| 1. |
- Abrahamsson, Cecilia, et al.
(författare)
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TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment
- 2013
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier. - 0901-5027 .- 1399-0020. ; 46:6, s. 752-758
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain
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| 2. |
- Abrahamsson, Cecilia, et al.
(författare)
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TMD in consecutive patients referred for orthognathic surgery
- 2009
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Ingår i: Angle orthodontist. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 33:4, s. 201-226
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group. MATERIALS AND METHODS: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general. CONCLUSIONS: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.
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| 3. |
- Al-Bishri, Awwad, et al.
(författare)
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Effect of betamethasone on the degree of macrophage recruitment and nerve growth factor receptor p75 immunoreaction during recovery of the sciatic nerve after injury : an experimental study in rats.
- 2008
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Ingår i: British Journal of Oral & Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 46:6, s. 455-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study was designed to explain our previous findings of beneficial effects of betamethasone given perioperatively on decreasing the incidence of neurosensory disturbance after sagittal split osteotomy and improving functional recovery after crush injury to rat sciatic nerves. We analysed the pattern of macrophage recruitment and expression of nerve growth factor p75. MATERIAL AND METHODS: The sciatic nerve was crushed in each of 42 animals by tying the nerve against a glass rod for 30s. Half the rats were given betamethasone and half were not. The effect of betamethasone was evaluated immunohistochemically in a double blind manner after 2, 7 and 17 days using antibodies against macrophage marker (ED1) and p75. RESULTS: We found an initial and significant decrease in the number of macrophages recruited after two days in the group treated with betamethasone compared with controls (p=0.001). By 7 days there were significantly more macrophages in the steroid group than in the control group (p=0.001). There was however, a tendency for the number of p75R to be higher in the in the steroid group but the difference was not significant. At 17 days, there were significantly fewer macrophages in the steroid group (p=0.008) than in the control. CONCLUSION: We conclude that the beneficial effect of a moderate perioperative dose of betamethasone on recovery of a nerve is reflected in the recruitment of macrophages but to only a small extent in expression of p75.
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| 4. |
- Al-Bishri, Awwad, et al.
(författare)
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Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy : as reported in questionnaires and patients' records
- 2005
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 34:3, s. 247-251
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This retrospective study aimed at evaluating the long-term incidence of neurosensory disturbance (NSD) after sagittal split osteotomy (SSO) and intraoral vertical ramus osteotomy (IVRO). Furthermore, a comparison was made between the results obtained by questionnaires and information in the patient records in the evaluation of nerve function. Finally, the degree of discomfort caused by the NSD was evaluated. One hundred and twentynine patients, who underwent IVRO (79 patients) and SSO (50 patients), were included. Questionnaires were mailed to the patients at least one year after the operation. The records of all patients, who returned the questionnaires, were reviewed. The results of NSD obtained by questionnaires and records differed indicating a disagreement between the judgement of the surgeon and the patient's opinion. Long lasting NSD was underestimated by the surgeon as compared to the patient's subjective symptom. Long lasting NSD was reported in 7.5% (questionnaire), 3.8% (record) after IVRO and in 11.6% (questionnaire) and 8.1% (record) after SSO.
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| 5. |
- Al-Bishri, Awwad, et al.
(författare)
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On neurosensory disturbance after sagittal split osteotomy
- 2004
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Ingår i: Journal of oral and maxillofacial surgery (Print). - : Elsevier BV. - 0278-2391 .- 1531-5053. ; 62:12, s. 1472-1476
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this retrospective study was to assess the incidence of the neurosensory disturbance (NSD) after sagittal split osteotomy and evaluate NSD in relation to patient age, gender, satisfaction, and effect of steroids. PATIENTS AND METHODS: Questionnaires were mailed to all patients (31 women, 19 men) who underwent bilateral sagittal split osteotomy between 1995 and 1999, at least 1 year after the operation. Patients were queried about perceived NSD in the distribution of both inferior alveolar and lingual nerves, duration of these changes, and any influence of these changes on their quality of life. RESULTS: Eightysix percent of the mailed questionnaires were returned and analyzed (27 women, 16 men). Eight patients with 10 affected sides (11.6% of sides) reported long lasting NSD correspond-ing to the distribution of the inferior alveolar nerve. NSD was re-ported in 16.7% of the operated sides in women, while 3% of the operated sides in the men had such changes. Fifty percent of the operated sides in patients over 40 years of age were affected. Steroid treatment seemed to decrease NSD. Four patients (9%) were not satisfied, but only 1 attributed the dissatisfaction to sensory impairment. CONCLUSION: The incidence of NSD after sagittal split osteotomy in-creases in patients over the age of 40. Steroid regimen might be beneficial in reducing NSD after sagittal split osteotomy, although further investigation is required. The discomfort of the nerve damage seems outweighed by the result of function and esthetics.
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| 6. |
- Hallmer, Fredrik, et al.
(författare)
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Jaw fractures diagnosed and treated at Malmö University Hospital : a comparison of three decades
- 2010
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 39:5, s. 446-451
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to report the distribution, frequency and aetiology of jaw fractures in patients treated at the University Hospital, Malmö, 1993-2003 and to compare two previous studies from 1952-1962 and 1975-1985. In 1993-2003, 461 patients, 137 women (mean age 42 years; range 15-82) and 324 men (mean age 28 years; range 17-59) were diagnosed and treated. Women were significantly older than men (P<0.001). The most frequent cause of jaw fractures was falls in women (45%). In men, interpersonal violence (46%) was most common followed by road traffic accidents (RTAs) (24%) mostly involving bicycles (14%). The frequency of falls in women and men was significantly different (P<0.001) as was the difference between violence in men and women (P<0.001). The proportion of fractures caused by RTAs was significantly higher in 1952-1962 than in 1993-2003 (P<0.001). There was a significant increase in the proportion of fractures caused by violence between the two studies (P=0.007). In 1993-2003 the proportion of fractures in women due to falls was significantly higher than in 1952-1962 (P=0.006). Violence has replaced RTAs as the main cause for jaw fractures in men; for women falling is the commonest cause.
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| 7. |
- Larsson, Christel, et al.
(författare)
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All-ceramic two- to five-unit implant-supported reconstructions. A randomized, prospective clinical trial
- 2006
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 30:2, s. 45-53
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Tidskriftsartikel (refereegranskat)abstract
- Syftet med denna studie var att kliniskt utvärdera helkeramiska två- till femleds rekonstruktioner på implantat, samt att jämföra två olika keramiska system, Denzir® (DZ) och In-Ceram Zirconia® (InZ). Arton patienter behandlades med totalt 25 två- till femleds rekonstruktioner på implantat. Nio patienter fick rekonstruktioner utförda i DZ och nio patienter fick rekonstruktioner utförda i InZ. Rekonstruktionerna cementerades med zinkfosfatcement på preparerbara titandistanser. Rekonstruktionerna utvärderades efter 6- och 12 månader. Vid uppföljning efter 12 månader var alla 25 rekonstruktioner i funktion, inga hade frakturerat. Ytliga kohesiva, sk. chip-off, frakturer noterades däremot hos 6 av 18 patienter (8 av 25 rekonstruktioner). Nio led i DZ-gruppen (7 av 13 rekonstruktioner) och ett led i InZ-gruppen (1 av 12 rekonstruktioner) uppvisade chip-off frakturer. Skillnaden mellan de båda grupperna var statisktiskt signifikant (p< 0.01). Kantanslutningen bedömdes som utmärkt vid 34 stöd (56%) och acceptabel vid 27 stöd (44%). Resultat från denna 12 månaders uppföljning indikerar att helkeramiska två- till femleds rekonstruktioner på implantat kan övervägas som behandlingsalternativ. Vid jämförelse mellan de båda keramiska systemen är slutsatsen att DZ-systemet uppvisar oacceptabelt många frakturer i ytporslinet och därför inte kan rekommenderas för den typ av behandling som utvärderats här. Fortsatta studier och långtidsuppföljningar är nödvändiga innan ovan nämda material och teknik kan rekommenderas för allmänt bruk.
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| 8. |
- Nyberg, Jan, 1960-
(författare)
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On implant integration in irradiated bone : clinical and experimental studies
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Radiation has an impact on the processes involved in bone- healing, regeneration and remodeling. The mechanisms that cause impaired bone healing of dental implants are not fully understood. Adjunctive treatments to revers radiation effects are limited. Dental implant surgery can be a risk in irradiated jaws and the risk for osteoradionecrosis is of concern. There is no consensus when to install implant after completed radiation therapy or what radiation dosage might cause impaired bone healing. The overall aim of the studies was to investigate bone tissue reactions adjacent to implants after irradiation.I. A clinically long-term follow-up study was performed to assess the outcome of 18 dental implants inserted in five patients with and without irradiated fibula-reconstructed mandibles. Bone tissue reactions adjacent to 14 micro-implants were histologically evaluated. In the clinical follow-up, 15 implants were in function, with an overall success rate of 83%. The histomorphometric analyses demonstrated an impaired osseointegration with reduced bone-to-implant contact (BIC) and bone area (BA), in irradiated sides.II. In an experimental animal study the aim was to find a critical level for a given single external radiation dosages causing impaired implant osseointegration. 9 rats received a single radiation dose of 2, 5, 10, 20 and 30 Gy, respectively to one hind-leg while the other served as a control. Three days post radiation two implants were inserted in each hind-leg and after a period of 5 weeks the implants (n=36) were harvested for histological examination. BIC and BA were lower for irradiated samples for dosages of 20 Gy and higher.III. The aim was to investigate the effects of HBO on osseointegration of titanium implants in irradiated bone. 15 rats received an external single radiation dose of 20 Gy to one hind-leg. 3-days post-irradiation 2 implants were inserted in each hind-leg (n=60). The rats were divided in to 2 groups and one group received hyperbaric oxygen treatment (HBOT) 3 days post-implant insertion (n=8). After 5 weeks the distal implants were harvested for histological examination (n=30) and the proximal implants were used for removal torque tests (n=30). BIC obtained significant higher values for non-irradiated side, independent of HBO or not. BA obtained significant higher values for irradiated sides in the non-HBO group.IV. The aim was to investigate gene expression in irradiate bone after implant insertion for bone formation, resorption and remodelling. 8 rats, received a single radiation dose of 20 Gy to one hind-leg and two implants inserted in each hind-leg 8 weeks after completed radiation therapy. After 5 weeks bone samples with implants were collected for gene expression analysis. ALP, OC (formation) and RANKL/OPG (remodelling) were down regulated in irradiated samples.Conclusion: Bone-anchored dental bridges can be used in selected oro-mandibular reconstructed patients. Bone quality disturbances with impaired osseointegration for dosages of 20 Gy and more were demonstrated in an animal study model. HBO did not enhance osseointegration of implants placed in rat bone during a five-week follow-up period. Irradiation significant reduces bone formation and remodeling under influence of pro-inflammatory and growth factor cytokines
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| 9. |
- Sjöström, Mats, et al.
(författare)
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Starting a Swedish national quality registry for orthognathic surgery: a tool for auditing fundamentals of care
- 2022
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: National quality registries (NQRs) provide open data for user-directed acquisition. National Quality Registry (NQR) data are often used to analyze the rates of treatment success and adverse events for studies that aim to improve treatment quality and patient satisfaction. Thus, NQRs promote the goal of achieving evidence-based therapies. However, the scientific literature seldom focuses on the complex process of initiating, designing, and implementing an NQR. Starting an NQR may be particularly challenging in a setting where specialized care is decentralized, such as orthognathic surgery in Sweden. The present study describes the initiation and early phases of a new NQR for orthognathic surgery in Sweden. Methods: The initial inventory phase included gaining knowledge on regulations, creating economic plans, and identifying pitfalls in existing NQRs. Next, a crude framework for the registry was achieved. Outcome measures were selected with a nation-wide questionnaire, followed by a Delphi-like process for selecting parameters to include in the NQR. Our inclusive process comprised a stepwise introduction, feedback-based modifications, and preparatory educational efforts. Descriptive data were collected, based on the first 2 years (2018–2019) of registry operation. Results: Two years after implementation, 862 patients that underwent 1320 procedures were registered. This number corresponded to a 91% coverage rate. Bimaxillary treatments predominated, and the most common were a Le Fort I osteotomy combined with a bilateral sagittal split osteotomy (n = 275). Reoperations were conducted in 32 patients (3.6%), and the rate of patient satisfaction was 95%. Conclusions: A National Quality Registry should preferentially be started and maintained by an appointed task force of active clinicians. A collaborative, transparent, inclusive process may be an important factor for achieving credibility and high coverage, particularly in a decentralized setting.
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| 10. |
- Åstrand, Per, et al.
(författare)
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Tapered implants in jaws with soft bone quality : a clinical and radiographic 1-year study of the Brånemark System Mark IV fixture.
- 2003
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Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 5:4, s. 213-218
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The survival rate of oral implants in soft-quality bone has been demonstrated to be inferior to that of implants inserted in good-quality bone. A possible way to increase the survival rate in soft-quality bone may be to use a tapered implant. Such an implant has been developed and manufactured by Nobel Biocare AB, Gothenburg, Sweden. So far, there have been only a few publications regarding this implant. PURPOSE: The aim of the study was to compare the outcome of using the tapered Brånemark System Mark IV fixture with the outcome of using earlier Brånemark fixtures in a controlled prospective study. MATERIALS AND METHODS: The study was performed as a multicenter study including seven specialist centers. The material consisted of 40 patients in need of implant-supported bridges in the maxilla. Twenty-five patients belonged to the test group, in which the tapered Mark IV implants were inserted, and 15 patients belonged to the control group, in which Brånemark Standard or Mark II implants were used. The patients were allocated to the test group or the control group according to randomization schedules. The implants were inserted according to the guidelines for Brånemark implants. A two-stage surgical protocol was used, and abutment connection was made 6 months after fixture insertion. The test group comprised 97 Mark IV implants, and the control group made up 92 implants. The prosthetic procedure followed the guidelines for Brånemark implants, and all patients were provided with full fixed maxillary bridges. The patients were followed up with clinical and radiographic records for 1 year after loading. RESULTS: The survival rate was 96.9% for the Mark IV implants and 98.9% for the control implants. There was no significant difference between the two groups. There was a mean marginal bone loss of 0.2 mm during the observation period, and there was no difference between test implants and control implants. CONCLUSIONS: With regard to survival rate and marginal bone level changes, no differences could be demonstrated between the Mark IV tapered implant and the Brånemark implants used earlier. However, compared with earlier results of Brånemark implants in soft-quality bone, the Mark IV implant demonstrated an improved survival rate.
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| 11. |
- Österberg, Marie, et al.
(författare)
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Knowledge Gaps in Oral and Maxillofacial Surgery : a Systematic Mapping
- 2017
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Ingår i: International Journal of Technology Assessment in Health Care. - : Cambridge University Press. - 0266-4623 .- 1471-6348. ; 33:1, s. 93-102
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Forskningsöversikt (refereegranskat)abstract
- Objectives: The aim of this study was to evaluate available knowledge and identify knowledge gaps within the field of oral and maxillofacial surgery, by systematically collecting and evaluating systematic reviews. Twelve specific domains were selected: surgical removal of teeth, antibiotic and corticosteroid prophylaxis, orofacial infections, dental and facial trauma, orthognathic surgery, reconstructive surgery, benign tumors, cysts, premalignant lesions, oral complications of treatment of malignant tumors, hyperbaric oxygen therapy, temporomandibular joint surgery, cost effectiveness of different surgical treatments, and ethics. Methods: The literature search, covering four databases, was conducted during September 2014: PubMed, The Cochrane library, Centre for Reviews and Dissemination and EBSCO dentistry and oral science source. Retrieved systematic reviews were quality assessed by AMSTAR. Results: In all, 1,778 abstracts were identified, of which 200 met the inclusion criteria. Forty-five systematic reviews were assessed as of high to moderate quality. The results disclosed some existing evidence in a few domains, such as surgical removal of teeth and implant survival after sinus lifts. However, in all domains, the search revealed a large number of knowledge gaps. Also of concern was the lack of data regarding health economics and ethics. Conclusions: In conclusion, there is a need for well-conducted clinical research in the fields of oral and maxillofacial surgery.
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