| 1. |
- Farzaneh, Farokh, et al.
(författare)
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von Langenbeck procedures at 14 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with bilateral complete cleft lip and palate: A study of facial growth.
- 2009
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 43:4, s. 214-24
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Tidskriftsartikel (refereegranskat)abstract
- We compared facial growth in patients with bilateral complete cleft lip and palate (BCLP) in whom the palate had been repaired by the von Langenbeck procedure at the age of 14 months (L-14), or by the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference group. Thirty-six adult patients, 26 in the L-14 group, and 10 in the W-18 group, were investigated clinically and with lateral skull radiography, and they also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effect of surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal and vertical jaw relations, and inclination of incisors. The BCLP group was characterised by a pre-normal basal relation (ss-n-sm), retroclined upper (ILs/NL) and lower (ILi/ML) incisors, maxillary retrognathism (s-n-ss) in men, larger maxillary plane angle (NSL/NL) in women, larger mandibular plane (NSL/ML) and intermaxillary vertical relation (NL/ML) in men, and smaller anterior facial height (n-gn) and upper anterior facial height (n-sp). In the BCLP group, differences in outcomes could be explained only by sex. The sagittal jaw base relation (ss-n-sm) was significantly smaller in men than in women, whereas the total anterior facial height (n-gn) was greater in men. Lateral crossbite was found in about 75% of patients. About 70% were satisfied with their dental condition. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.
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| 2. |
- Farzaneh, Farokh, et al.
(författare)
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von Langenbeck procedures at 8 months or Wardill at 18 months for primary repair of cleft palate in adult Swedish patients with unilateral complete cleft lip and palate: A study of facial growth.
- 2008
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 42:2, s. 67-76
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare facial growth in patients with unilateral complete cleft lip and palate (UCLP) in whom the palate was repaired with the von Langenbeck procedure at 8 months (L-8), or the Wardill procedure at 18 months (W-18). A total of 151 unaffected subjects were used as a reference series. Sixty-one adult patients, 34 in the L-8 group and 27 in the W-18 group, were investigated clinically and with lateral skull radiography and also filled out a questionnaire about their dental condition. Multiple linear regression was used to analyse the effects of the surgical strategy, sex, and the presence of a velopharyngeal flap on several dependent variables indicating sagittal jaw relations, vertical jaw relations, and inclination of incisors. The UCLP group was characterised by a short (n-sp) and retrusive maxilla (s-n-ss) and a retrusive mandible for women (s-n-sm), larger maxillary inclination (NSL/NL), more retroclined lower incisors (IL(I)/ML), shorter upper facial heights (n-sp) and normal total face height (n-gn) than the reference group. In the UCLP group there were significant differences between men and women in mandibular prognathism (s-n-sm), maxillary/mandibular relations (ss-n-sm), maxillary inclination (NSL/NL), total anterior facial height (n-gn), and upper anterior facial height (n-sp). Lateral crossbite was found in 20% of the UCLP group. The prevalence was similar in the L-8 and W-18 groups. Almost 80% of the patients in the UCLP group considered that their dental condition was good. The choice of surgical strategy had no significant influence on the variables measured on facial morphology.
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| 3. |
- Larsson, Britt, et al.
(författare)
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Blood supply and oxidative metabolism in muscle biopsies of female cleaners with and without myalgia
- 2004
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 20:6, s. 440-446
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Pathomechanisms of work-related myalgia are poorly understood. Myalgia is thought to be caused by excitation of nociceptors present in the muscular tissue but not in the muscle fiber itself. Muscle contraction in combination with hypoxia is known to excite nociceptors. Morphologic analysis can contribute to the knowledge of the excitation of nociceptors. This study thoroughly examines the morphology of the trapezius muscle's capillary supply and signs of disturbed oxidative metabolism to understand their role in work-related myalgia. METHODS: Surgical trapezius muscle biopsies were obtained from 25 female cleaners with long-standing work-related myalgia, 25 female cleaners without trapezius myalgia, and 21 healthy teachers. Enzyme and immunohistochemical stainings were performed to highlight fibers with aberrant intermyofibrillar patterns, indicating a disturbed oxidative metabolism (also known as moth-eaten fibers) and a disturbed capillary supply of different fibers. RESULTS: A significantly lower number of capillaries per fiber area in cleaners suffering from myalgia compared with cleaners without trapezius myalgia was found. Moth-eaten fibers were found in the 3 groups, but these fibers were significantly more prevalent in the groups of cleaners than in the healthy teacher group. CONCLUSION: This work indicates that the capillary supply of trapezius is affected in work-related trapezius myalgia. More studies are needed to understand possible mechanisms that would explain the occurrence of moth-eaten fibers.
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| 4. |
- Lindman, Rolf, et al.
(författare)
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Abnormal palatopharyngeal muscle morphology in sleep-disordered breathing
- 2002
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Ingår i: Journal of the Neurological Sciences. - : Elsevier. - 1878-5883 .- 0022-510X. ; 195:1, s. 11-23
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate whether histopathological changes can be detected in two soft palate muscles, the palatopharyngeus and the uvula, in 11 patients with long duration of sleep-disordered breathing (SDB). Muscle samples were collected froth patients undergoing uvulo-palatopharyngoplasty (UPPP). Reference samples from the corresponding areas were obtained at autopsy froth five previously healthy subjects. Muscle morphology, fibre type and myosin heavy chain (MyHC) compositions were analysed with enzyme-histochemical, immunohistochemical and biochemical techniques. The muscle samples from the patients, and especially those from the palatopharyngeus, showed several morphological abnormalities. The most striking findings were (i) increased amount of connective tissue, (ii) abnormal variability in fibre size, (iii) increased proportion of small-sized fibres, (iv) alterations in fibre type and MyHC compositions, (v) increased frequency of fibres containing developmental MyHC isoforms. Our findings point towards a pathological process of denervation and degeneration in the patient samples. Conclusively. the morphological abnormalities suggest a neuromuscular disorder of the soft palate in SDB patients. (C) 2002 Elsevier Science B.V. All rights reserved.
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| 5. |
- Lindman, Rolf, et al.
(författare)
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Morphological characterization of the levator veli palatini muscle in children born with cleft palates
- 2001
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Ingår i: The Cleft Palate-Craniofacial Journal. - 1055-6656 .- 1545-1569. ; 38:5, s. 438-448
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to analyze, morphologically and biochemically, one of the soft palate muscles, the levator veli palatini (LVP), in children born with cleft palate.SUBJECTS AND METHODS: Biopsies were obtained from nine male and three female infants in connection with the early surgical repair of the hard and soft palate. Samples from five adult normal LVP muscles were used for comparison. The muscle morphology, fiber type and myosin heavy chain (MyHC) compositions, capillary supply, and content of muscle spindles were analyzed with different enzyme-histochemical, immunohistochemical, and biochemical techniques.RESULTS: Compared with the normal adult subjects, the LVP muscle from the infantile subjects with cleft had a smaller mean fiber diameter, a larger variability in fiber size and form, a higher proportion of type II fibers, a higher amount of fast MyHCs, and a lower density of capillaries. No muscle spindles were observed. Moreover, one-third of the biopsies from the infantile subjects with cleft LVP either lacked muscle tissue or contained only a small amount.CONCLUSIONS: The LVP muscle from children with cleft palate has a different morphology, compared with the normal adult muscle. The differences might be related to different stages in maturation of the muscles, changes in functional demands with growth and age, or a consequence of the cleft. The lack of contractile tissue in some of the cleft biopsies offers one possible explanation to a persistent postsurgical velopharyngeal insufficiency in some patients, despite a successful surgical repair.
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| 6. |
- Naoumova, Julia, et al.
(författare)
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Soft tissue profile changes after vertical ramus osteotomy
- 2008
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Ingår i: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 30:4, s. 359-365
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Tidskriftsartikel (refereegranskat)abstract
- Patients with mandibular prognathism have, for a number of years, been treated by orthognathic surgery and post-surgical changes in the facial profile have been widely reported. However, little is known about the influence of gender and age on the soft tissues. The aim of this study was to investigate changes in the soft tissue profile following orthognathic surgery and to evaluate gender and age differences in the ratios of soft-to-hard tissue change. Forty-two Caucasian adults (18 males and 24 females) aged from 17 to 46 years with mandibular prognathism who underwent vertical ramus osteotomy were included. Lateral cephalograms were taken 2-8 months pre- (T1) and 12-19 months post- (T2) surgically. Five skeletal, two dental, and seven soft tissue parameters were hand traced. Paired and unpaired Student's t-tests, Pearson's correlation coefficients, and multiple regression analyses were used to evaluate the data. Due to the setback of the mandible, soft and hard tissues changed in a 1:1 ratio at the mentolabial fold and chin in females and 1:1,1 in males. Significant differences of soft-to-hard tissue ratios were found at points Pg (P < 0.05) and Gn (P < 0.01). Age effects on the ratios were not significant. Other effects of the mandibular setback on the soft tissue profile were a significant increase in facial convexity, a deepening of the mentolabial fold, an increase in lower lip thickness, and a decrease in upper lip thickness, which increased the nasolabial angle. These findings indicate that use of gender-specific ratios in treatment planning might improve the accuracy of predicting treatment results
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| 7. |
- Sonesson, Mikael, et al.
(författare)
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Fluoride varnish for the prevention of white spot lesions during orthodontic treatment with fixed appliances : a randomized controlled trial
- 2020
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 42:3, s. 326-330
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances.Objective: To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment.Subjects and methods: The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12-18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score.Results: One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL's on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P < 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1.Limitations: The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out.Conclusions: Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances.Clinical trial registration: ClinicalTrials.gov (NCT03725020).Protocol: The protocol was not published before trial commencement.
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| 8. |
- Sonesson, Mikael, et al.
(författare)
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Fluoride varnish for white spot lesion prevention during orthodontic treatment : results of a randomized controlled trial 1 year after debonding
- 2021
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:4, s. 473-477
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Topical fluorides are commonly recommended to prevent the development of white spot lesion (WSL) during treatment with fixed orthodontic appliances (FOAs), but the certainty of evidence is low, and long-term effects of fluoride preventive methods to reduce lesions seem to be rare.OBJECTIVE: To evaluate the long-term effectiveness of professional applications of a fluoride varnish containing 1.5% ammonium fluoride in preventing WSL development in adolescents undergoing multi-bracket orthodontic treatment.SUBJECTS AND METHODS: We performed a randomized controlled trial in which 166 healthy adolescents (12-18 years) from three different clinics were enrolled and randomly allocated to a test or a placebo group. The randomization was performed by a computer program, generating sequence numbers in blocks of 15. The fluoride varnish or the non-fluoride placebo varnish was applied in a thin layer around the bracket base every sixth week during the course of the orthodontic treatment (mean duration 1.7 years). We scored the prevalence of WSL on the labial surfaces of the maxillary incisors, canines and premolars immediately after debonding (baseline) and approximately 1 year after debonding, from digital photos with aid of a four-step score. The examiners were not involved in the treatment of the patients and blinded for the group assignment.RESULTS: One hundred and forty-eight patients were available at debonding and 142 of them could be re-examined after 1 year (71 in the test and 71 in the placebo group). The 1-year attrition rate was 4.0%. On patient level, the prevalence of post-orthodontic WSLs (score ≥ 2) dropped by over 50% during the follow-up with no significant difference between the groups. On surface level, there were significantly fewer remaining WSLs in the test group compared with the placebo group (4.5% versus 10.4%; relative risk 0.44, 95% confidence interval 0.28-0.68).LIMITATIONS: The compliance with fluoride toothpaste was not checked, and the patients' general dentists may have instigated additional risk-based preventive measures. No cost-benefit analysis was carried out.CONCLUSIONS: This follow-up study displayed a small beneficial long-term effect of fluoride varnish in reducing WSL development during treatment with FOA.REGISTRATION: NCT03725020.PROTOCOL: The protocol was not published before trial commencement.
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| 9. |
- Stål, Per, et al.
(författare)
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Capillary supply of the soft palate muscles is reduced in long-term habitual snorers
- 2009
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Ingår i: Respiration. - : S. Karger AG. - 0025-7931 .- 1423-0356. ; 77:3, s. 303-310
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Tidskriftsartikel (refereegranskat)abstract
- Background: Snoring and obstructive sleep apnea (OSA) cause vibration and stretch of the upper airway tissues that may result in neuromuscular damage and changes in the microcirculation. Objectives: The aim of this investigation was to test whether long-term snoring affects capillary supply in soft palate muscles. Methods: Samples from the palatopharyngeus (PP) and uvula (UV) muscles were collected from 8 patients undergoing uvulo-palatopharyngoplasty because of habitual snoring and OSA. Control samples were obtained at autopsy. The muscles were analyzed using immunohistochemistry and morphometry. Results: The patients' palate muscles had a lower capillary density (PP 443 vs. 711 capillaries/mm(2), p < 0.001, and UV 452 vs. 624 capillaries/mm(2), p = 0.009), a lower number of capillaries related to an individual muscle fiber (PP 1.3 vs. 2.7, p = 0.003, and UV 1.0 vs. 1.9, p = 0.03) and a lower number of capillaries related to the fiber size (PP 0.9 vs. 2.1, p = 0.001, and UV 0.6 vs. 1.9, p = 0.002). Conclusions: Our results indicate that reduced capillary supply of palate muscles plays a pathophysiological role in long-term snorers and OSA. The cause of the low capillary supply is unclear, but neuromuscular injury due to repeated vibratory and stretch trauma of the soft palate during snoring is a plausible mechanism.
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| 10. |
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| 11. |
- Wickström, Malin, et al.
(författare)
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The novel alkylating prodrug J1: diagnosis directed activity profile ex vivo and combination analyses in vitro
- 2008
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Ingår i: Investigational new drugs. - : Springer Science and Business Media LLC. - 0167-6997 .- 1573-0646. ; 26:3, s. 195-204
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The dipeptide J1 acts as a prodrug of melphalan with a significant increased potency in vitro resulting from activation by cellular aminopeptidases. The current study was performed to evaluate the ex vivo profile of J1 using 176 primary tumor cell cultures from patients. In addition, the activity of J1 in combination with eight standard drugs, representing different mechanistic classes, was studied in nine different human tumor cell lines of different histopathological origin. Methods: Ex vivo evaluation of tumor type selectivity, was performed using the established fluorometric microculture cytotoxicity assay (FMCA). Combinations between J1 and eight standard chemotherapeutic drugs were analyzed using the median-effect method. Results: The prodrug J1 expressed approximately 50- to 100-fold higher potency but similar activity profile as that of its metabolite, melphalan. The difference was greater in some diagnoses (e.g. breast cancer, NHL and AML), and exceptionally high in some breast cancer samples with aggressive phenotypes. Combination analysis of J1 and standard chemotherapeutics yielded several potentially additive and synergistic interactions, most striking for etoposide with significant synergism in all studied cell lines. Conclusions: In conclusion, the ex vivo profile suggests that further evaluation of J1 as the alkylating agent in for example aggressive breast cancer might be of particular interest, preferentially in combination with DNA-topoisomerase II inhibitors like etoposide.
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