level as in the control group. The masticatory performance index increased significantly but was still lower than in the control group. Both the masticatory ability and masticatory performance were affected by the number of occlusal contacts during maximal biting pressure and by the self-estimated overall symptoms of TMD. CONCLUSIONS: Patients with dentofacial deformities, corrected by orthognathic treatment, have a significant positive treatment outcome in respect of masticatory ability and masticatory performance. Furthermore, the occlusion and symptoms of TMD have an impact on both masticatory ability and masticatory performance.
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6.
  • Abrahamsson, Cecilia, et al. (författare)
  • TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment
  • 2013
  • Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier. - 0901-5027 .- 1399-0020. ; 46:6, s. 752-758
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain
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7.
  • Abrahamsson, Cecilia, et al. (författare)
  • TMD in consecutive patients referred for orthognathic surgery
  • 2009
  • Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 33:4, s. 201-226
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. MATERIALS AND METHODS: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. CONCLUSIONS: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.
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8.
  • Bazargani, Farhan, 1969-, et al. (författare)
  • Three-dimensional Analysis of Effects of Rapid Maxillary Expansion on Facial Sutures and Bones : A systematic review
  • 2013
  • Ingår i: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 83:6, s. 1074-1082
  • Forskningsöversikt (refereegranskat)abstract
    • Objective: To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. Materials and Methods: The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. Results: The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. Conclusions: CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
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9.
  • Bjerklin, Krister, et al. (författare)
  • Ectopic maxillary canines and root resorption of adjacent incisors : Does computed tomography (CT) influence decision-making by orthodontists?
  • 2008
  • Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 32:4, s. 179-186
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this investigation was to evaluate whether access to computed tomography (CT) influences orthodontists' decision-making about management of incisor root resorption due to ectopic maxillary canines. The study base comprised orthodontic specialists and active members of the Swedish Orthodontic Society: 182 orthodontists under 65 years of age, who had been registered specialists for at least one year and were providing specialist treatment for regular orthodontic patients. A questionnaire was sent out, comprising 8 questions about management and decision-making in cases of ectopic maxillary canines with root resorption of adjacent incisors and 7 questions about practice profile. The orthodontists were asked whether they altered their treatment decisions when CT was available as a diagnostic tool. The response rate was high, 86%. Sixty of the orthodontists had access to CT. Sixty-one percent of the 97 orthodontists without access to CT stated that, in cases with space deficiency, they seldom or never considered extraction of a lateral incisor with suspected root resorption if the resorption was not discernible on intra-oral or panoramic radiographs. It was evident that even in cases of root resorption of lateral incisors due to ectopic canines, the orthodontists' management decisions were not particularly influenced by availability of CT diagnostic data. In the extraction cases 55% of the orthodontists considered extraction of the affected incisor first when root resorption was severe, i.e. involving the pulp and 37% when the resorption reached half way to the pulp. in cases without space deficiency 82% preferred to extract these resorbed lateral incisors not until the resorption reached the pulp.
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10.
  • Bjerklin, Krister, et al. (författare)
  • Management of ectopic maxillary canines : variations among orthodontists
  • 2008
  • Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 78:5, s. 852-859
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To document and analyze factors involved in decision-making by orthodontists in managing disturbances of eruption of maxillary canines. MATERIAL AND METHODS: The participants comprised orthodontic specialists and active members of the Swedish Orthodontic Society. Those selected for the study sample were under 65 years of age or younger and had been treating orthodontic patients for at least 1 year as a specialist. Three typical cases were presented for treatment proposals. The case notes, including radiographs and specific background data, were sent to the 182 selected orthodontists. The orthodontists were also requested to complete a questionnaire about practice profile, comprising eight questions. RESULTS: The response rate was 86.3%; yielding 157 participants (mean age 53.8 years, SD 8.12). Analysis disclosed no differences between responders and nonresponders regarding age, gender, and years of specialist practice. For treatment plans based on panoramic radiographs, intraoral radiographs, and status and anamnesis, there was general consensus. However, when supplementary information from computer tomography (CT) was provided, disclosing root resorption half-way to the pulp or more on the lateral incisor, the orthodontists' treatment proposals varied. Gender, age, and practice profile of the orthodontists had little association with the decision-making. CONCLUSIONS: Supplementary CT information led to variations in decision-making with respect to treatment of eruption disturbances of maxillary canines. This lack of consensus among specialist orthodontists can have negative implications for patients.
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