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1.	Lindstrand, Anna, et al. (författare) Genome sequencing is a sensitive first-line test to diagnose individuals with intellectual disability 2022 Ingår i: Genetics in Medicine. - : ELSEVIER SCIENCE INC. - 1098-3600 .- 1530-0366. ; 24:11, s. 2296-2307 Tidskriftsartikel (refereegranskat)abstract Purpose: Individuals with intellectual disability (ID) and/or neurodevelopment disorders (NDDs) are currently investigated with several different approaches in clinical genetic diagnostics. Methods: We compared the results from 3 diagnostic pipelines in patients with ID/NDD: genome sequencing (GS) first (N = 100), GS as a secondary test (N = 129), or chromosomal microarray (CMA) with or without FMR1 analysis (N = 421). Results: The diagnostic yield was 35% (GS -first), 26% (GS as a secondary test), and 11% (CMA/FMR1). Notably, the age of diagnosis was delayed by 1 year when GS was performed as a secondary test and the cost per diagnosed individual was 36% lower with GS first than with CMA/FMR1. Furthermore, 91% of those with a negative result after CMA/FMR1 analysis (338 individuals) have not yet been referred for additional genetic testing and remain undiagnosed. Conclusion: Our findings strongly suggest that genome analysis outperforms other testing strategies and should replace traditional CMA and FMR1 analysis as a first-line genetic test in individuals with ID/NDD. GS is a sensitive, time-and cost-effective method that results in a confirmed molecular diagnosis in 35% of all referred patients. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
2.	Norlin, Maria, et al. (författare) Drug-mediated gene regulation of vitamin D3 metabolism in primary human dermal fibroblasts 2017 Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7835 .- 1742-7843. ; 120:1, s. 59-63 Tidskriftsartikel (refereegranskat)abstract Vitamin D metabolism was studied in primary human dermal fibroblasts with focus on drug-mediated gene regulation related to adverse side effects of antiretroviral drugs used in HIV therapy. The fibroblasts expressed mRNA for cytochrome P450 (CYP) enzymes catalysing bioactivating (CYP2R1, CYP27A1 and CYP27B1) and catabolic reactions (CYP24A1). The cells produced both 25-hydroxyvitamin D3 and 1a,25-dihydroxyvitamin D3. The results demonstrate that primary dermal fibroblasts have an active vitamin D3 metabolising system. High incidence of low bone mineral density is a concern for HIV-infected patients treated with antiretroviral drugs. Osteomalacia and severe vitamin D deficiency have been reported. We investigated whether drug-mediated gene regulation could be a possible mechanism behind these adverse drug effects. Fibroblasts were treated with different drugs used in HIV therapy and the 1a,25-dihydroxyvitamin D3 levels and relative mRNA-levels for crucial enzymes were determined. Efavirenz, stavudine and ritonavir significantly downregulated the bioactivating CYP2R1 and upregulated the catabolic CYP24A1. The drugs reduced bioactivating enzyme activities and cellular levels of 1a,25-dihydroxyvitamin D3. The current results indicate that effects on gene expression may lead to disturbed vitamin D-metabolism and decreased cellular levels of active vitamin D3. The data are consistent with the impaired bone health in patients treated with certain antiretroviral drugs.
3.	Alkhateeb, Noor, et al. (författare) Patient-perceived features and clinical characteristics of tooth pain : A comparison between apical periodontitis and persistent dento-alveolar pain disorder (PDAP) – preliminary results 2017 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: Differential diagnosis between tooth pain of inflammatory and neuropathic origin is crucial since treatment strategies differ. Aim: Evaluate and compare self-reported and clinically observed pain characteristics in patients with SAP (symptomatic apical periodontitis) and PDAP (persistent dento-alveolar pain disorder). Methodology: Patients diagnosed with SAP and PDAP were recruited from Malmö University and Folktandvården Östergötland. Data collection included clinical examination and questionnaire (tooth pain characteristics, verbal pain description [short-form McGill Pain Questionnaire; SF-MPQ], factors affecting the pain). Results: Data from 24 patients with SAP and 20 with PDAP (24 females, mean age 53 years) were analyzed. Average pain intensity was 4.4 (0–10 numeric rating scale) and average duration 1527 days. 64% reported continuous and 27% recurrent pain. 58% of teeth were tender to percussion and 66% to apical palpation. 27% reported concurrent pain from jaw muscles/joints. Significant differences were found for gender (% females; PDAP>SAP;p=0.013), pain duration (PDAP>SAP;p<0.0001), pain frequency (PDAP>SAP;p<0.001), percussion tenderness (SAP>PDAP;p=0.012), muscle/joint pain (PDAP>SAP;p=0.021). SF-MPQ and affecting factors did not differ (p=0.096–1.000). Conclusion: Preliminary results indicate that pain intensity, pain description and factors affecting the pain are similar for SAP and PDAP. Female gender, long pain duration, high pain frequency, and concurrent muscle/joint pain presented more frequently in PDAP.
4.	Alstergren, Per, et al. (författare) Clinical diagnosis of temporomandibular joint arthritis 2018 Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:4, s. 269-281 Tidskriftsartikel (refereegranskat)abstract Evidence-based clinical diagnostic criteria for temporomandibular joint (TMJ) arthritis are not available. To establish (i) criteria for clinical diagnosis of TMJ arthritis and (ii) clinical variables useful to determine inflammatory activity in TMJ arthritis using synovial fluid levels of inflammatory mediators as the reference standard. A calibrated examiner assessed TMJ pain, function, noise and occlusal changes in 219 TMJs (141 patients, 15 healthy individuals). TMJ synovial fluid samples were obtained with a push-pull technique using the hydroxycobalamin method and analysed for TNF, TNFsRII, IL-1, IL-1ra, IL-1sRII, IL-6 and serotonin. If any inflammatory mediator concentration exceeded normal, the TMJ was considered as arthritic. In the patient group, 71% of the joints were arthritic. Of those, 93% were painful. About 66% of the non-arthritic TMJs were painful to some degree. Intensity of TMJ resting pain and TMJ maximum opening pain, number of jaw movements causing TMJ pain and laterotrusive movement to the contralateral side significantly explained presence of arthritis (AUC 0.72, P<.001). Based on these findings, criteria for possible, probable and definite TMJ arthritis were determined. Arthritic TMJs with high inflammatory activity showed higher pain intensity on maximum mouth opening (P<.001) and higher number of painful mandibular movements (P=.004) than TMJs with low inflammatory activity. The combination TMJ pain on maximum mouth opening and Contralateral laterotrusion <8mm appears to have diagnostic value for TMJ arthritis. Among arthritic TMJs, higher TMJ pain intensity on maximum mouth opening and number of mandibular movements causing TMJ pain indicates higher inflammatory activity.
5.	Baad-Hansen, Lene, et al. (författare) Chair-side intraoral somatosensory examination in patients with atypical odontalgia and healthy subjects 2012 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Chair-side intraoral somatosensory examination in patients with atypical odontalgia and healthy subjects L Baad-Hansen, M Pigg, S Elmasry Ivanovic, H Faris, T List, M Drangsholt, P Svensson Aim of investigation: In patients with persistent orofacial pain, assessment of somatosensory function is recommended. A chair-side qualitative examination with good reliability revealing signs of hyper-/hyposensitivity to touch, cold and painful pinprick stimulation may be performed. The aim of this multicenter study was to compare three qualitative measures of intraoral somatosensory function between patients with atypical odontalgia (AO) and healthy subjects. Methods: 31 AO patients (6 male, 25 female; mean age: 54±13) and 47 healthy age- and sex-matched controls (15 male, 32 female: mean age: 47±12) were recruited from Malmö University (Sweden), University of Washington (USA) and Aarhus University (Denmark). In AO patients, sensitivity to touch, cold, and pinprick stimuli was evaluated on the buccal gingiva adjacent to the painful site and the corresponding contralateral ‘mirror-image’ gingival site. In healthy subjects, tests were performed bilaterally on the buccal gingiva adjacent to the first maxillary premolars. Patients were asked to report hyper-, hypo-, or normo-sensitivity/- algesia to touch, cold and painful stimuli on the painful site compared with the contralateral site; healthy subjects were asked to compare sensitivity between sides. Χ2-tests were used to analyze differences in frequency of hyper-, hyposensitivity or normosensitivity between groups. Results: The frequency of subjectively reported normosensitivity to all stimulus modalities were significantly lower in patients (23-58%) than in healthy subjects (68-91%), P<0.001. Frequency of hypersensitivity to all modalities were significantly higher in patients (29-61%) than in controls (9-17%), P<0.015, whereas reports of hyposensitivity were similar between groups (2-16%), P>0.054. Conclusion: A quick and simple chair-side evaluation of intraoral somatosensory function can detect intraoral sensory disturbances in AO patients, mainly in the form of hyper-sensitivity. These tests may be useful in the initial screening of patients with persistent orofacial pain.
6.	Baad-Hansen, Lene, et al. (författare) Chairside intraoral qualitative somatosensory testing : reliability and comparison between patients with atypical odontalgia and healthy controls 2013 Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:2, s. 165-170 Tidskriftsartikel (refereegranskat)abstract AIMS: To assess intraoral inter- and intraexaminer reliability of three qualitative measures of intraoral somatosensory function and to compare these measures between patients with atypical odontalgia (AO) and healthy controls. METHODS: Thirty-one AO patients and 47 healthy controls participated. Inter- and intraexaminer reliability was tested on a subgroup of 46 subjects (25 AO; 21 healthy). Sensitivity to touch, cold, and pinprick stimuli was evaluated on the painful gingival site and the corresponding contralateral site in AO patients, and bilaterally on the gingiva of the first maxillary premolars in controls. Patients were asked to report hypersensitivity, hyposensitivity, or normal sensitivity to stimuli on the painful site compared with the nonpainful site. Kappa values were calculated, and chi-square and Fisher's exact tests were used to compare frequencies between groups. RESULTS: Kappa values ranged between 0.63 and 0.75. The frequency of hypersensitivity to either modality was significantly higher in patients (29% to 61%) than in controls (9% to 17%) (P < .015), whereas reports of hyposensitivity were similar between groups (2% to 16%) (P > .057). Only 3.2% of the AO patients had no reports of abnormal sensitivity on any of the tests, compared with 59.6% of the healthy subjects (P < .001). CONCLUSION: Intraoral qualitative somatosensory testing can detect intraoral sensory disturbances in AO patients, and the reliability is sufficient for initial screening of orofacial somatosensory function.
7.	Baad-Hansen, Lene, et al. (författare) Intraoral somatosensory abnormalities in atypical odontalgia : a multicenter study 2013 Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 92:Special Issue A Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
8.	Baad-Hansen, Lene, et al. (författare) Intraoral somatosensory abnormalities in patients with atypical odontalgia : a controlled multicenter quantitative sensory testing study 2013 Ingår i: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 154:8, s. 1287-1294 Tidskriftsartikel (refereegranskat)abstract Intraoral somatosensory sensitivity in patients with atypical odontalgia (AO) has not been investigated systematically according to the most recent guidelines. The aims of this study were to examine intraoral somatosensory disturbances in AO patients using healthy subjects as reference, and to evaluate the percent agreement between intraoral quantitative sensory testing (QST) and qualitative sensory testing (QualST). Forty-seven AO patients and 69 healthy control subjects were included at Universities of Washington, Malmö, and Aarhus. In AO patients, intraoral somatosensory testing was performed on the painful site, the corresponding contralateral site, and at thenar. In healthy subjects, intraoral somatosensory testing was performed bilaterally on the upper premolar gingiva and at thenar. Thirteen QST and 3 QualST parameters were evaluated at each site, z-scores were computed for AO patients based on the healthy reference material, and LossGain scores were created. Compared with control subjects, 87.3% of AO patients had QST abnormalities. The most frequent somatosensory abnormalities in AO patients were somatosensory gain with regard to painful mechanical and cold stimuli and somatosensory loss with regard to cold detection and mechanical detection. The most frequent LossGain code was L0G2 (no somatosensory loss with gain of mechanical somatosensory function) (31.9% of AO patients). Percent agreement between corresponding QST and QualST measures of thermal and mechanical sensitivity ranged between 55.6% and 70.4% in AO patients and between 71.1% and 92.1% in control subjects. In conclusion, intraoral somatosensory abnormalities were commonly detected in AO patients, and agreement between quantitative and qualitative sensory testing was good to excellent.
9.	Baad-Hansen, Lene, et al. (författare) Reliability of chair-side intraoral somatosensory examination 2012 Ingår i: Journal of Dental Research. - : Sage Publications. ; 91:Special Issue B Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
10.	Baad-Hansen, Lene, et al. (författare) Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls : a multicentre study 2015 Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 42:2, s. 127-135 Tidskriftsartikel (refereegranskat)abstract The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). Intra-class correlation coefficients and kappa values for interexaminer and test-retest reliability were computed. Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.
11.	Baad-Hansen, Lene, et al. (författare) Reliability of intraoral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls : a multicenter study 2014 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Reliability of intraoral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls – a multicenter study The reliability of a comprehensive intraoral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic orofacial pain. Also, the reliability of QST z-scores has not been reported. Aim of Investigation: The aim of the present multi-center study was to examine test-retest and inter-examiner reliability of intraoral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Methods: Fourty-five AO patients and 68 healthy controls were subjected to bilateral intraoral gingival QST and unilateral extraoral QST (thenar) on three occasions (twice on one day by two different examiners and once approximately one week later by one of the examiners). Interclass correlation coefficients and kappa values for inter-examiner and test-retest reliability were computed. Results: Most of the standardized intraoral QST measures (absolute values and z-scores) showed fair to excellent inter-examiner (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between AO patients and the healthy reference group. Conclusions: These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intraoral QST (absolute values as well as z-scores) is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.
12.	Benca, Laura, et al. (författare) Comparing reliability of extraoral versus intraoral trigeminal quantitative sensory testing 2013 Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 92:Special Issue A Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
13.	Brodén, Joséphine, et al. (författare) “Experts already have the answers". A mixed methods study on dental students’ reflections on risk assessment of root filled teeth 2023 Ingår i: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Aims: Reflection on a deeper level is recognized as an important skill to learn for undergraduate students since mastering reflection can be helpful throughout their future careers. The aim with this study was to (i) examine if short structured written reflections could stimulate deep reflection among a group of dental students and (ii) explore specifically how the students reflected on clinical experience in relation to uncertainty when assessing the risk for exacerbation of apical periodontitis in root filled teeth.Methods: Short reflections were written by 52 dental students at Malmö University in 2021. All students first answered some questions associated with the risk for exacerbation of apical periodontitis in a case with a root filled tooth with a diffuse widening of the periodontal ligament space. After this, they were asked to write short reflections following prompts developed specifically to stimulate reflection. For each student, the reflections were analyzed and the level of reflection according to the 4Rs framework (Reporting/responding, Relating, Reasoning, Reconstructing) was assessed. The written content in the reflections were analyzed by a qualitative method, Systematic Text Condensation (STC). Results: Thirteen of the students (25%) reached the deepest level of reflection, Reconstructing. Sixteen students (31%), reached only the most superficial level, Report/respond. Two themes about experience and lack of experience were identified in the reflections: Theme 1 “The meaning of clinical experience” and Theme 2 “Differences and similarities”. The themes were subdivided into nine subgroups and described in more detail the relationship between experience and certainty as perceived by the students.Conclusions: A short reflection exercise stimulated deep reflection in a proportion of, but not all, dental students. The students believed that certainty comes with experience even when there is a lack of scientific evidence.
14.	Brodén, Joséphine, 1979-, et al. (författare) Reflection to enhance students' awareness of and comfort with uncertainty. Annan publikation (övrigt vetenskapligt/konstnärligt)
15.	Brodén, Joséphine (författare) Uncertainty in Endodontics : Strategies for Understanding and Management 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Dentists often experience uncertainty when deciding on the most effective treatment for a particular patient. There are various sources of uncertainty and different strategies for coping with it, such as reducing or accepting it and learning how to make decisions despite feeling uncertain.The overall objectives of the thesis are to contribute with information that reduces uncertainty regarding the treatment of cariously exposed pulps in young permanent teeth and to improve dental education to ensure that future dental students manage well despite uncertainty.By means of a systematic review and a model analysis, the thesis evaluates the available evidence and cost-effectiveness of a pulp capping procedure compared to a root canal treatment to reduce the uncertainty regarding the cost-effectiveness of treatments for young permanent teeth with vital pulps exposed by caries.The thesis also addresses the acceptance of uncertainty. A reflection exercise was developed and tested in a group of dental students. Prompts from an established model were used to stimulate the students to write reflections during the risk assessment of a root-filled tooth. The effect of the reflections on the student’s awareness of and comfort with uncertainty was explored with a repeated questionnaire. The written reflections were analyzed with a qualitative method to explore how dental students reflected on clinical experience in relation to uncertainty.In the systematic review, the success rate for pulp capping in children and adolescents varied between 64 and 100 percent in the included studies. The model indicated that pulp capping procedures are cost-effective compared to root canal treatment in teeth with pulp exposure due to caries. Fewer teeth were extracted after a pulp capping during the 9 years the patients were followed in the model and the cost for the initial treatment and follow-up treatments during this time period was lower compared to a root canal treatment.The reflection exercise had an effect on the students’ responses to the questions regarding how certain they believed an experienced colleague would feel, and how certain they felt of their capacity to handle the case. Most students did not state that they felt certain about assessing the risk for exacerbation of apical periodontitis in root-filled teeth but felt certain of their own capacity to handle the case, as well as comfortable with their ability to handle the situation and do their best for the patient.Three themes about experience and lack of experience were identified in the reflections: “the meaning of clinical experience”, “assumed differences regarding assessment” and “relating to the same risk factors”.The following conclusions were drawn from the four studies:For children and adolescents with pulp exposure due to caries, pulp capping procedures are cost-effective compared to root canal treatment, but there is a lack of prospective studies concerning root canal treatment. Moreover, the existing studies on pulp capping procedures are of low quality.Most final-year dental students participating in a reflection exercise did not feel certain of their risk assessment of root-filled teeth but still felt certain of their capacity to handle the situation, as well as comfortable with their ability to do the best for the patient. The students believed that clinical experience leads to certainty even when the scientific evidence is lacking and experts who meet students have a great responsibility to be transparent with their own uncertainty.
16.	Brodén, Joséphine, et al. (författare) What is the relationship between certainty and experience? : A qualitative study on dental students’ reflections on risk assessment of root filled teeth. Annan publikation (övrigt vetenskapligt/konstnärligt)
17.	Drangsholt, Mark, et al. (författare) Quantitative Sensory Testing of Chronic Continuous Dentoalveolar Pain 2010 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Objectives: Chronic continuous dentoalveolar pain (CCDAP) is a new term for chronic pain around teeth. Quantitative sensory testing (QST) has shown promise as a tool for studying mechanisms of pain conditions. Aims: 1) compare sensory parameter values in CCDAP patients and symptom-free controls; and 2) characterize the somatosensory profile of patients with CCDAP. Methods: The German Neuropathic Pain QST protocol of 13 somatosensory function tests was adapted for intraoral use. Cases with CCDAP from tertiary care clinics were tested along with symptom-free controls. QST was performed intra-orally on symptomatic facial gingiva, asymptomatic contralateral site, and non-trigeminal site (thumb). Means and standard deviations were compared between symptomatic and asymptomatic sites within cases and with controls. Results: Interim analyses of 17 controls and 13 cases showed a mean age of 37 years for controls and 55 for cases. At the thumb, significant differences (p < 0.05) between cases/controls were apparent for pressure pain threshold (PPT) 353 vs. 453 kPa; mechanical pain threshold (MPT) 75 vs. 161 mN; and cold pain threshold (CPT) 8.4 vs. 2.8 C, all showing cases more sensitive. At the painful gingival site, significant differences between cases/controls existed for: CPT 17.4 vs. 8.1 C; HPT 44 vs. 49 C; MPT 55 vs. 154 mN; and PPT 106 vs. 172 kPa. Non-painful parameters, such as cold and warm detection threshold were generally not significantly different between cases/controls at thumb and painful gingival sites. Among cases only, comparing painful to nonpainful side, MPT was 55 vs. 96 mN; mechanical pain sensitivity 4.7 vs. 3.0; PPT 106 vs. 122 kPa, all more sensitive on the painful site. Conclusions: These results suggest that CCDAP patients are more sensitive to multiple modalities of painful stimulation at both non-trigeminal and trigeminal sites, and may be exhibiting a trigeminal neuropathy with gain in function. Grant: NIHR21DE018768.
18.	Edvinsson, Olivia, et al. (författare) Double-Blind Concealment Inadequate When Administering Local Anesthetic and Non-Active Control. 2018 Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 97:Special Issue B Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
19.	Engfalk, Paul, et al. (författare) Influence of intra- and extraoral sites and size of stimulation area on thermal detection and pain threholds. A methodological study 2007 Ingår i: Swedish Dental Journal. - 0347-9994. ; 31:4 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Aim: This study compared cool detection thresholds, warm detection thresholds and heat pain thresholds at intra- and extraoral locations and measured the influence of spatial summation. Material and Methods: Thirty healthy individuals (15 females and 15 males), mean age 24.9 years, range 20-31 years) participated in the study. Thresholds for warm detection (WDT), cool detection (CDT) and heat pain threshold (HPT) were measured using a thermotester (MSA–Modular sensory Analyzer, Somedic). The intraoral thermode was custom-made with a 9x9mm square surface. The average of three measurements was recorded. Four intraoral sites (gingival regions 24 and 34, tip of the tongue, lower lip) and two extraoral sites (infraorbitalis, thenar) were measured in each participant. To measure spatial summation, five acrylic covers (tip areas: 0.81 cm2, 0.50 cm2, 0.28cm2, 0.125cm2, 0 cm2) were made to fit the thermode. Five measurements on the tip of the tongue were averaged for each acrylic cover. Results: Of the extraoral sites, the cold detection threshold was significantly higher and the heat pain threshold was significantly lower at the infraorbitalis than at the thenar. Of the intraoral sites, the cold detection threshold was significantly lower at the tongue than at any of the other intraoral locations; the heat pain threshold was significantly lower on the tip of the tongue than on the lower lip. Warm detection and heat pain thresholds rose slightly with increasing thermode size, and this association was more pronounced than for cold detection thresholds. Conclusion: Temperature thresholds differed significantly between several anatomic sites, and the association between size of stimulation area and temperature thresholds was weak.
20.	Fransson, Helena, et al. (författare) EndoReCo banar väg för ökad kunskap och akademisk meritering 2022 Ingår i: Tandläkartidningen. - : Sveriges tandläkarförbund. - 0039-6982. ; 114:12, s. 46-52 Tidskriftsartikel (refereegranskat)abstract För att minska kunskapsluckorna inom odontologin krävs samarbete mellan lärosätena. Det ger även möjlighet till akademisk meritering, vilket är angeläget då antalet seniora forskare med behörighet för forskningshandledning i Sverige är färre än någonsin. EndoReCo (Endodontic Research Collaboration) är ett skandinaviskt forskningsnätverk i endodonti som kan ta del av just dessa fördelar.
21.	Gudmundsson, Sanna, et al. (författare) Revertant mosaicism repairs skin lesions in a patient with keratitis-ichthyosis-deafness syndrome by second-site mutations in connexin 26 2017 Ingår i: Human Molecular Genetics. - : OXFORD UNIV PRESS. - 0964-6906 .- 1460-2083. ; 26:6, s. 1070-1077 Tidskriftsartikel (refereegranskat)abstract Revertant mosaicism(RM) is a naturally occurring phenomenon where the pathogenic effect of a germline mutation is corrected by a second somatic event. Development of healthy-looking skin due to RM has been observed in patients with various inherited skin disorders, but not in connexin-related disease. We aimed to clarify the underlying molecular mechanisms of suspected RM in the skin of a patient with keratitis-ichthyosis-deafness (KID) syndrome. The patient was diagnosed with KID syndrome due to characteristic skin lesions, hearing deficiency and keratitis. Investigation of GJB2 encoding connexin (Cx) 26 revealed heterozygosity for the recurrent de novo germline mutation, c. 148G>A, p. Asp50Asn. At age 20, the patient developed spots of healthy-looking skin that grew in size and number within widespread erythrokeratodermic lesions. Ultradeep sequencing of two healthy-looking skin biopsies identified five somatic nonsynonymous mutations, independently present in cis with the p. Asp50Asn mutation. Functional studies of Cx26 in HeLa cells revealed co-expression of Cx26-Asp50Asn and wild-type Cx26 in gap junction channel plaques. However, Cx26-Asp50Asn with the second-site mutations identified in the patient displayed no formation of gap junction channel plaques. We argue that the second-site mutations independently inhibit Cx26-Asp50Asn expression in gap junction channels, reverting the dominant negative effect of the p. Asp50Asn mutation. To our knowledge, this is the first time RM has been reported to result in the development of healthy-looking skin in a patient with KID syndrome.
22.	Gånemo, Agneta, et al. (författare) Autosomal recessive congenital ichthyosis in Sweden and Estonia: clinical, genetic and ultrastructural findings in eithty-three patients 2003 Ingår i: Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 83:1, s. 24-30 Tidskriftsartikel (refereegranskat)abstract Congenital (non-bullous) ichthyosis is a rare group of keratinizing disorders which can be tentatively subclassified based on clinical criteria, analysis of transglutaminase 1 gene mutations and electron microscopy of epidermis. We studied 83 patients who were all on topical therapy and in 16 cases also on oral retinoids. Three main groups of patients were distinguished: (A) those with transglutaminase 1 gene mutations (n=44), (B) those without transglutaminase 1 gene mutations showing a coarse, generalized scaling (n=19), and (C) those without transglutaminase 1 gene mutations showing only fine or focal scaling (n=20). On clinical scoring, patients in group A were more hyperkeratotic and less erythematous than those in group B (p < 0.05). Anhidrosis was recorded in nearly all patients (> or = 80%), but ectropion and a collodion phenotype at birth were more common in group A versus other groups. Ultrastructurally, a high frequency of type I (Anton-Lamprecht's classification) was found in all three groups (37-63%), 20 cases of type II in group A and a few cases of types III and IV in groups B and C, respectively. In conclusion, transglutaminase 1 gene mutation is a major cause of congenital ichthyosis in Sweden and Estonia, and is often associated with severe scaling and ultrastructural type II in corneocytes. The transglutaminase-unrelated cases are more heterogeneous, probably reflecting a more varied aetiology.
23.	Havsed, Kristian, et al. (författare) Multivariable prediction models of caries increment : a systematic review and critical appraisal. 2023 Ingår i: Systematic Reviews. - : BioMed Central (BMC). - 2046-4053. ; 12:1 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Multivariable prediction models are used in oral health care to identify individuals with an increased likelihood of caries increment. The outcomes of the models should help to manage individualized interventions and to determine the periodicity of service. The objective was to review and critically appraise studies of multivariable prediction models of caries increment.METHODS: Longitudinal studies that developed or validated prediction models of caries and expressed caries increment as a function of at least three predictors were included. PubMed, Cochrane Library, and Web of Science supplemented with reference lists of included studies were searched. Two reviewers independently extracted data using CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) and assessed risk of bias and concern regarding applicability using PROBAST (Prediction model Risk Of Bias ASessment Tool). Predictors were analysed and model performance was recalculated as estimated positive (LR +) and negative likelihood ratios (LR -) based on sensitivity and specificity presented in the studies included.RESULTS: Among the 765 reports identified, 21 studies providing 66 prediction models fulfilled the inclusion criteria. Over 150 candidate predictors were considered, and 31 predictors remained in studies of final developmental models: caries experience, mutans streptococci in saliva, fluoride supplements, and visible dental plaque being the most common predictors. Predictive performances varied, providing LR + and LR - ranges of 0.78-10.3 and 0.0-1.1, respectively. Only four models of coronal caries and one root caries model scored LR + values of at least 5. All studies were assessed as having high risk of bias, generally due to insufficient number of outcomes in relation to candidate predictors and considerable uncertainty regarding predictor thresholds and measurements. Concern regarding applicability was low overall.CONCLUSIONS: The review calls attention to several methodological deficiencies and the significant heterogeneity observed across the studies ruled out meta-analyses. Flawed or distorted study estimates lead to uncertainty about the prediction, which limits the models' usefulness in clinical decision-making. The modest performance of most models implies that alternative predictors should be considered, such as bacteria with acid tolerant properties.TRIAL REGISTRATION: PROSPERO CRD#152,467 April 28, 2020.
24.	Hotz, Alrun, et al. (författare) Meta-Analysis of Mutations in ALOX12B or ALOXE3 Identified in a Large Cohort of 224 Patients 2021 Ingår i: Genes. - : MDPI. - 2073-4425 .- 2073-4425. ; 12:1 Tidskriftsartikel (refereegranskat)abstract The autosomal recessive congenital ichthyoses (ARCI) are a nonsyndromic group of cornification disorders that includes lamellar ichthyosis, congenital ichthyosiform erythroderma, and harlequin ichthyosis. To date mutations in ten genes have been identified to cause ARCI: TGM1, ALOX12B, ALOXE3, NIPAL4, CYP4F22, ABCA12, PNPLA1, CERS3, SDR9C7, and SULT2B1. The main focus of this report is the mutational spectrum of the genes ALOX12B and ALOXE3, which encode the epidermal lipoxygenases arachidonate 12-lipoxygenase, i.e., 12R type (12R-LOX), and the epidermis-type lipoxygenase-3 (eLOX3), respectively. Deficiency of 12R-LOX and eLOX3 disrupts the epidermal barrier function and leads to an abnormal epidermal differentiation. The type and the position of the mutations may influence the ARCI phenotype; most patients present with a mild erythrodermic ichthyosis, and only few individuals show severe erythroderma. To date, 88 pathogenic mutations in ALOX12B and 27 pathogenic mutations in ALOXE3 have been reported in the literature. Here, we presented a large cohort of 224 genetically characterized ARCI patients who carried mutations in these genes. We added 74 novel mutations in ALOX12B and 25 novel mutations in ALOXE3. We investigated the spectrum of mutations in ALOX12B and ALOXE3 in our cohort and additionally in the published mutations, the distribution of these mutations within the gene and gene domains, and potential hotspots and recurrent mutations.
25.	Iordanidou Mojir, Katerina, et al. (författare) Reliability and validity of punctuate pain thresholds and self-reported pain 2013 Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 92:Special Issue A Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
26.	Jonsson Sjögren, Jakob, et al. (författare) The Prevalence of Pain and Discomfort from Root-Filled Teeth 2017 Ingår i: Journal of Dental Research. ; :Special Issue A Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
27.	Lagerstedt-Robinson, Kristina, et al. (författare) A retrospective two centre study of Birt-Hogg-Dube syndrome reveals a pathogenic founder mutation in FLCN in the Swedish population 2022 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:2 Tidskriftsartikel (refereegranskat)abstract Birt-Hogg-Dube syndrome (BHDS) (MIM: 135150) is a rare autosomal dominant disorder with variable penetrance, caused by pathogenic variants in the FLCN gene. Only a few hundreds of families have so far been described in the literature. Patients with BHDS present with three distinct symptoms: fibrofolliculomas, pneumothorax due to lung cyst formation, and increased lifetime risk of kidney tumours. The aim of the current study was to estimate the incidence of BHDS in the Swedish population and further describe the clinical manifestations and their frequency. Splice variant c.779+1G>T was the most common pathogenic variant, found in 57% of the families, suggesting this may be a founder mutation in the Swedish population. This was further investigated using haplotype analysis in 50 families that shared a common haplotype. Moreover, according to gnomAD the carrier frequency of the c.779+1G>T variant has been estimated to be 1/3265 in the Swedish population, however our data suggest that the carrier frequency in the Swedish population may be significantly higher. These findings should raise awareness among physicians of different specialties to patients presenting with fibrofolliculomas, pneumothorax and/or kidney tumours. We also stress the importance of consensus recommendations regarding diagnosis and clinical management of this, not that uncommon, syndrome.
28.	List, Thomas, et al. (författare) A new protocol to evaluate the effect of topical anesthesia 2014 Ingår i: Anesthesia Progress. - : Allen Press. - 0003-3006 .- 1878-7177. ; 61:4, s. 135-144 Tidskriftsartikel (refereegranskat)abstract This double-blind, placebo-controlled, randomized cross-over clinical experimental study tested the reliability, validity, and sensitivity to change of punctuate pain thresholds and self-reported pain on needle penetration. Female subjects without orofacial pain were tested in 2 sessions at 1- to 2-week intervals. The test site was the mucobuccal fold adjacent to the first upper right premolar. Active lidocaine hydrochloride 2% (Dynexan) or placebo gel was applied for 5 minutes, and sensory testing was performed before and after application. The standardized quantitative sensory test protocol included mechanical pain threshold (MPT), pressure pain threshold (PPT), mechanical pain sensitivity (MPS), and needle penetration sensitivity (NPS) assessments. Twenty-nine subjects, mean (SD) age 29.0 (10.2) years, completed the study. Test-retest reliability intraclass correlation coefficient at 10-minute intervals between examinations was MPT 0.69, PPT 0.79, MPS 0.72, and NPS 0.86. A high correlation was found between NPS and MPS (r = 0.84; P < .001), whereas NPS and PPT were not significantly correlated. The study found good to excellent test-retest reliability for all measures. None of the sensory measures detected changes in sensitivity following lidocaine 2% or placebo gel. Electronic von Frey assessments of MPT/MPS on oral mucosa have good validity.
29.	Markvart, M., et al. (författare) Frequency of additional treatments in relation to the number of root filled canals in molar teeth in the Swedish adult population 2021 Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 54:6, s. 826-833 Tidskriftsartikel (refereegranskat)abstract Aim To investigate the 5-year frequency of additional treatments in relation to the number of reported root filled canals in molar teeth in Sweden. Methodology The cohort included first and second molars in adult individuals who were registered with a root filling performed in 2009. Treatment codes corresponding to root fillings of teeth with from one up to four root filled canals were identified in the Swedish Social Insurance Agency database. The studied additional treatments were extraction, non-surgical root canal retreatment and endodontic surgery during the subsequent 5 years, identified by corresponding codes for these treatments registered on these specific teeth. Differences in the frequency of additional treatments based on the number of root filled canals were analysed using chi-square test and considered statistically significant at P In 2009, root fillings on a first or second molar tooth were registered in 100 720 individuals. The study included 32 901 maxillary first molars (6.4% with four root filled canals), 12 763 maxillary second molars (3.3% with four root filled canals), 37 703 mandibular first molars (19.2% with four root filled canals) and 17 353 mandibular second molars (3.7% with four root filled canals). The total frequency of additional treatments was 14.3% (n = 14 425) during the 5-year observational period. Additional treatments were more frequent in teeth with 1-3 root filled canals compared to teeth with four root filled canals for maxillary first molars (15.2% vs. 12.7%, P = 0.002), maxillary second molars (13.8% vs. 9.1%, P = 0.007) and mandibular first molars (14.0% vs. 10.7%, P < 0.001) but not mandibular second molars (15.6% vs. 13.7%, P = 0.200). Conclusions Over 5 years, 85.7% of the included teeth were not registered with any additional treatments. Maxillary first and second molars and mandibular first molar teeth had a greater frequency of additional treatments when <= 3 root canals were filled compared to four canals.
30.	May, Arne, et al. (författare) Orofacial pain for clinicians : A review of constant and attack-like facial pain syndromes 2023 Ingår i: Cephalalgia. - : Sage Publications. - 0333-1024 .- 1468-2982. ; 43:8 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Primary headache syndromes such as migraine are among the most common neurological syndromes. Chronic facial pain syndromes of non-odontogenic cause are less well known to neurologists despite being highly disabling. Given the pain localization, these patients often consult dentists first who may conduct unnecessary dental interventions even if a dental cause is not identified. Once it becomes clear that dental modalities have no effect on the pain, patients may be referred to another dentist or orofacial pain specialist, and later to a neurologist. Unfortunately, neurologists are also often not familiar with chronic orofacial pain syndromes although they share the neural system, i.e., trigeminal nerve and central processing areas for headache disorders.CONCLUSION: In essence, three broad groups of orofacial pain patients are important for clinicians: (i) Attack-like orofacial pain conditions, which encompass neuralgias of the cranial nerves and less well-known facial variants of primary headache syndromes; (ii) persistent orofacial pain disorders, including neuropathic pain and persistent idiopathic facial/dentoalveolar pain; and (iii) other differential diagnostically relevant orofacial pain conditions encountered by clinicians such as painful temporomandibular disorders, bruxism, sinus pain, dental pain, and others which may interfere (trigger) and overlap with headache. It is rewarding to know and recognize the clinical picture of these facial pain syndromes, given that, just like for headache, an internationally accepted classification system has been published and many of these syndromes can be treated with medications generally used by neurologists for other pain syndromes.
31.	Mikkilä, Hanna, et al. (författare) A comparison of two different methods to measure pressure pain thresholds : An experimental study 2017 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Introduction: Assessment of somatosensory function is recommended in orofacial pain investigations. Quantitative Sensory Testing (QST) is a comprehensive method in which pressure pain threshold (PPT) measurement is included. PPT is usually obtained with a conventional Algometer Type II. A new computer-controlled and potentially more user-friendly algometer, the SENSEBox, could replace the conventional device provided that threshold values and other properties are similar between devices. Aim: Compare two algometers regarding absolute PPT, variability, time, and test-retest-reliability. Materials and methods: PPT was measured with both devices on thenar, masseter muscle and gingiva (upper premolar region) in twenty healthy adults. For each anatomic site and device, the mean value of three registrations was calculated. Paired t-test and Wilcoxon sign-rank test compared mean PPT, variability and time duration. Intraclass Correlation Coefficient (ICC) analyzed test-retest reliability. Results: The SENSEBox showed overall lower PPTs (p<0.05). No significant differences in variability and time duration were found (p>0.05). Both devices showed very good to excellent test-retest-reliability (ICC 0.75–0.88) for thenar and masseter. On gingiva, Algometer Type II showed poor (ICC 0.38) and SENSEBox good reliability (ICC 0.43). Conclusion: The Algometer Type II and SENSEBox are not readily interchangeable in PPT assessment and QST in orofacial pain investigations.
32.	Nagendrababu, V, et al. (författare) Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) guidelines : a development protocol 2021 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 54:7, s. 1051-1055 Forskningsöversikt (refereegranskat)abstract Diagnostic accuracy studies play an important role in informing clinical practice and patient management, by evaluating the ability of diagnostic testing and imaging to identify the presence or absence of a disease or condition. These studies compare the relative diagnostic strength of the test or device with a reference standard, therefore, guiding clinical decisions on the reliability of the test, the need for further tests, and whether to monitor or treat a particular condition. Inadequate and incomplete reporting of diagnostic accuracy studies can disguise methodological deficiencies and ultimately result in study bias and the inability to translate research findings into daily clinical practice. The Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) guidelines are being developed in order to improve the accuracy, transparency, completeness and reproducibility of diagnostic accuracy studies in the speciality of Endodontology. The aim of this paper is to report the process used to develop the PRIDASE guidelines based on a well-established consensus process. The project leaders (PD, VN) formed a steering committee of nine members (PD, VN, PA, AF, DR, SP, CK, MP, HD) to oversee and manage the project. The PRIDASE steering committee will develop the initial draft of the PRIDASE guidelines by adapting and modifying the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines, adding new items related specifically to the nature of Endodontics and incorporate the Clinical and Laboratory Images in Publication (CLIP) principles. The initial guidelines will consist of a series of domains and individual items and will be validated by the members of a PRIDASE Delphi Group (PDG) consisting of a minimum of 30 individuals who will evaluate independently the individual items based on two parameters: 'clarity' using a dichotomous scoring (yes/no) and 'suitability' for inclusion using a 9-point Likert Scale. The scores awarded by each member and any suggestions for improvement will be shared with the PDG to inform an iterative process that will result in a series of items that are clear and suitable for inclusion in the new PRIDASE guidelines. Once the PDG has completed its work, the steering committee will create a PRIDASE Meeting Group (PMG) of 20 individuals from around the world. Members of the PDG will be eligible to be the part of PMG. The draft guidelines and flowchart approved by the PDG will then be presented for further validation and agreement by the PMG. As a result of these discussions, the PRIDASE guidelines will be finalized and then disseminated to relevant stakeholders through publications and via the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org). Periodic updates to the PRIDASE guidelines will be made based on feedback from stakeholders and end-users.
33.	Nagendrababu, V., et al. (författare) Preferred Reporting items for OBservational studies in Endodontics (PROBE) guidelines : a development protocol 2020 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 53:9, s. 1199-1203 Tidskriftsartikel (refereegranskat)abstract Observational studies have a significant role in establishing the prevalence and incidence of diseases in populations, as well as determining the benefits and risks associated with health-related interventions. Observational studies principally encompass cohort, case-control, case series and cross-sectional designs. Inadequate reporting of observational studies is likely to have a negative impact on decision-making in day-to-day clinical practice; however, no reporting guidelines have been published for observational studies in Endodontics. The aim of this project is to develop reporting guidelines for authors when creating manuscripts describing observational studies in the field of Endodontology in an attempt to improve the quality of publications. The new guidelines for observational studies will be named: 'Preferred Reporting items for OBservational studies in Endodontics (PROBE)'. A steering committee was formed by the project leaders (PD, VN) to develop the guidelines through a five-phase consensus process. The steering committee will review and adapt items from the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as identify new items that add value to Endodontics. The steering committee will create a PROBE Delphi Group (PDG), consisting of 30 members across the globe to review and refine the draft checklist items and flowchart. The items will be assessed by the PDG on a nine-point Likert scale for relevance and inclusion. The agreed items will then be discussed by a PROBE Face-to-Face meeting group (PFMG) made up of 20 individuals to further refine the guidelines. After receiving feedback from the PFMG, the steering committee will pilot and finalize the guidelines. The approved PROBE guidelines will be disseminated through publication in relevant journals, and be presented at national and international conferences. The PROBE checklist and flowchart will be available and downloadable from the Preferred Reporting Items for study Designs in Endodontics (PRIDE) website: . The PROBE steering committee encourages clinicians, researchers, editors and peer reviewers to provide feedback on the PROBE guidelines to inform the steering group when the guidelines are updated.
34.	Nagendrababu, Venkateshbabu, et al. (författare) PRIDASE 2024 guidelines for reporting diagnostic accuracy studies in endodontics : A consensus‐based development 2024 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. Tidskriftsartikel (refereegranskat)abstract Studies investigating the accuracy of diagnostic tests should provide data on how effectively they identify or exclude disease in order to inform clinicians responsible for managing patients. This consensus-based project was undertaken to develop reporting guidelines for authors submitting manuscripts, which describe studies that have evaluated the accuracy of diagnostic tests in endodontics. These guidelines are known as the Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) 2024 guidelines. A nine-member steering committee created an initial checklist by integrating and modifying items from the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding a number of new items specific to the specialty of endodontics. Thereafter, the steering committee formed the PRIDASE Delphi Group (PDG) and the PRIDASE Online Meeting Group (POMG) in order to collect expert feedback on the preliminary draft checklist. Members of the Delphi group engaged in an online Delphi process to reach consensus on the clarity and suitability of the items in the checklist. The online meeting group then held an in-depth discussion on the online Delphi-generated items via the Zoom platform on 20 October 2023. According to the feedback obtained, the steering committee revised the PRIDASE checklist, which was then piloted by several authors when preparing manuscripts describing diagnostic accuracy studies in endodontics. Feedback from this process resulted in the final version of the PRIDASE 2024 checklist, which has 11 sections and 66 items. Authors are encouraged to use the PRIDASE 2024 guidelines when developing manuscripts on diagnostic accuracy in endodontics in order to improve the quality of reporting in this area. Editors of relevant journals will be invited to include these guidelines in their instructions to authors.
35.	Nagendrababu, V., et al. (författare) PRIRATE 2020 guidelines for reporting randomized trials in Endodontics: a consensus-based development 2020 Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 53:6, s. 764-773 Tidskriftsartikel (refereegranskat)abstract In evidence-based health care, randomized clinical trials provide the most accurate and reliable information on the effectiveness of an intervention. This project aimed to develop reporting guidelines, exclusively for randomized clinical trials in the dental specialty of Endodontology, using a well-documented, validated consensus-based methodology. The guidelines have been named Preferred Reporting Items for RAndomized Trials in Endodontics (PRIRATE) 2020. A total of eight individuals (PD, VN, HD, LB, TK, JJ, EP and SP), including the project leaders (PD and VN) formed a steering committee. The committee developed a checklist based on the items in the Consolidated Standards of Reporting Trials (CONSORT) guidelines and Clinical and Laboratory Images in Publications (CLIP) principles. A PRIRATE Delphi Group (PDG) and PRIRATE Face-to-Face Meeting group (PFMG) were also formed. Thirty PDG members participated in the online Delphi process and achieved consensus on the checklist items and flowchart that make up the PRIRATE guidelines. The guidelines were discussed at a meeting of the PFMG at the 19th European Society of Endodontology (ESE) Biennial congress, held on 13 September 2019 in Vienna, Austria. A total of 21 individuals from across the globe and four steering committee members (PD, VN, HD and LB) attended the meeting. As a consequence of the discussions, the guidelines were modified and then piloted by several authors whilst writing a manuscript. The PRIRATE 2020 guidelines contain a checklist consisting of 11 sections and 58 individual items as well as a flowchart, considered essential for authors to include when writing manuscripts for randomized clinical trials in Endodontics.
36.	Nagendrababu, Venkateshbabu, et al. (författare) PROBE 2023 guidelines for reporting observational studies in endodontics : explanation and elaboration 2023 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 56:6, s. 652-685 Tidskriftsartikel (refereegranskat)abstract Observational studies play a critical role in evaluating the prevalence and incidence of conditions or diseases in populations as well as in defining the benefits and potential hazards of health-related interventions. There are currently no reporting guidelines for observational studies in the field of Endodontics. The Preferred Reporting Items for study Designs in Endodontology (PRIDE) team have developed and published new reporting guidelines for observational-based studies called the “Preferred Reporting items for OBservational studies in Endodontics (PROBE) 2023” guidelines. The PROBE 2023 guidelines were developed exclusively for the specialty of Endodontics by integrating and adapting the “STrengthening the Reporting of OBservational studies in Epidemiology (STROBE)” checklist and the “Clinical and Laboratory Images in Publications (CLIP)” principles. The recommendations of the Guidance for Developers of Health Research Reporting Guidelines were adhered to throughout the process of developing the guidelines. The purpose of this document is to serve as a guide for authors by providing an explanation for each of the items in the PROBE 2023 checklist along with relevant examples from the literature. The document also offers advice to authors on how they can address each item in their manuscript before submission to a journal. The PROBE 2023 checklist is freely accessible and downloadable from the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org/probe/).
37.	Nagendrababu, Venkateshbabu, et al. (författare) PROBE 2023 guidelines for reporting observational studies in Endodontics: A consensus‐based development study 2023 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 56:3, s. 308-317 Tidskriftsartikel (refereegranskat)abstract Observational studies are non-interventional studies that establish the prevalence and incidence of conditions or diseases in populations or analyse the relationship between health status and other variables. They also facilitate the development of specific research questions for future randomized trials or to answer important scientific questions when trials are not possible to carry out. This article outlines the previously documented consensus-based approach by which the Preferred Reporting items for Observational studies in Endodontics (PROBE) 2023 guidelines were developed. A steering committee of nine members was formed, including the project leaders (PD, VN). The steering committee developed an initial checklist by combining and adapting items from the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding several new items specifically for the specialty of Endodontics. The steering committee then established a PROBE Delphi Group (PDG) and a PROBE Online Meeting Group (POMG) to obtain expert input and feedback on the preliminary draft checklist. The PDG members participated in an online Delphi process to reach consensus on the clarity and suitability of the items present in the PROBE checklist. The POMG then held detailed discussions on the PROBE checklist generated through the online Delphi process. This online meeting was held via the Zoom platform on 7th October 2022. Following this meeting, the steering committee revised the PROBE checklist, which was piloted by several authors when preparing a manuscript describing an observational study for publication. The PROBE 2023 checklist consists of 11 sections and 58 items. Authors are now encouraged to adopt the PROBE 2023 guidelines, which will improve the overall reporting quality of observational studies in Endodontics. The PROBE 2023 checklist is freely available and can be downloaded from the PRIDE website (https://pride-endodonticguidelines.org/probe/).
38.	Närhi, Matti, et al. (författare) Acute dental pain I : pulpal and dentinal pain 2016 Ingår i: Tandlægebladet. - : Tandlægeforeningen. - 0039-9353. ; 120:2, s. 110-119 Forskningsöversikt (refereegranskat)abstract Den specialiserede anatomi i pulpa-dentin-organet samt den rige pulpale innervation fra trigeminusnerven forklarer de forskellige typer af smertefølelser i en tand. En kort skarp smerte er typisk for en A-(nerve) fibermedieret smerte, imens en langvarig, bankende smerte indikerer C-(nerve) fiberaktivitet. A-fibre reagerer på termiske eller mekaniske stimuli, såsom kolde drikke eller tandbørstning, imens C-fibre hovedsagelig aktiveres ved inflammatoriske mediatorer. Således vil en dvælende smerte indikere en irreversibel pulpal inflammation. Ved pulpitis vil der opstå strukturelle ændringer i de pulpale nerver, der samtidig frigiver neuropeptider, som udløser et immunrespons: neurogen inflammation. Smertefornemmelser under pulpitis kan variere fra hypersensibilitet overfor termiske stimuli til svære dunkende og uudholdelige smerter. Smerterne kan være meddelte og ofte vanskelige at lokalisere, hvorfor diagnostik af inflammation i pulpa er en klinisk udfordring. En biofilm forstærker hypersensitivitet af eksponerede dentinoverflader, fordi de mikrobielle irritamenter kan nå pulpa gennem åbne dentintubuli, hvorved der fremkaldes inflammation. Fjernelse af biofilm reducerer isninger i tænderne, men supplerende behandling er ofte nødvendigt med det formål at opnå en reduktion af dentinens permeabilitet. Cariesekskavering samt fyldningsterapi er en tilstrækkelig behandling ved en klinisk bedømt reversibel pulpitis, hvorimod endodontisk behandling er nødvendigt, når pulpitis har nået et irreversibelt stadium.
39.	Närhi, Matti, et al. (författare) Akut tandvärk I : Pulpasmärta och dentinsmärta 2016 Ingår i: Tandläkartidningen. - : Tandläkarförbundet. - 0039-6982. ; 108:1, s. 64-71 Forskningsöversikt (refereegranskat)abstract Pulpasmärta och dentinsmärta kan orsaka patienten avsevärda besvär, och många faktorer påverkar utvecklingen av smärtan och hur länge den kvarstår. Diagnos och behandling är därför ofta ett problem för tandläkaren. Goda kunskaper om de underliggande strukturerna och smärtmekanismerna är en förutsättning för lyckad smärtbehandling.
40.	Olsson, Sara R, et al. (författare) Demographic factors in the choice of coronal restoration after root canal treatment in the Swedish adult population 2017 Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 50:S1, s. 33-33 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Aim: To compare demographic characteristics between individuals choosing an indirect coronal restoration (crown, inlay/onlay) and individuals receiving other restorations after completion of a root filling. The hypothesis was that there are demographic differences for individuals who chose an indirect and those who chose another coronal restoration after root canal treatment. Methodology: This was a registry study of a cohort consisting of all root filled upper first molars that were reported to the tax-funded Swedish Social Insurance Agency (SSIA) during 2009. The root filled teeth were identified by tooth position 16 and 26, and by specific registry codes applied to root fillings. After registration of the root filling, any subsequent coronal restorations within two years was identified. The study group consisted of individuals registered with a root filling followed by an indirect coronal restoration and the control group was the remaining individuals with a root-filled tooth and a direct coronal restoration or no registration of any coronal restoration. Data on nationality, disposable income, educational level, civil status, age and gender were received from Statistics Sweden or SSIA. Chi-square test, t-test and logistic regression compared groups. P<0.05 was considered statistically significant. Results: 7 806 individuals (21.9%) received an indirect coronal restoration and 27 886 individuals (78.1%) comprised the control group. All demographic variables but gender and nationality differed significantly between groups A significantly larger proportion of individuals in the study group had higher education, higher disposable income, were older and were less likely to be living on their own. Conclusions: The identified demographic differences between individuals having their newly root filled teeth restored with an indirect restoration compared to those receiving other restorations indicate that the tax-funded Swedish dental insurance fails to provide dental care on equal terms for Swedish citizens.
41.	Olsson, Sara R, et al. (författare) Demographic factors in the choice of coronal restoration after root canal treatment in the Swedish adult population 2019 Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 46:1, s. 58-64 Tidskriftsartikel (refereegranskat)abstract Background: After root canal treatment, a choice is made between different coronal restorations which in the long run could affect the survival of the tooth. Objective: To compare demographic characteristics between individuals choosing an indirect coronal restoration (crown, inlay/onlay) and individuals choosing other restorations after completion of a root filling. Methods: The cohort consisted of all root-filled upper first molars that were reported to the tax-funded Swedish Social Insurance Agency (SSIA) during 2009. After registration of the root filling, any subsequent coronal restorations within 2 years were identified. The crown group consisted of individuals registered with an indirect coronal restoration and the restoration group was the remaining individuals with a direct coronal restoration or lacking registration. Demographic data (gender, disposable income, age, educational level, civil status and country of birth) were received from Statistics Sweden or the SSIA. Statistical analyses included chi-square test, t test and logistic regression analysis. P < 0.05 was considered statistically significant. Results: An indirect coronal restoration was received by 7806 individuals (21.9%), and 27 886 individuals (78.1%) received a direct restoration. All demographic variables except gender differed significantly between groups. Logistic regression analysis found significant associations for all demographic variables and the registration of an indirect restoration except for country of birth and gender. Conclusions: The identified demographic differences between individuals choosing to restore their newly root-filled teeth with an indirect restoration compared to those receiving other restorations may indicate that the tax-funded Swedish dental insurance fails to provide dental care on equal terms for Swedish citizens.
42.	Olsson, Sara R, et al. (författare) Interventions in root‐filled teeth identified in general dental practice : A 6‐year longitudinal observational study 2024 Ingår i: International Endodontic Journal. - 0143-2885 .- 1365-2591. Tidskriftsartikel (refereegranskat)abstract Aim: To investigate what happens to cross- sectionally identified root- filled teeth over a 6- year period, regardless of the time that elapsed since primary root canal treatment, in a cohort of adult patients regularly attending a Public Dental Service. A secondary aim was to investigate how the cumulative events affecting root- filled teeth over the same time were associated with variables obtained from a baseline examination.Methodology: Adult patients with ≥1 previously root- filled tooth and regularly at-tending the Public Dental Service in Örebro County were enrolled for study partici-pation in 2015. General dental practitioners examined all identified root- filled teeth in this cohort at baseline using a standardized protocol and were also responsible for further decision- making and treatments. After six years, information on events of the root- filled teeth was collected from dental records. The highest rating (most invasive treatment) on a 5- point ordinal scale was used in the analyses. Regression analyses with stepwise selection were performed for associations between patient- and tooth- related factors and events.Results: A total of 445 patients with 1007 root- filled teeth were followed the entire observation time. Twenty (2.0%) of the root- filled teeth had endodontic retreatment and 150 (14.9%) were extracted over six years. Among teeth with periapical radio-lucency or pain, the majority did not undergo retreatment or extraction; however, the multivariate analysis demonstrated that retreatment or extraction was associated with baseline recordings of teeth with periapical radiolucency (p< .0001), tenderness to percussion (p< .0001), and poor coronal restoration (p< .0001).Conclusions: This study corroborates the notion that in general dentistry, root- filled teeth with radiological signs of apical disease often remain untreated over time. Furthermore, it also reveals that root- filled teeth presenting with mild pain do not necessarily receive any intervention. However, teeth with baseline signs of apical periodontitis, pain, or inadequate coronal restoration were more likely to have re-ceived intervention during the six- year period.
43.	Pigg, Maria, et al. (författare) 7-year follow-up of patients with persistent idiopathic dentoalveolar pain : preliminary results 2010 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: Persistent idiopathic facial pain (intraoral dentoalveolar subset), earlier described as atypical odontalgia (AO), is a chronic continuous dentoalveolar pain (CCDAP) condition commonly suggested to involve neuropathic pain mechanisms. The longterm prognosis of neuropathic pain conditions is generally not favorable, but has been insufficiently studied in intraoral pain patients. Aim: The aim of this prospective study was to examine the long-term prognosis of CCDAP (AO). Methods: We have earlier described the characteristics of 46 consecutive patients diagnosed with AO (List et al. 2007). Follow-up data on 27 of these patients have so far been collected and are included in this report. In 2002 and 2009, the patients completed validated questionnaires and instruments including pain and disability characteristics (pain frequency, characteristic pain intensity (CPI), average pain intensity (0-10 numerical rating scale, NRS) and graded chronic pain severity (GCPS)); psychological status (SCL-90 according to the RDC/TMD: depression and non-specific physical symptoms scores); ongoing treatment and a global improvement rating. Baseline and follow-up data were compared using paired samples t-test at 5 % significance level. Results: 23 women and 4 men were included (mean age 64, range 38-80 years). Pain frequency: 67% reported continuous pain at baseline and 33% at follow-up (p = .03). Occasional pain was reported by 0% at baseline compared to 19% at follow-up (p = .02). CPI scores (mean ± SD) decreased from baseline (59 ± 18) to follow-up (40 ± 25; p = .001). Also, average pain intensity decreased from baseline (5.6 ± 2.0) to follow-up (3.6 ± 2.5; p=.001). A >30 % pain reduction was seen for 24 % of the patients, 1-30 % pain reduction for 40 %, unchanged pain for 24 %, and 12 % reported increased pain. GCPS: Fewer patients scored Grade III-IV at follow-up (7.4 %) than at baseline (29.6 %; p=0.031). Grade 0 was 0% at baseline and 11.1 % at follow-up (p = .083). SCL-90 scores reported by the AO patients for depression at follow-up was: 39% severe, 26% moderate and 42% normal, and for non-specific physical symptoms 62% severe, 11% moderate and 27% normal with no significant differences between baseline and follow-up (p > .5). Global improvement: 54% rated their overall pain status as improved, 42% as unchanged and 4% as worse. Ongoing treatment was use of occlusal splints (41%); analgesics, tranquilizers and sedatives (all 22%); antidepressants (15%); physiotherapy (11%); and gabapentin or pregabalin (both 7%). Conclusions: The preliminary data suggest that a majority of CCDAP (AO) patients improve over time and experience pain reduction of some degree. Psychological status does not change accordingly, and a number of patients report unchanged or even increased pain. The objective of future analysis of this material will be to identify positive and negative predictors for persistent pain.
44.	Pigg, Maria, et al. (författare) A 7-year follow-up of patients with atypical odontalgia (AO) 2011 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background and Aim: Atypical odontalgia (AO) is a severe chronic dentoalveolar pain condition with a prevalence of about 3% after endodontic treatment. The etiology is suggested to involve neuropathic pain mechanisms, possibly deafferentation of primary sensory neurons in dental pulp. Prior to correct diagnosis, patients with AO frequently undergo multiple and repeated endodontic treatments because of unresolved pain. The aim of this prospective study was to examine the long-term prognosis of AO. Methods: The study included 43 patients diagnosed with AO. Baseline (2002) and follow-up (2009) data were collected by means of validated questionnaires and instruments including pain frequency, characteristic pain intensity (CPI 0—100 score), average pain intensity (0—100 numerical rating scale), graded chronic pain severity (GCPS), psychological status (depression and non-specific physical symptoms scores of the SCL-90R according to the RDC/TMD) and a global improvement rating (PGIC). Baseline and follow-up data were compared using paired samples t-test at 5% significance level. Results: 37 patients (86%) responded; 31 women and 6 men (mean age 63, range 38—81 years). 62% reported continuous pain at baseline and 27% at follow-up (p=.001); 0% at baseline and 16% at follow-up had occasional pain (p=.012). CPI scores decreased from baseline 61±19 to follow-up 39±25 (p<.001). Average pain also decreased, from 5.7±2.0 to 3.5±2.4 (p<.001). 11% had GCPS scores indicating high disability at follow-up compared to 32% at baseline (p=.003). 14% at follow-up and 0% at baseline reported no disability (p=.023). SCL-90R depression scores and non-specific physical symptoms scores showed no significant differences between baseline and follow-up, but remained high. 54% of the patients rated their global status as improved, 41% as unchanged and 5% as worse at follow-up. Conclusion: We conclude that a majority of AO patients experience pain reduction of some degree over time. Psychological status does not change accordingly.
45.	Pigg, Maria, et al. (författare) A comparative analysis of magnetic resonance imaging and radiographic examinations of patients with atypical odontalgia 2014 Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:3, s. 233-242 Tidskriftsartikel (refereegranskat)abstract AIMS: To examine (1) the occurrence of magnetic resonance imaging (MRI) signal changes in the painful regions of patients with atypical odontalgia (AO) and (2) the correlation of such findings to periapical bone defects detected with a comprehensive radiographic examination including cone beam computed tomography (CBCT). METHODS: A total of 20 patients (mean age 52 years, range 34 to 65) diagnosed with AO participated. Mean pain intensity (± standard deviation) was 5.6 ± 1.8 on a 0-10 numerical rating scale, and mean pain duration was 4.3 ± 5.2 years. The inclusion criterion was chronic pain (> 6 months) located in a region with no clear pathologic cause identified clinically or in periapical radiographs. In addition to a clinical examination and a self-report questionnaire, the assessments included radiographic examinations (panoramic, periapical, and CBCT images), and an MRI examination. Changes in MRI signal in the painful region were recorded. Spearman's rank correlation between radiographic and MRI findings was calculated. RESULTS: Eight of the patients (40%) had MRI signal changes in the pain region. The correlation to radiographic periapical radiolucencies was 0.526 (P = .003). Of the eight teeth displaying changes in MRI signal, six showed periapical radiolucency in the radiographs. CONCLUSION: MRI examination revealed no changes in the painful region in a majority of patients with AO, suggesting that inflammation was not present. MRI findings were significantly correlated to radiographic findings
46.	Pigg, Maria, et al. (författare) A comparative analysis of MRI, CBCT and conventional radiography in patients with atypical odontalgia and symptomatic apical periodontitis : preliminary results 2006 Ingår i: Swedish Dental Journal. - 0347-9994. ; 30:4, s. 173-174 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Aim: Atypical odontalgia(AO) is a chronic pain condition located in the teeth and jaws. It has been suggested, that AO is best regarded as a neuropathic pain condition, but knowledge regarding the etiology, diagnostics, and management of AO is not yet satisfactory. This pilot study evaluates the clinical usefulness of more recently developed imaging methods for intraoral pain conditions. The aim is to compare the diagnostic findings using magnetic resonance imaging(MRI) and cone beam computed tomography(CBCT) with the findings from conventional radiography in patients with atypical odontalgia(AO) and symptomatic apical periodontitis(SAP). Material and methods: 12 patients (9 F, 3 M) mean age 50,25 years, range 36 - 63 years participated in the study. The patients were referred to the Orofacial Pain Unit or the Department of Endodontics, Faculty of Odontology, Malmö University. Inclusion criteria for AO were chronic pain (>6 months) located in a region where a tooth had been endodontically or surgically treated, pain with no pathological cause detectable in clinical or radiological examinations. For SAP, the inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in a clinical and radiographic examination. Ten of the patients in the study were diagnosed with AO and two with SAP. The patients were clinically assessed with a qualitative somatosensory examination, a dental examination, an examination of the masticatory system(RDC/TMD), and panoramic and intraoral radiographs. A questionnaire was used to gather information about pain characteristics, psychosocial status(SCL-90), and quality of life. Besides these measures, each patient underwent a CBCT(3D-Accuitomo, J Morita Co) examination and a MRI(Siemens Sonata Vision 1.5 T) examination with and without contrast enhancement. Contrast was enhanced by injections of Magnevist (469 mg/ml, Schering Nordiska). Bone destruction, sclerosis, and signs of inflammation were the main parameters studied. Results: In the preliminary results, average pain intensity was 6.3 on a numerical rating scale(NRS) and average pain duration was 3,6 years. 83% exhibited somatosensory abnormalities. Bone destruction not visible in the intraoral and panoramic radiographs was detected with CBCT in 40% (4/10) of the patients diagnosed with AO, and signs of inflammation were detected in the MRIs of 20% (2/10) of the patients diagnosed with AO. Conclusion: Preliminary findings indicate that CBCT and MRI can provide additional information to conventional radiography in the diagnosis of intraoral orofacial pain. Further studies with larger sample sizes of AO and SAP patients are necessary to determine the clinical relevance of these findings.
47.	Pigg, Maria, et al. (författare) A comparative analysis of MRI, CBCT and conventional radiography in patients with intraoral pain 2007 Konferensbidrag (populärvet., debatt m.m.)
48.	Pigg, Maria, et al. (författare) CBCT provides additional diagnostic information in patients with atypical odontalgia 2011 Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 90:Special Issue A Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
49.	Pigg, Maria (författare) Chronic intraoral pain - assessment of diagnostic methods and prognosis 2011 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall goal of this thesis was to broaden our knowledge of chronic intraoral pain. The research questions were:•What methods can be used to differentiate inflammatory, odontogenic tooth pain from pain that presents as toothache but is non-odontogenic in origin?•What is the prognosis of chronic tooth pain of non-odontogenic origin, and which factors affect the prognosis?Atypical odontalgia (AO) is a relatively rare but severe and chronic pain condition affecting the dentoalveolar region. Recent research indicates that the origin is peripheral nerve damage: neuropathic pain. The condition presents as tooth pain and is challenging to dentists because it is difficult to distinguish from ordinary toothache due to inflammation or infection. AO is of interest to the pain community because it shares many characteristics with other chronic pain conditions, and pain perpetuation mechanisms are likely to be similar. An AO diagnosis is made after a comprehensive examination and assessment of patients’ self-reported characteristics: the pain history. Traditional dental diagnostic methods do not appear to suffice, since many patients report repeated care-seeking and numerous treatment efforts with little or no pain relief. Developing methods that are useful in the clinical setting is a prerequisite for a correct diagnosis and adequate treatment decisions.Quantitative sensory testing (QST) is used to assess sensory function on skin when nerve damage or disease is suspected. A variety of stimuli has been used to examine the percep¬tion of, for example, touch, temperature (painful and non-painful), vibration, pinprick pain, and pressure pain. To detect sensory abnormalities and nerve damage in the oral cavity, the same methods may be possible to use.Study I examined properties of thermal thresholds in and around the mouth in 30 pain-free subjects: the influence of measurement location and stimulation area size on threshold levels, and time variability of thresholds. Thresholds for cold, warmth and painful heat were measured in four intraoral and two extraoral sites. Measurements were repeated 3 times over 6 weeks, using four sizes of stimulation area (0.125–0.81 cm2). The threshold levels were highly dependent on location but less dependent on measuring probe size and time variability was small, and this knowledge is important for the interpretation of QST results.Study II applied a recently developed standardized QST examination protocol (intended for use on skin) inside the oral cavity. Two trained examiners evaluated 21 pain-free subjects on three occasions over 1–3 weeks, at four sites—three intraoral and one extraoral. Most tests had acceptable reliability and the original test instruments and techniques could be applied intraorally with only minor adjustments. Study III examined the value of cone-beam computed tomography (CBCT) in pain investigations. Twenty patients with AO and 5 with symptomatic apical periodontitis (inflammatory tooth pain) participated. The results indicate that when AO is suspected, addition of CBCT can improve the diagnostic certainty compared to sole use of periapical and panoramic radiographs, especially because of the superior ability of CBCT to exclude inflammation as the pain cause.Study IV assessed the long-term prognosis of AO, and analyzed potential outcome predictors.. A comprehensive questionnaire including validated and reliable instruments was used to gather data on patient and pain charac¬teristics and pain consequences from 37 patients in 2002 and 2009. Thirty-five percent of the patients reported substantial overall improvement at follow-up, but almost all still had pain of some degree after many years. The initial high level of emotional distress was unchanged. Low baseline pain intensity predicted improvement over time.
50.	Pigg, Maria, et al. (författare) Clinical diagnosis of temporomandibular joint arthritis 2014 Ingår i: Journal of Dental Research. - 0022-0345 .- 1544-0591. ; 93:Special Issue B Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)

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