| 1. |
- Fredricson, Adrian Salinas, et al.
(författare)
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Are there early signs that predict development of temporomandibular joint disease?
- 2018
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Ingår i: Journal of Oral Science. - : Nihon University School of Dentistry. - 1343-4934 .- 1880-4926. ; 60:2, s. 194-200
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Tidskriftsartikel (refereegranskat)abstract
- Temporomandibular joint disorders (TMJD) involve orofacial pain and functional limitations that may limit important daily activities such as chewing and speaking. This observational case-control study attempted to identify factors associated with TMJD development, particularly inflammation. The study participants were patients treated at Karolinska University Hospital, Stockholm, Sweden. The cases were patients who received a diagnosis of TMJD, chronic closed lock, or painful clicking and were treated surgically during the period from 2007 through 2011. The control group was randomly selected from among patients who had undergone tooth extraction and was matched by age and sex. A total of 146 cases and 151 controls were included in the analyses. The response rate was 55.3% for the case group and 21.8% for the control group. The male:female ratio for patients with TMJD was 1:4.4. TMJD was significantly associated with pneumonia (odds ratio [OR], 2.1), asthma (OR, 2.1), allergies (OR, 1.8), headache (OR, 3.1), general joint hypermobility (OR, 3.8), orofacial trauma (OR, 3.9), rheumatism (OR, 2.5), and orthodontic treatment (OR, 2.4) (P < 0.05 for all outcomes). In conclusion, autoimmune diseases and inflammatory conditions are associated with increased risk of TMJD. Moreover, certain lung disorders may predict subsequent development of TMJD.
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| 2. |
- Salinas Fredricson, Adrian
(författare)
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Causes and consequences of temporomandibular joint diseases
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Temporomandibular joint disorders (TMJD), a subgroup of Temporomandibular disorders (TMD), has a multifactorial etiology with still largely unknown pathophysiology. Although many risk factors have been proposed, few population-based studies have been conducted. There are known associations between TMJD and mental and behavioral disorders (MBD) and musculoskeletal diseases (MSD). MBD and MSD cause high work disability and are the leading causes for sick leave (SL) and disability pension (DP) both globally and in Sweden. However, no studies have investigated work disability among patients with TMJD (pwTMJD) or the effect of MBD and MSD comorbidity on work disability among pwTMJD. This thesis includes all Swedish citizens aged ≥18 registered between 1998 and 2016 in the National Patient Registry with a TMJD diagnosis or TMJD surgical procedure code. These pwTMJD (n=33 316) were matched to a comparison cohort (n=333 160) from the Total Population Registry. pwTMJD were categorized depending on whether they had received surgical treatment or not, and on the number of surgical procedures. Study I shows that pwTMJD have 2–3 times more mean annual days of SL and DP than the general population and that patients who had undergone several surgical treatments were most dependent on these benefits. The increased work disability among pwTMJD was noticeable as early as five years before first time diagnosis or treatment. Study II and Study III investigate the probability of developing TMJD among individuals with and without MBD/MSD. Study II shows that many MBD increase the probability of TMJD and that individuals with MBD had a higher risk of needing repeated surgical procedures compared to individuals with no MBD. Study III shows that virtually all MSD increase the probability of TMJD, especially TMJD that require repeated surgical procedures. Study IV further examines the impact of MBD and MSD comorbidity on mean annual days of SL and DP among pwTMJD compared to the general population, by using strata of comorbidity. The results show that both MBD and MSD comorbidity by themselves have a large impact on the use of social insurance benefits but that combined MBD/MSD comorbidity had the largest impact on SL and DP. Regardless of comorbidity, pwTMJD displayed the highest mean annual days of SL and DP in almost all strata of comorbidity. In conclusion, the results in this thesis show that MBD and MSD are strong predictors for the development of TMJD. The results also show that pwTMJD have more work disability than the general population, and that this increased dependence on social insurance benefits is strongly influenced by comorbidities. These findings emphasize how pwTMJD are suffering from their condition and that a multimodal approach is warranted, preferably steered by national guidelines designed by specialists in orofacial pain and function, oral and maxillofacial surgeons, and colleagues from the medical field.
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| 3. |
- Salinas Fredricson, Adrian, et al.
(författare)
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Diseases of the musculoskeletal system and connective tissue in relation to temporomandibular disorders : A SWEREG-TMD nationwide case-control study
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:10, s. e0275930-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Temporomandibular disorders (TMD) are comprised by a heterogenous group of diagnoses with multifaceted and complex etiologies. Although diseases of the musculoskeletal system and connective tissue (MSD) have been reported as risk factors for developing TMD, no nationwide population-based registry studies have been conducted to investigate this possible link. The aim of this study was to investigate the association between MSD and TMD in a population-based sample using Swedish registry data, and to further investigate the difference in such association between patients diagnosed with TMD in a hospital setting and patients surgically treated for the condition.MATERIALS AND METHODS: Population based case-control study using Swedish nationwide registry data. Data was collected between 1998 and 2016 from 33 315 incident cases and 333 122 controls aged ≥18, matched for sex, age, and living area. Cases were stratified into non-surgical (NS), surgically treated once (ST1) and surgically treated twice or more (ST2). Information on MSD exposure (ICD-10 M00-M99) was collected between 1964 and 2016. Odds ratios were calculated using conditional logistic regression, adjusted for country of birth, educational level, living area, and mental health comorbidity.RESULTS: A significant association between MSD and the development of TMD was found for all diagnostic categories: arthropathies (OR 2.0, CI 1.9-2.0); systemic connective tissue disorders (OR 2.3, CI 2.1-2.4); dorsopathies (OR 2.2, CI 2.1-2.2); soft tissue disorders (OR 2.2, CI 2.2-2.3); osteopathies and chondropathies (OR 1.7, CI 1.6-1.8); and other disorders of the musculoskeletal system and connective tissue (OR 1.9, CI 1.8-2.1). The associations were generally much stronger for TMD requiring surgical treatment. The diagnostic group with the strongest association was inflammatory polyarthropathies, M05-M14 (OR 11.7, CI 8.6-15.9), which was seen in the ST2 group.CONCLUSIONS: Patients with MSD diagnoses have a higher probability of being diagnosed with TMD, in comparison to individuals without MSD. This association is even stronger for TMD that requires surgery. The results are in line with earlier findings, but present new population-based evidence of a possible causal relationship between MSD and TMD, even after adjusting for known confounders. Both dentists and physicians should be aware of this association and be wary of early signs of painful TMD among patients with MSD, to make early referral and timely conservative treatment possible.
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| 4. |
- Salinas Fredricson, Adrian, et al.
(författare)
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Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders : A SWEREG-TMD population-based cohort study
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2-3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated.METHODS: All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23-59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations.RESULTS: TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2-3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect.CONCLUSION: TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients' impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.
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| 5. |
- Salinas Fredricson, Adrian, et al.
(författare)
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Sick leave and disability pension in a cohort of TMD-patients : The Swedish National Registry Studies for Surgically Treated TMD (SWEREG-TMD)
- 2022
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Temporomandibular disorders (TMD) are common and affect approximately 10% of the adult population. TMD is usually associated with headache, pain in the masticatory muscles and/or the temporomandibular joint, clicking or crepitations during mandibular movement as well as painful and/or reduced mouth opening. This study aimed to investigate the level TMD-patients use social insurance benefits before and after their first time of diagnosis or first surgical event, compared to the general population. Furthermore, the aim was to investigate the differences in the use of social insurance benefits between surgically and non-surgically treated TMD-patients that were diagnosed in a hospital setting.METHODS: All Swedish citizens aged 23-59 diagnosed with TMD in a hospital setting and/or surgically treated for the condition during 1998-2016 were identified via the Swedish National Board of Health and Welfare. A non-exposed comparison cohort was collected via the Total Population Registry. Outcome and sociodemographic data were collected via Statistics Sweden. Main outcome was annual net days on sick leave and disability pension five years before (-T5) and five years after (T5) diagnosis and/or surgical treatment (T0). Regression analysis was conducted with generalized estimated equations.RESULTS: The study included 219 255 individuals (73% female) - 19 934 in the exposed cohort and 199 321 in the comparison cohort. The exposed group was classified into three subgroups: non-surgical, surgically treated once, and surgically treated twice or more. The mean annual net days of sick leave and disability pension combined during the ten-year follow-up was 61 days in the non-surgical group, 76 days in the surgically treated once group, and 104 days in the surgically treated twice or more subgroup. The corresponding number for the non-exposed comparison cohort was 32 days.CONCLUSION: Patients diagnosed with TMD in a hospital setting are 2-3 times more dependent on the use of social benefits than the general population. The reliance on sick leave and disability pension is seen as early as five years before diagnosis, and the reliance remains after surgical treatment. The reliance is stronger in patients with several surgical interventions. These findings indicate that patients diagnosed with TMD constitute a patient group with a high burden of health issues causing long-term dependence on social security benefits.
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| 6. |
- Salinas Fredricson, Adrian, et al.
(författare)
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The role of mental health and behavioral disorders in the development of temporomandibular disorder : A SWEREG-TMD nationwide case-control study
- 2022
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Ingår i: Journal of Pain Research. - : Dove Press. - 1178-7090. ; 15, s. 2641-2655
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: There is a well-known association between mental and behavioral disorders (MBD) and temporomandibular disorder (TMD), although the association has not been established in population-based samples. This study aimed to investigate this relationship using national population-based registry data.Patients and Methods: This case-control study used prospectively collected data from Swedish national registries to investigate exposure to MBD and the probability of developing TMD in all Swedish citizens with hospital-diagnosed or surgically treated TMD between 1998 and 2016. Odds ratios were calculated using conditional logistic regression adjusted for educational level, living area, country of birth, musculoskeletal comorbidity, and history of orofacial/neck trauma.Results: A statistically significant association between MBD and TMD was found for mood affective disorders (OR 1.4), neurotic, stress-related and somatoform disorders (OR 1.7), behavioral syndromes associated with psychological disturbances and physical factors (OR 1.4), disorders of adult personality and behavior (OR 1.4), disorders of psychological development (OR 1.3), behavioral and emotional disorders with onset usually occurring in childhood and adolescence (OR 1.4), and unspecified mental disorder (OR 1.3). The association was stronger for TMD requiring surgery, with the strongest association in patients with disorders of psychological development (OR 2.9). No significant association was found with schizophrenia, schizotypal and delusional disorders, or mental retardation.Conclusion: The findings indicate an increased probability of TMD among patients with a history of certain MBD diagnoses, and a stronger association with TMD requiring surgery, specifically repeated surgery. This highlights the need for improved preoperative understanding of the impact of MBD on TMD, as TMD and chronic pain itself may have a negative impact on mental health.
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