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- Christidis, Nikolaos, et al.
(författare)
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Pharmacological Treatments of Temporomandibular Disorders : A Systematic Review Including a Network Meta-Analysis
- 2023
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Ingår i: Drugs. - : Springer. - 0012-6667 .- 1179-1950.
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD.METHOD: An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane's tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE).RESULTS: When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose.CONCLUSIONS: The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient's individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches.
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| 2. |
- Christidis, Nikolaos, et al.
(författare)
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Swedish dental students’ clinical notes and reflections as part of a case-based examination – challenges for undergraduate education
- 2023
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Ingår i: Medical Research Archives. - : European Society of Medicine. - 2375-1916 .- 2375-1924. ; 11:10
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Tidskriftsartikel (refereegranskat)abstract
- Clinical records are the basis for clinical reasoning, diagnostics, treatment planning, and management as well as for management of the patient and the outcome of the treatment, and therefore an important aspect of health professionals’ work. Several articles emphasize the importance of adequate and correct content in these records. Previous research shows that even health professionals need to improve the content and structure of their clinical records, for them to give the information needed for various needs. The focus of this article are the clinical records of undergraduate dental students. The aim of the study was to explore patterns of adequate and inadequate content in clinical notes of undergraduate dental students in their final year of education. Secondly, whether these results could provide insights for development of health professions education.Data comprised of 33 cased-based examinations collected during January 2020 at the University Dental Clinic, Department of Dental Medicine, Karolinska Institutet, in Huddinge Sweden. Also, data included teachers’ assessment of these examinations. The texts were analyzed with thematic analysis.Analytical results showed three themes. The first theme, (i) Professional content knowledge, concerned information in patient history, status, diagnostics and treatment plan, and an information ambiguity. The theme also included the students' use of professional terminology and the choice of articles to support reflections. The second theme (ii) incomplete method of investigation involved the actual patient interview, but also students’ various misunderstandings of the template. The third theme was (iii) Academic formalities. This theme concerned students' understanding of the purpose of referencing and its function, but also a non-use of references, the use of irrelevant references, errors in the given citation style, and an incorrect structure of the text according to the template. In conclusion, results showed the need for continuous training in clinical note-taking and reflections during dental students' professional education. In this training, teachers’ assessment is important for students' development of professional literacy and professional judgment. Also, a continuous reminder of science and proven experience as the basis for the profession which is also made visible through academic formalities.
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| 3. |
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| 4. |
- Lindberg, Viveca, 1954-, et al.
(författare)
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Literacy as part of professional knowing in a Swedish dental education
- 2021
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Academic reading and writing are seen as self-evident literacy competences in most contemporary higher educations, however, whether students also are introduced to professional literacy of relevance for dentistry during their education is a question. The purpose of this study is to analyze one of the Swedish dental programmes, with respect to its design, in relation to possible content of relevance for academic and professional literacy. Secondarily, to identify and analyze Swedish dental students’ writing in an academic setting, i.e. what these students are expected to read and write, and how they write.Methods: Data, for this ethnographically inspired case-study, was produced by observations and audio-recordings of lectures, copies of teachers’ handouts and of volunteering students’ notes, and a multiple-choice-test. Dataanalysis was made in five steps, starting with macro-level data, i.e. curriculum and syllabuses, followed by the syllabuses for the two observed modules, the teacher-provided material, analysis of the students’ notes, while in the fifth and final step, the results from the previous steps were compared, to find patterns of what students were expected to read and write, and what in the teacher-provided multimodal material that was emphasized in teachers’ talk.Results: This study showed that students were engaged in several types of literacy events, such as reading, finding and watching videos on their learning platform, writing, and following instructions. The study also showed that there is a recurrent academic content comprised of anatomy, physiology and pathology, while the professional content comprised of patient communication and anamnesis. Further, an integrated content was found and was initiated in teacher-constructed PowerPoints and by student-questions. Note-taking patterns varied between individual students, but the general pattern for this group of students were the use of complementary notes. This type of note-taking was used to make available further descriptions of the teacher-constructed text in PowerPoints, but also an independent text describing pictures shown on teachers’ PowerPoints or the blackboard.Conclusion: Findings from the present study reveal that students either copy text from teachers’ PowerPoint-slides, re-formulate text from teachers’ PowerPoint-slides, or write complementing text to teachers’ PowerPoint-slides. Further, the students individually choses type of note-taking based on situation. The study also revealed that the academic literacy – in the two modules during the fifth and sixth semesters of a dental education analyzed – mainly has a professional basis for reading, writing, and communication purposes. The study also showed that academic and professional literacy are closely connected through recurrent integration.
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| 5. |
- Nilsson, Håkan, et al.
(författare)
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Experiences by patients and health professionals of a multidisciplinary intervention for long-term orofacial pain
- 2013
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press Ltd. - 1178-2390 .- 1178-2390. ; 6, s. 365-371
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe patients’ and health professionals’ experiences of a multidisciplinary stress-focused clinical evaluation with prolonged engagement as an intervention for patients with long-term orofacial pain. Data in the patient part of this study were collected by free-text questionnaires using open-ended questions. Data were collected by group interview in the part of the study concerning health professionals. All data were analyzed according to qualitative content analysis. Data from patients revealed three categories for the intervention, ie, “helpful for most and crucial for some”, “being listened to, respected and validated”, and “gives important coping strategies”. The results showed that a vast majority of patients described themselves as having been helped by the intervention. Some patients reported that meeting with the orofacial pain consultant team was crucial to the future course of their lives. Most patients described still having residual pain and symptoms, and only a few described their pain as being fully remitted. However, because of the intervention, the patients reported being able to adopt more constructive coping strategies. They also described their perception of the pain as being different, in that it was not so frightening once they had been given a model with which to understand it. Data from the health professionals revealed similar categories. Concordance between the patients' and health professionals' experiences was striking. In their descriptions, the health professionals and patients underscored the same components as being effective, with understanding, respect, and validation being the most important. The multidisciplinary approach was highlighted as being key to success by both the patients and health professionals.
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