| 1. |
- Alajbeg, Ivan, et al.
(författare)
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Intraoralelectrostimulator for xerostomia relief : along-term, multicenter, open-label, uncontrolled, clinical trial
- 2012
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier. - 2212-4403 .- 2212-4411. ; 113:6, s. 773-781
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A previous sham-controlled multinational study demonstrated the short-term efficacy and safety for xerostomia treatment of an intraoral device that delivers electrostimulation to the lingual nerve. The objective of this study was to test the hypothesis that those beneficial effects would be sustained over an 11-month period. STUDY DESIGN: The device was tested on a mixed sample of 94 patients with xerostomia in an open-label, uncontrolled, prospective multicenter trial. Statutory outcome assessments were done at 5th, 8th, and 11th months and analyzed by multiple comparisons. RESULTS: Improvements achieved at month 5 from baseline were sustained throughout the follow-up period for the primary outcome, xerostomia severity, and the secondary outcomes resting whole salivary flow rate, xerostomia frequency, oral discomfort, and difficulties in speech, swallowing, and sleeping. No significant side effects were detected. CONCLUSIONS: The beneficial effects of a removable intraoral electrostimulating device were sustained for an 11-month period.
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| 2. |
- Strietzel, Frank P, et al.
(författare)
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Efficacy and safety of an intraoral electrostimulation device for xerostomia relief : A multicenter randomized trial
- 2011
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 63:1, s. 180-190
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of the study was to evaluate the efficacy in treating xerostomia and the safety of an intraoral electrostimulation device, containing stimulating electrodes, an electronic circuit and a power source. The device delivers electrostimulation through the oral mucosa to the lingual nerve, in order to enhance the salivary reflex. Methods: The device was tested on a sample of patients with xerostomia due to Sjögren’s syndrome and other sicca conditions in a prospective randomized multi-center trial consisting of two stages: (I) a double blind, cross-over designed stage to compare the effects of the electrically “active” device with the “sham” device, both used for one month, and (II) a 3- month open label stage to assess the long-term influence of the “active” device. Improvement of xerostomia severity from baseline was the primary outcome. Results: A total of 114 subjects were randomized. In Stage I, “active” device performed better than “sham” for patient-reported xerostomia severity (p<0.002), xerostomia frequency (p<0.05), quality of life impairment (p<0.01) and swallowing difficulty (p<0.02). At the end of Stage II, statistically significant improvements were verified for patient-reported xerostomia severity (p<0.0001), xerostomia frequency (p<0.0001), oral discomfort (p<0.001), speech difficulty (p<0.02) and sleeping difficulty (p<0.001), and for resting salivary flow-rate (p<0.01). Conclusion: Daily use of the device alleviated oral dryness, discomfort and some complications of xerostomia, such as speech and sleeping difficulties, and increased salivary output. The results show a cumulative positive effect of the device over the period of the study, from baseline to the trial’s end.
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| 3. |
- Gullberg, Joanna, et al.
(författare)
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The challenge of applying digital image processing software on intraoral radiographs for osteoporosis risk assessment
- 2022
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Ingår i: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 51:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to evaluate rater agreement and the accuracy of a semi-automated software and its fully automated tool for osteoporosis risk assessment in intraoral radiographs. Methods: A total of 567 intraoral radiographs was selected retrospectively from women aged 75-80 years participating in a large population based study (SUPERB) based in Gothenburg, Sweden. Five raters assessed participants' risk of osteoporosis in the intraoral radiographs using a semi-automated software. Assessments were repeated after 4 weeks on 121 radiographs (20%) randomly selected from the original 567. Radiographs were also assessed by the soft wares' fully automated tool for analysis. Results: Overall interrater agreement for the five raters was 0.37 (95% CI 0.32-0.41), and for the five raters with the fully automated tool included as 'sixth rater' the overall Kappa was 0.34 (0.30-0.38). Intrarater agreement varied from moderate to substantial according to the Landis and Koch interpretation scale. Diagnostic accuracy was calculated in relation to reference standard for osteoporosis diagnosis which is T score values for spine, total hip and femoral neck and presented in form of sensitivities, specificities, predictive values, likelihood ratios and odds ratios. All raters' mean sensitivity, including the fully automated tool, was 40,4% (range 14,3%-57,6%). Corresponding values for specificity was 69,5% (range 59,7%-90,4%). The diagnostic odds ratios ranged between 1 and 2.7. Conclusion: The low diagnostic odds ratio and agreement between raters in osteoporosis risk assessment using the software for analysis of the trabecular pattern in intraoral radiographs shows that more work needs to be done to optimise the automation of trabecular pattern analysis in intraoral radiographs.
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| 4. |
- Lindh, Christina, et al.
(författare)
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Tooth loss and osteoporosis
- 2006
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Konferensbidrag (refereegranskat)abstract
- Objectives: To test the relationship between the number of existing teeth (3rd molars and impacted teeth excluded) and the Bone Mineral Density (BMD). Methods: The study entailed perimenopausal and postmenopausal subjects (age 45-70 years). The BMD at three different sites (standardized total hip t-score, standardized femoral neck t-score and standardized lumbar spine t-score) was measured using DXA. The subjects received a panoramic radiograph and their medical history was evaluated. The number of existing teeth was calculated using the panoramic radiographs and the relation between the BMD and the number of existing teeth in different age groups of the subjects was examined.The equation introduced by Taguchi et al (1995) for calculating the probability of osteoporosis using two variables (age and number of existing teeth) Pv =1/(1+e-z) was also applied and assessed. Results: Data of 178 subjects (mean age 54,38 y; sd =6,32y) were available for analysis. Patients with a standardized t-score value less than -2.5 at any of the three sites were classified as osteoporotic. Those with a score above this were classified as normal or osteopenic. When osteoporosis was diagnosed at any of the three sites, there were fewer existing teeth (mean 18,47 ,95% CI;15,89 to 21,05) compared with normal (mean 21,24, 95% CI; 19.96 to 22,53) and osteopenic subjects (mean 19,97 95% CI;18,58 to 21,37). The results approaches statistical significance. Conclusions: It seems that there is a relationship between the number of remaining teeth and BMD.This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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| 5. |
- Al-Okshi, Ayman, et al.
(författare)
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Using GafChromic film to estimate the effective dose from dental cone beam CT and panoramic radiography
- 2013
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 42:7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To demonstrate the feasibility of GafChromic(®) XR-QA2 (ISP Corp., Wayne, NJ) as a dosemeter when performing measurements of the effective dose from three cone beam CT (CBCT) units and to compare the doses from examinations of three common dental clinical situations. A second aim was to compare the radiation doses for three digital panoramic units with the doses for the CBCT units. METHODS: The CBCT units used were Veraviewepocs 3De(®) (J Morita MFG Corp., Kyoto, Japan), ProMax(®) 3D (Planmeca, Helsinki, Finland) and NewTom VGi(®) (Quantitative Radiology, Verona, Italy). GafChromic XR-QA2 films were placed between the selected layers of the head and neck of a tissue-equivalent human skull (RANDO(®) phantom; The Phantom Laboratory, Salem, NY). The exposure parameters were set using the automatic exposure control function of the units. Depending on the availability, medium and smaller field of view (FOV) scanning modes were used. The effective dose was estimated using the 2007 International Commission on Radiological Protection formalism. RESULTS: The lowest effective dose of a CBCT unit was observed for ProMax 3D, FOV 4 × 5 cm (10 μSv), the highest for NewTom VGi, FOV 8 × 8 cm-high resolution (129 μSv). The range of effective doses for digital panoramic machines measured was 8-14 μSv. CONCLUSIONS: This study demonstrates the feasibility of using radiochromic films for dental CBCT and panoramic dosimetry.
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| 6. |
- Lindh, Christina, et al.
(författare)
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Mandibular cortical index for osteoporosis diagnosis : the OSTEODENT project
- 2006
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Konferensbidrag (refereegranskat)abstract
- Objectives: to determine the diagnostic validity of the mandibular cortical index (MCI) for the diagnosis of osteoporosis in peri- and post-menopausal women. Methods: Volunteer female subjects in the 45 to 70 year age band, recruited from four European centres, underwent dual x-ray energy absorptiometry of the hip and lumbar spine, to provide a gold standard diagnosis of osteoporosis, and a DPR examination. Five observers, all oral radiologists but of different experience, made an assessment of porosity of the cortex of the lower border of the mandible using MCI. Results: Data of 661 subjects (mean age 54.8y; sd = 6.19y) were available for analysis, with 140 (21.2%) being classified as having osteoporosis. MCI data for each observer were dichotomosed so that MCI grade 3 indicated a positive test result and grades 1 and 2 a negative test result. The sensitivities and specificties of MCI for osteoporosis diagnosis were determined: Osteoporosis at any site Osteoporosis at femoral neck Observer Sensitivity (%) Specificity (%) Sensitivity (%) Specificity (%) 1 24.8 93.3 27.3 91.3 2 23.4 93.2 24.2 91.3 3 23.4 91.5 24.2 89.8 4 20.6 99.8 22.7 91.8 5 19.1 91.1 22.7 90.3 Interobserver repeatability (using weighted Kappa) showed a range of 0.183 to 0.780, with a median value of 0.467. This median indicated moderate agreement. Conclusions: MCI had low sensitivity but high specificity for diagnosis of osteoporosis. This high specificity might prove to be more appropriate for use in primary dental care than using a different diagnostic threshold. This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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| 7. |
- Lindh, Christina, et al.
(författare)
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ROC analysis of directly measured mandibular cortical width from panoramic radiogarphs for diagnosis of osteoporosis : the OSTEODENT study
- 2006
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Konferensbidrag (refereegranskat)abstract
- Objectives: To determine the diagnostic validity of the width of the inferior mandibular cortex on dental panoramic radiographs (DPRs), as measured directly by observers, for the diagnosis of osteoporosis in peri- and post-menopausal women. Methods: Volunteer female subjects in the 45 to 70 year age band, recruited from four European centres, underwent dual x-ray energy absorptiometry of the hip and lumbar spine, to provide a gold standard diagnosis of osteoporosis, and a DPR examination. Five observers, all oral radiologists but of different experience, made manual measurements of width of the mandibular lower border cortex below the mental foramina bilaterally. Results: Data of 661 subjects (mean age 54.8y; sd = 6.19y) were available for analysis, with 140 (21.2%) being classified as having osteoporosis. Az values are given below: Osteoporosis at any site Osteoporosis at femoral neck Observer Az (se) 95% CI Az (se) 95% CI 1 0.782 0.748-0.813 0.804 0.771-0.833 2 0.766 0.731-0.799 0.757 0.722-0.791 3 0.756 0.721-0.788 0.790 0.757-0.821 4 0.746 0.711-0.779 0.762 0.727-0.794 5 0.710 0.673-0.744 0.752 0.718-0.785 A diagnostic threshold of 3mm resulted in a sensitivity of 50.7% and a specificity of 80.4% (data for median observer, 2). Mean within-subject variance for the five observers was 0.126mm (sd = 0.355mm). Repeatability is the difference between two measurements made by any pair of observers for the same subject and was expected to be less than 0.983 mm for 95% of pairs of observations. Conclusions: Direct measurement of mandibular cortical width was diagnostically effective in diagnosis of osteoporosis. However, repeatability may be a problem in clinical use. This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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| 8. |
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| 9. |
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| 10. |
- Taguchi, Akira, et al.
(författare)
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Visual assessment of non-eroded thin cortex on panoramic radiographs in identifying women with osteoporosis : Osteoporosis Screening Project in Dentistry (OSPD)
- 2009
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Ingår i: Programme and abstract book. ; , s. 65-65
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction The presence of an eroded or thinned cortex of the mandible on panoramic radiographs may be useful in identifying women with osteoporosis. However, little is known as to whether a non-eroded thin cortex predicts osteoporosis. Objective To clarify whether visual assessment of non-eroded thin cortex increases the diagnostic efficacy of identifying women with osteoporosis. Materials and methods Of 60 observers who participated in OSPD (Taguchi et al., Bone, 2008), 41 observers visually assessed non-eroded thin cortex in addition to Klemetti’s index (KI) for 100 panoramic radiographs on the OSPD website via the Internet twice with approximately a two-week interval. The area under the receiver operating characteristics curves (AUROC) in identifying women with osteoporosis by both KI and non-eroded thin cortex was calculated on two occasions; non-eroded thin cortex was included in “class 1 of KI (decreased probability of osteoporosis)” or “class 3 of KI (increased probability of osteoporosis)”. Mean AUROC was compared between these two occasions with paired ttest. Results In the first series of observations, the mean AUROC significantly increased when noneroded thin cortex was considered as a sign of increased probability of osteoporosis (mean +/- SD, 0.68 +/- 0.08 vs. 0.70 +/- 0.07, P=0.011). In the second set of observations, the result was unchanged (0.68 +/- 0.09 vs. 0.71 +/- 0.08, P<0.001). Conclusions and discussion Visual identification of a non-eroded thin cortex on panoramic radiographs may increase the diagnostic efficacy of identifying women with osteoporosis.
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